Associates: to hire and to keep

Feb. 1, 2002

by Roger P. Levin, DDS, MBA

You may think this article is only for people who are in the process of hiring associates. Well, it's not. Finding and hiring an associate is the easy part. The hard part begins when the associate comes on board. There are many factors that must be dealt with to keep a good associate: personalities, relationships with the staff, and the associate's ability to manage patients. It is crucial to prepare the practice — from a management perspective — for an associate.

Many associate relationships fail because of poor practice-management preparation. All too often, the practice is extremely busy and the easy decision is simply to hire an associate. Most dentists believe that hiring an associate will immediately eliminate chaos and enable them to make more money. The truth is that associates are often hired after a practice has already become a management disaster; the associate just becomes the next casualty.

One reason this happens is that there is no established system into which the associate fits. Often, the associate has little practice-management experience and needs guidance to develop his own working style. The owner thinks that the rules of the practice will prevail and the associate will do everything the way the owner does. Everything will be fine because there is one more doctor to treat more patients, right?

In reality, having one more doctor in a chaotic situation merely leads to more chaos. I can think of more than 50 practices in which the associate left solely because the practice had high stress and daily crises. Even after a year, the associates could not get comfortable with their place in the practices, were unhappy with production, and never felt that there was potential for growth. Rather than becoming partners at the end of one or two years, these associates opted to leave.

What a shame and a waste of time and productivity! Some practices have gone through as many as five associates and still do not understand that it is the lack of management preparation that caused the associates to leave. Everyone focuses on finding the right person with the right personality and the right attitude, but failure is a near certainty without proper preparation.

Here are some steps to follow:

Be sure your schedule makes sense for both the current doctors and the associates. Be able to project exact production, collections, and specific goals. Show the associate exactly how these goals are to be achieved within the time available to produce quality patient care.Understand that the associate is not you. While many dentists believe they have tremendous case-presentation skills, the same is not necessarily true for their associates. Many associates do not know how to present even small- to medium-sized cases; they either undersell or oversell patients. You must have case-presentation systems in place with training for your financial coordinators. Although you may be skilled enough to close cases prior to the coordinator presenting financial options, more than likely, the associate is not.Make sure your entire staff understands all practice systems. You can't force them to get excited about having an associate, but you can help them understand your systems to make the associate's transition smooth.Check in monthly with your associate and review goals, satisfaction, observations, and improvements. Associates are not owners, but they can begin to think like them. They will not know how to fix most of the practice's problems, but they can learn to identify them. The question is, are you prepared and able to fix the problems?

Recently, we held a seminar in Baltimore, Md. One of the dentists there had just started out on his own, having left a reasonably successful practice. When asked why he left, he said the practice systems were a mess, the senior dentist had no interest in fixing them, and the staff treated him like an outsider. In those circumstances, I would leave too! Fix your practice-management system. Don't make the same mistakes others have made before you.

Roger P. Levin, DDS, MBA, president and CEO of The Levin Group and the Levin Advanced Learning Institute, provides worldwide leadership in dental management for general dentists and specialists. Contact The Levin Group at (410) 654-1234.

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