Out with the old and in with the new!

Aug. 26, 2015
Bringing on a new associate is often one of the most difficult decisions we as dentists encounter in our careers. We all too often forget the pressure, insecurity, and vulnerability we felt when we graduated from dental school and signed on for our first real job as a dentist.

Brad Guyton, DDS, MBA, MPH, and Alex Sharifian, DDS

Bringing on a new associate is often one of the most difficult decisions we as dentists encounter in our careers. We all too often forget the pressure, insecurity, and vulnerability we felt when we graduated from dental school and signed on for our first real job as a dentist. This article will focus on the three areas of alignment needed to successfully integrate another dentist into our dental practices and the tools that will help drive these results.

Result Consider creating a tool

Alignment of core values

Clinical culture worksheet

Alignment of expectations

Owner/associate expectation worksheet

Alignment of clinical outcomes

Clinical guidelines document

Alignment of core values: Identification of your clinical culture

The first step in welcoming a new associate to a practice is to ensure that he or she understands and is willing to embrace the culture you have created for the practice. This is a great opportunity to identify your leadership style and how you will approach coaching associates. When communicating your clinical culture to your new associate, you may also identify behaviors that will help the associate integrate into the culture and feel part of the team. Make certain to document the core values and desired behaviors in the practice; this can ensure clarity and priority.

Alignment of expectations: Creating a predictable path for associate success

Communicating your expectations to a new associate on day one will help him or her ramp up to happiness and success faster. Although this is difficult for most of us, after outlining your expectations, you must then listen to the associate doctor describe his or her own expectations. Once the owner and associate listen to each other, they can work together to create a consensus document. Only when expectations are aligned can goals be set and full potential reached. The document that is created in the beginning of a relationship should be referenced during subsequent one-on-one meetings with the new associate in order to track and reward progress together.

Alignment of clinical outcomes: effectively

Communicating clinical guidelines

If you asked any group of practitioners what defines success in clinical quality outcomes, each doctor would likely have a slightly different answer. As practice owner, you must maintain the integrity of your practice by ensuring that clinical outcomes for patients are consistent with the level of care you would provide. By creating a clinical guidelines document, you will be able to share your personal definition of quality and success with associates.

Using each of the described documents together will ensure that both the owner and associate are aligned on the behaviors that will translate to the success of the practice.

Finally, roll out the red carpet

As practice owner, you interview and select a new associate because you feel he or she will add value and purpose for your practice. You must take time to carefully architect a customized career path for the new doctor to make him or her feel welcome and to provide the tools, mentorship, and coaching that will set the associate up for success. Being intentional about your associate's career will benefit your patients, your team, and the financial future of your practice.

Acknowledgment: A special thanks to our friend and colleague, Cari Callaway, DDS, for her ideas in helping us create and implement these tools.

Brad Guyton, DDS, MBA, MPH, serves as vice president of clinician development and dean of the PDS Institute for Pacific Dental Services and as associate professor at the University of Colorado School of Dental Medicine. He practices dentistry in Denver, Colorado. He can be reached at [email protected].

Alex Sharifian, DDS, was one of the first Pacific Dental Services-supported owner dentists, and is currently a multiple office owner-doctor, member of the PDS National Dental Advisory Board, and chair of Owner Doctor Development for the PDS Institute. Dr. Sharifian can be reached at [email protected].


For successful integration of a new dentist

Clinical culture worksheet

• Align core values

1. List two to three core values that you are looking for in your associate. These should be character traits that are essential to the culture of your practice. (For example, "Our practice does not make patients wait, and the doctor always meets the patient first.")

2. Describe the behaviors or actions that demonstrate these core values. What five specific things do you want your associate to do on a daily basis to assimilate into your clinical culture? (For example, "Design your first 50 crowns with the CEREC machine before handing that off to your assistant.")

3. As an owner-doctor, describe what actions you will take to integrate your associate. What are you willing to do to help the ramp-up be quick and successful? (For example, "I will coach you shoulder-to-shoulder one procedure per week for the first 90 days.")

Owner/associate expectation worksheet•

• Align expectations

Create a worksheet to document the key questions, and then fill in the expectations from the owner point of view and the associate point of view. Examples of questions may include:

• "What percentage of new patients will the associate see?"

• "How much time per month should the associate spend discussing cases with the owner doctor?"

• "What is the maximum amount of time a patient should wait in the chair without a doctor in the room?"

• "What should the associate expect his/her average daily production to be at months three, six, nine and 12?"

The worksheet should allow both you and the associate to enter a response and document a consensus after your one-on-one meeting. It may look something like this:

Key questions

Associate response

Owner response

Agreement after consultation

Determine the frequency that you should meet with your associate to discuss progress and refine your expectations.

Clinical guidelines document

• Align clinical outcomes

1. Define what you consider to be the essential components of quality and success for the dentistry in your practice. This may include patient education and communication, quality standards for each procedure, and post-op follow-up protocols.

2. Describe the behaviors that will help your associate achieve successful clinical outcomes based on your defined clinical standards. (For example, "A successful root canal in our office means obturation at the apex or .5 mm from the apex and no postoperative pain, etc.")

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