Why some associateships fail

Many of you reading this column have had associateships that have resulted in less-than-ideal relationships or dissolution.

By Roger P. Levin, DDS, MBA

Many of you reading this column have had associateships that have resulted in less-than-ideal relationships or dissolution. This can be extremely disappointing and costly, especially when the intention is for the associate to become a partner and buy out part of the practice.

The majority of reasons that associateships fail can be attributed to certain emerging patterns:

•Reason #1: The primary reason that associateships do not work is that the practice is completely unprepared for the associate. In many cases the associate is brought into a chaotic practice that is stressed by a high volume of patients or lack of clear systems. The associate theoretically is supposed to reduce all stress and chaos by increasing the practice treatment capacity. Unfortunately, the opposite often happens. The associate feels the chaos and stress, does not feel a future for himself or herself in the practice, and often finds it easier to leave than try to help with corrective action.

•Solution: Systemize, document, and improve all of your practice systems before bringing in an associate. The systems for a one-doctor practice are vastly different than the systems for a two-doctor practice. Simply adding one doctor complicates the systems of a dental practice, sometimes to the breaking point. This usually leads to a difficult associateship relationship where we blame the personality of the associate rather than recognizing the inefficiencies and inequities within our systems.

•Reason #2: The staff often treats the associate as an underling. Dental assistants and front desk personnel frequently view the associate as an inconvenience, threat, and contributor to the disorder.

•Solution: Unless you intend to micromanage the associate and every patient that he or she sees, the staff needs to understand that this individual is in charge of his or her area. The staff always can feel free to report back to the owner/dentist if they feel that the associate is not performing properly. This can be a dangerous area because the staff may come back to the owner/dentist every time they do not like something the new associate does. If you constantly side with the staff on this type of issue when there is no danger of malpractice or poor clinical judgement, you will undermine the associate who eventually will recognize the lack of confidence, and choose to leave. Associates are doctors and should be treated accordingly.

•Reason #3: Many owners/ dentists actually think that an associate will come into the practice and be like them. After all, you think you know what works best in your practice, and it is unacceptable for anyone to do anything that is different. If your way works it must be the only way - right?

•Solution: No two practices are the same, and no associate will be the same as you. Short of poor clinical judgment or malpractice-oriented issues, the associate needs to be given some level of freedom. They are doctors who have been trained and licensed to perform treatment. Whether you agree or disagree with the ability of the associate (and why would you hire one in whom you do not have confidence?), understand that micromanaging the associate from a diagnostic and treatment perspective will cause that individual to leave.

•Reason #4: Most practices do not have a vision statement or specific goals for the future. Associates are often young, in severe debt (approximately $100,000 or more), and hungry. They are not at the pinnacle of their career and usually are not worried about sending kids to college. They are worried about buying a house and a car. While you may be set and doing well, they are just starting their lives. They want to know the future. While the future may be obvious to you, it is not always clear to the associate.

•Solution: Write a vision statement and create a set of three- to five-year goals so the associate can see exactly where the practice is going and where he or she fits in. People always are more comfortable when they have a sense of the future.

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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