The majority of associateships or partnerships will fail. The average associateship lasts less than 24 months. From a new doctor’s perspective, your first job will last about 6 months. From the senior doctor’s perspective, why would you even think that without some trial and error, adding a doctor to your practice would work? When we speak with senior doctors that have tried an “associateship” that failed, they always seem to think it was the junior doctor’s fault. The young doctor was lazy, a terrible clinician, had a bad attitude, irritated the staff, and alienated the patients. If we speak with the associate, they always think the senior doctor is taking advantage of them while they, the senior doctor, becomes wealthy from the associate’s efforts. While there may be some kernel of truth in the above statements, most of the blame can be laid at the feet of the senior doctor. Below is a list you should take seriously. Look inward and consider if you are at a time in your life and career where these things will not trip you up.
Senior doctor’s ego: In bringing in a new doctor, your goal should be to have someone who is capable of being better than you are. Better clinically, personally, leadership, management, and even better at inspiring patients. Get ready, because if this actually happens, you will have patients that you have treated for 20 years saying they would rather see the young doctor. You never know how you will react until this happens. Just remember that the goal is to have such a great team that the patients feel comfortable with any doctor in the group.
Staff not involved in the decision-making: Over and over, I see the same scene unfold. The staff is the last to know that the senior doctor is considering retiring or bringing in a partner. In my office the staff hired everyone. I interviewed the staff candidates and doctors, but it was the existing staff that made the final decision to hire or not. Involving your team members in decisions affecting the practice will engender an ownership mentality in them. It creates a team spirit that is missing in most practices. One of the main reasons we averaged over 14.5 years longevity per staff person was the staff ownership model. They were responsible for controlling overhead and boosting productivity. I consulted with them about every aspect of my practice. This will make all the difference. If you have not already read The Super General Dental Practice, please, please take the time to download it and read it. It builds the foundation to the type of practice that you always wished you would have: www.supergeneralpractice.com It is free, get it today.
Junior doctors believe that great practices have staff that always gets along: Keep in mind that as an employee they will always compare and contrast what they see with their expectations. Initially, there is always a “halo effect” where the new doctor tends to overlook the obvious red flags for working in a particular office. Time will tell, but remember that there are no perfect transitions, jobs, or offices. Each job will have its individual challenges. Both the senior doctor and the new hire need to work in consort to make sure you do whatever it takes to get past this common challenge.
Lack of Flexibility: Put on your “Whatever It Takes” T-shirt and make this work. When you consider the impact on your practice (and your bank account) of a successful transition, there will be few decisions that are more important than making this work.
Lack of equal access to facility, staff, and new patients: Get your head screwed on right and engage your brain before taking action. This new doctor is not there to make your life easier. It was a business decision, and you should carefully consider anything you do that might decrease their productivity as counterproductive. I see doctors who unknowingly sabotage their transition by being greedy with staff, patients, and facility.
No written contract: Contracts must act as a matrix to create expectations that are in line with good business practices. Your contracts protect you in the event of death, disability, or dissolution of your partnership. They are your safety net when it comes to business. It defines what you can and cannot do. It helps you focus on the important issues before they become a huge problem. The challenge is that most attorneys are skilled enough to create an employment contract. The problem is that their job is to create remedy for 99% of the challenges you might face. This is the very reason that many attorneys do a poor job is crafting an employment agreement in a dental office. They just don’t know all the ways that two doctors can mess up this transition. If they did, they would have addressed this in a well-crafted contract. Bottom line is that if everything goes great, you will never look at your employment contracts or corporate operating agreements. It is when an impasse occurs or some challenge to the employment scenario arises, that you find the attorney fell short in memorializing your contracts. They can easily miss something, and this can be expensive.
No written expectation and philosophy: While your partnership contracts construct the framework for your business, you must go further and have each of you put into a written document your expectations and philosophy. It is this culture captured in writing that will help frame each of your expectations. Do not skip this step.
The last item concerns how the Associate or potential Partner can cause the process to fail: Ignoring practice policies, having unrealistic expectations, unwillingness to accept advice and/or constructive criticism, not devoting sufficient effort to building the practice, and not supporting the staff when they confront the owner are all pitfalls for the young doctor. We will go into detail as we move along in fleshing out the actual steps in preparing for and successfully accomplishing bringing in another dentist to your practice.
Michael Abernathy, DDS