Hiring and Retaining Associates

Oct. 1, 1996
Apractice probably will witness the additon of an associate, partner or employee dentist in its lifetime. In a fast-growing practice, an associate usually is brought in during the first five years. In most cases, however, the associate is brought in during the senior doctor`s final years of practice.

Linda L. Miles, CSP, CMC

Apractice probably will witness the additon of an associate, partner or employee dentist in its lifetime. In a fast-growing practice, an associate usually is brought in during the first five years. In most cases, however, the associate is brought in during the senior doctor`s final years of practice.

I have been able to examine the causes for and solutions to negative results by traveling from state to state and hearing the reasons why associateships are not working. With this information, I have been able to process the experiences into a seminar topic, audio cassette and this article. The following are the key reasons as to why some associateships fail:

- Mismatched behavioral styles and practice philosophies

- Expectations that are not met

- Staff sabotage

When the process of selection plays true to nature, an individual tends to hire someone very much like himself or herself. In searching for prospective associates, keep in mind that in marriages or working relationships, opposites can create a synergy that complements the strengths and weaknesses of the pair.

When two creative, sociable doctors team up, they will find that they have a lot of great ideas and enjoy talking about them; however, the pair usually has difficulty in getting down to the business of implementation.

When a dominant driver-achiever hires another driver-achiever, they will probably be too competitive to work harmoniously together.

If two steadfast, loyal, resistant-to-change individuals pair up, the office will find that it has two followers, but no leader.

When two perfectionists become a team, the work they produce undoubtedly will be flawless; however, this pair will have difficulty in retaining a support staff, because they will find few people who meet their own, individual standards of excellence.

When behavioral tendencies differ and the philosophy of patient care is the same, you can expect a better chance of success than that of a pair that has the same behavior and different care philosophies.

Issues regarding the associateship should be clearly outlined in a contract before the relationship begins. Expectations should be clearly defined, for a lack of preparedness, combined with a doctor`s inability to confront, might lead to disaster.

If a senior dentist expects the new associate to share in administrative duties, cost containment, marketing and personnel, he or she should discuss this openly in the first meeting. Having open communication at one month, three months, six months, and each year is essential for starting and remaining on the right track with the new associate.

In the event that the associate isn`t meeting the senior doctor`s expectations, action should be taken immediately to correct the problem. If associates aren`t meeting the senior doctor`s expectations, they cannot possibly be meeting their own. Left unchecked, this disappointment eventually will filter down through the staff and patients, dooming the relationship and, quite possibly, the practice.

Staff sabotage can be a major reason as to why an associateship isn`t working. Staff does not always intentionally sabotage a relationship, but it does happen. When staff members are experiencing difficulty in transferring or dividing their loyalty from one doctor to another, patients will detect the lack of confidence in the associate.

A simple task, such as answering the telephone, can make or break the associate`s success. In an office where the staff has little confidence or regard the associate as "more work and nothing in it for me," the telephone might be answered in the following manner: "I`m sorry, Mrs. Levine. Dr. Brown doesn`t have late afternoon appointments available for weeks, but you could see our associate." This makes the associate sound second rate. When the staff member answering the telephone sounds enthusiastic about the associate, the response might be: "I`m sorry, Mrs. Levine. Dr. Brown doesn`t have late afternoon appointments available for weeks, but he would, in no way, want you to wait. He would want you to see Dr. Allen, who has joined our practice since your last visit." Giving both of the doctors equal respect is one way to avoid and correct any unintentional sabotage.

In my seminars, I ask the doctors who are attending what their main reasons for bringing in an associate are. Responses have included:

"My wife and I have reached the age that we`d like to do more traveling, about 10 weeks per year. I need someone to cover those days for me." This is a valid reason if the patient load can adequately support two providers 52 weeks per year.

"I`m going to my 10-year dental school reunion and thought that it would sound cool to say that I have an associate." This is not a valid reason to bring an associate dentist into the practice. The only reasons to hire an associate are a busy workload or retirement.

Doctors who meet with the entire team and create a five-year business plan-that include plans for an associate-have a much better chance of success and retention. It is never a good idea to have the staff and patients surprised by the sudden appearance of another doctor.

Goals for the associate, practice and staff should be outlined and monitored closely. Rewards from the associate-doctor relationship should be shared by everyone when the goals are met. When the staff members feel there is something in it for them, the practice and the patients, they will become very supportive of the new venture.

In closing, try not to have excessive expectations about the net-profit increase during the first year of the associateship. The first 12 months generally are not an accurate indication of the net profit to be expected for the following years. Entering the relationship with this in mind will help in the success of the new union.

If you have an experience that you`d like to share regarding this subject for an upcoming publication, please write to Miles & Associates, 484 Viking Drive, Suite 190, Virginia Beach, VA 23452, or fax 757-498-0290.

The author is an internationally-recognized consultant and speaker on practice and staff development. She is founder and chief executive officer of Miles and Associates in Virginia Beach, VA, and can be reached at 800-922-0866.

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