My career in dentistry began the summer before I moved away to college. I worked hourly as a dental assistant to pay for part of my college expenses and to gain knowledge and experience in the field of dentistry. I didn’t have to think about negotiating contracts, noncompete clauses, production versus collection compensation rates, and 401(k)s. I was just hoping to get a job!
Fast-forward 10 years, and I’ve swapped my assistant chair for the doctor’s chair, and there were many things I had to consider when I interviewed for my ideal first associate position. Here are some of the important questions you should be asking when you go in search of an office that matches your career goals and values.
How are patients and treatments assigned?
This may be different depending on the type of practice: small solo-doctor practice or large group practice. Things to inquire about are whether you’re responsible for recruiting your own new patients, whether you will see your patients for all visits including periodic exams or are reponsible for restorative treatment only, how existing treatment plans will be handled while transitioning to a new doctor, and how to conduct appointments with recall patients or patients who are in for restorative treatment only. There are many possible scenarios, so it’s important to iron out these details early in a relationship.
How are after-hours emergencies handled?
Let’s say it’s a Saturday afternoon and you’re enjoying a picnic in the park, and your phone rings. The call is from a patient who just fell off of a waterslide and avulsed one of his central incisors. What do you do? And no, I’m not asking about treatment recommendations. I’m asking who confirms the patient, whether it’s a patient of record or a person who just found you online from one of your fabulous five-star reviews? Is there an assistant who can go into the office with you? Identifying weekends for group practice doctors to rotate the call schedule may need to be a consideration.
How am I going to get paid?
This is an important one. The most popular terms used are daily rate, percentage of production, percentage of collections, and bonus. From my experience, the most popular compensation formulas are a guaranteed daily rate or a percentage of collections, whichever is higher. The percentage of collections for an associate can usually be around 30%–35%, but it depends on the type of practice, location, specialty, and more. I would recommend researching the averages in your area.
It is also important to ask about the office’s collection rate, with the ideal rate being 100%. Your focus is to take care of patients, not collect payments. Bonus structures can come in all shapes and sizes. I would make sure you understand the system and believe it’s an achievable goal. Fellow associates in the practice can be good resources for these types of conversations.
Who chooses the lab, suppliers, and materials?
There are many different brands and suppliers for the many dental materials, instruments, and other items that are used in daily practice, and not all dentists are created equal in this area. While we were all trained at different institutions that used different materials, the methods we learned are not necessarily right or wrong. Only we know what works best in our hands. Keep in mind, trying new materials and learning from others’ experiences might help you grow in your practice.
Here are some of the things you want to ask about materials and labs: Do you have the freedom to order the materials you need? Are you able to send your work to a laboratory of your choice? Who is responsible for the laboratory costs?
Am I subject to a noncompete or nonsolicitation agreement?
A noncompete agreement (or restrictive covenant) means that you agree to not work in another office for a certain number of years within a certain mile radius from the practice after the employment is terminated. Nonsolicitation refers to solicitation of employees from the practice. Essentially, the owner doesn’t want you to leave his or her office and open an office across the street and take the practice’s patients or employees with you.
There is no set radius or time frame, since rural Texas is not going to be the same as downtown Manhattan. In my experience, the average time frame was two years. Urban dental practices may have an average of a few blocks to a few miles, while rural practices could have a radius of 10 or more miles. Your attorney or dental practice consultant are good resources for the norms in your area.
You should also ask about not having a restrictive covenant for the first few months while you and the owner are testing the waters. You don’t want to isolate yourself from an entire area if a job doesn’t quite work out as you had planned.
The goal of the interview
Think of the associate interview as a two-way street. The dentist-owner is not just interviewing you; you are also interviewing the dentist-owner. Arrive prepared with the questions you want to have answered. It’s better to figure out all of the details in advance than to have to return and ask, “Hey, Thanksgiving is coming up. Is that a paid or nonpaid vacation day? I don’t see it in my contract.”
Finally, it’s always a good idea to have a second set of eyes review your contract after you have read it closely. I encourage you to hire an attorney familiar with dental contracts to review it and provide suggestions. This person will understand the nitty gritty legal jargon that should be included and will know how to guide you.
Adrien l. Theriot, DDS, MSD, is a pediatric dentist in Houston, Texas. She received her doctor of dental surgery, master’s, and certificate in pediatric dentistry from the University of Texas Health Science Center at Houston School of Dentistry. Contact Dr. Theriot at [email protected].