Transitions roundtable

June 1, 2011
We ask two experts the same question to give you two different answers on a complex issue.

Question: How do I know if I am ready for an associate?

By Tom Snyder, DMD, MBA

There are several key tell-tale signs that are quite predictive of your need for an associate. Here are five indicators:

1. You are scheduled a solid six to eight weeks in advance. — Our rule of thumb is that if you have 90% of your schedule filled six to eight weeks in advance on a consistent basis, you are showing one of the cardinal signs of saturation.

2. Hygienists are booked out three to six months in advance. — This is particularly true in practices that pre-appoint patients, as scheduling flexibility becomes very difficult when you have an abundance of patients eligible for a recare appointment with not enough hygiene days available to meet that demand.

3. New patient hygiene appointment is difficult to schedule. — With the high demand for recare appointments, chances are you may sacrifice “designated” slots that are to remain open for new patient hygiene appointments. In order to satisfy patents who want to schedule their recare appointment, those “designated” slots get filled, thus new patients’ hygiene appointments cannot be scheduled in a timely manner

4. Clinical production and patient revenue is stagnant. — It is difficult to effectively increase production in a saturated practice. Oftentimes to meet increasing patient demand, many “saturated” doctors begin to schedule shorter appointment times or less clinical procedures per hour in order to accommodate patients who need to be seen. Saturation not only adds stress but can also reduce productive days. If you review the last few years’ revenue, saturated practices show no growth at all except for an annual fee increase.

5. Increase in number of “patient of record emergencies.” — Saturated practices are characterized by an increasing number of “emergencies.” These patients are not “off-the-street” emergencies, rather patients who have missed a few recare appointment intervals. So a clinical issue that may have been addressed during a recare appointment now becomes a patient “emergency.”

So, if you meet the criteria for several of these indicators, chances are you are ready for an associate.

Tom Snyder, DMD, MBA, is the director of transition services for The Snyder Group, a division of Henry Schein. He can be reached at (800) 988-5674 or [email protected].

By Lynne Nelson

From a business approach, you will need to be collecting more than $800,000 and have a full and healthy hygiene department that produces at least 30% of your overall production. Other business markers that indicate you need an associate could be if you are unable to see a new patient for three weeks, or you can no longer accept new patients because you can’t provide care to anymore patients. However there is so much more to consider.

Allow me to put my consulting hat on for a moment and tell you that some practitioners are in the situation described and are never ready for an associate dentist, and that is OK too. It’s like inviting another cook into your kitchen and wanting him or her to use all of your recipes, but the person has his or her own new and improved cookbook. It can be stressful for some doctors to have a dentist/employee.

This is why you need to examine your own proclivities before you make an action plan of this nature. You need to develop a strategy well in advance of how you want it to look after an associate joins the practice. Your ideas may or may not be feasible for some associates. Some associates are just getting started in dentistry and may not know all that they need to for your comfort level. Are you ready to be a mentor?

On the other hand, they may have enough experience and confidence to make you very comfortable, but understand that unless they want to be an employee for the remainder of their career they will soon tire of employment and you may experience some turnover.

If you can see yourself retiring in the next five years, an associate may be a great way to have a built-in buyer, but I would not make promises if you don’t know you can keep them. Having an associate is not for everyone, but can be rewarding if you have the personality and determination for it.

Lynne Nelson is senior broker at Consani Seims, Ltd. and ADS Northwest, and cofounder of Practice Management Associates, LLC. For more information, contact her at (866) 348-3849 or [email protected].

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