Should I hire an associate?

Dentists often give many of the same reasons when it comes to whether or not they think they should hire an associate. Many of these reasons do not warrant the expense of hiring another person. It’s important to weigh many factors before taking such a big step for your practice.

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Dear Dianne,

I’m considering adding an associate doctor in my practice. I’ve been in practice more than 20 years, and I’d like to be able to take more time off to do things with my family. Also, I’d like help with hygiene exams since I have two full-time hygienists. A third reason for an associate is that I’d like to be able to focus more on endo and implants. At present, I’m scheduled out about two weeks solidly. What are your thoughts on my reasoning, and how do I know when the time is right to add an associate?

—Dr. Dave

Dear Dr. Dave,

Adding an associate doctor is one of the most important decisions a dentist can make. There’s no way I can discuss all the things you should consider in the confines of this column.

There is a reason that a majority of practicing dentists choose to be in solo practice, although there is now a trend toward multidoctor practices. Over the years I’ve seen many associateships, some successful and some failures.

You list three very common reasons that dentists consider adding an associate. Who wouldn’t like to have more freedom to travel and focus on a profitable niche area of the practice? I believe you can have those things without adding an associate.

First of all, consider hiring a locum tenens dentist to be in your office while you travel. You might be able to find a retired colleague who would still like to work occasionally.

If too many hygiene exams are stressing you out, some schedule modification might be in order. Maybe you need to allow slightly more time in your schedule to relieve that stress. Also, you might consider moving to an assisted hygiene model where you have only one hygienist who works with a dedicated assistant and uses two operatories. This would slightly reduce your number of hygiene exams and be more profitable in the long run.

One of the most telling aspects of your question is that you are only scheduled out for two weeks. This makes me wonder if you have enough demand to keep two dentists busy. My guess is (without seeing some practice management data), you probably don’t.

In my opinion, there are several good reasons to add an additional dentist, but the most important reason is demand. If you were scheduled out for six weeks or more solidly, that would mean you have more demand than you can comfortably handle as a solo practitioner. This is a good “problem.” Just ask any of your colleagues who have large blocks of open time in their immediate schedules.

Another good reason to add an associate is if you are nearing retirement. You could bring in another dentist to buy you out. In most situations, it is good if the owner can stay on temporarily to ease the transition to a new owner. Often, that decision depends on the busyness level of the practice.

Many people have written articles related to associate dentists, but the most comprehensive article is one by David Dunning, PhD, MA, and Robert Madden, DDS, MBA. I urge you to access this article and read it carefully.i

Please consider this information. Your practice may not be able to support two dentists. Your goal is to decrease stress, but adding an associate may bring on new stressors that you did not consider.

All the best,



i. Dunning D, Manning R. Understanding and evaluating associateship opportunities. Dental Care website.

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