Most dental school graduates today are burdened with substantial
debt, so they begin practice as Associates. While some enter GPRs or the
Armed Services until they complete their obligations, the outcome is
the same — they enter private practice. As associates, they have the
opportunity to improve their clinical skills, increase speed and
proficiency, and learn about dental business management. There are five
classification of a Group Practice from the ADA. www.ada.org
They are:
1. Goverment
2. Medicaid
3. Hybrid
4. DSO – Dental Support Organization
5. Dentists Owned and Operated
Being an Associate of any of these types of Group Models as an
associate may be the beginning of the majority of new dentists today,
however there still is opportunities in many solo practices that can
offer a more mentoring association as well as an associate position to
begin your career and ultimately become a stakeholder or the owner of
the practice and have the seller continue to work for your associate if
the patient base can support both providers.
In addition, most associates hope the position they choose will lead to
long-term associate position, a stakeholder position or ownership of the
solo practice model.
Understanding the way of success as an associate is the best route to
achieve the desired goals of all parties in all the practice models.
This article examines the top 5 ways to accomplish success as an
Associate Dentist.
1st Way: Realistic Expectations
Possessing a Realistic expectation of the contribution and capacity you
have as a new dentist and Associate. If you are entering into a solo
practice model with the intention to purchase this practice immediately
or within a designated time frame, make sure you there is a
predetermined purchase price. The number-one reason that the promised
buy-in/buy-out does not occur after a one- to three-year time frame is
that the parties did not agree on the purchase price before the
associate was hired. Therefore, the two parties can be at odds with
vastly different ideas of practice valuation and appropriate buy-in
price.
The purchase price needs to be determined and agreed upon prior to
commencement of employment. If not, the senior doctor expects the
practice will be valued at its current value, but the recent graduate
expects to receive credit for the increased production and profit
provided during his or her employment. Subsequently, the associate feels
he is being asked to pay for his own sweat equity that increased the
value of the practice.
However, if the purchase price was established prior to commencement
of employment, three out of four associateships lead to the intended
equity position. Conversely, if the purchase price has not been
predetermined, nine out of 10 associateships lead to termination without
achieving the ownership intended or promised.
2nd Way: Contract Details
Clarity of written details. The second way to succeed as an Associate is
that the details of the buy-in have not been agreed to in writing prior
to or immediately upon employment. A common but fatal mistake is to
say, “If we like each other, we’ll work out the details later.” Do not
procrastinate on the details of one of the most important transactions
of your career.
The more items discussed and agreed to in writing beforehand, the better
the chance of a successful equity ownership occurring as planned. The
written instruments consist of two specific documents:
- Employment Agreement, which details the responsibilities of each party for employment.
- Letter of Intent, which details the proposed equity acquisition. The
letter of intent includes the proposed date of sale, the proposed sale
price, what will happen in the event of irreconcilable differences and
will there be an obligation to buy the remaining portion of the
practice, what will happen if the practice owner also owns the building,
i.e., will it be a requirement or an option that the new doctor be
allowed to purchase a position in the building, how will income be
shared, how will patients be distributed, how would additional partners
be handled, and a statement indicating that while the letter of intent
is not binding on the parties, it does represent their agreement to the
anticipated details of the proposed sale.
3rd Way: Budget and Written Marketing Strategies
There is a four Prong approach for all new dentists that become Associates :
1. Insurance:
Becoming a Provider of the top (3) three insurance plans in your ip
code area and having those fees negotiated by a professional insurance
consultant to save you 10-15% of your normal 30-35% loss. Credentialing
and negotiating insurance provider plans that you will participate with
as a new dentist to any of the practice models. Clarify with your
employer who will be doing this and the time frame in which it may take
to get you on the insurance companies lists. It usually takes a total of
8-12 weeks for the process to be activated and integrated.
2. Global:
Being Incorporated on all Internet, Search Engine, Social Media sites
and Customer Relationship Management software communication and all
Email, Mobile and Electronic processes that are associated with the
practice.
3. Internal: marketing campaigns: Patient Referral and incentivized marketing campaigns.
4. External: Direct Mail Marketing still works! Do it too!
The more that you clarity this 3rd way the faster you will succeed as
an productive asset without compromising the current state of the
practice’s profitability.
4th Way: Assess to Patients
For a successful experience in the shortest period of time as a new
associate, co-create a structure of what and how you will execute a
multi-disciplinary patient care delivery model with your employer.
(types of procedures, emergency-on-call, and new patients.)
The patient base comprises the goodwill value in every practice.
Goodwill value typically constitutes 70 to 80 percent of the value of a
practice. If the senior doctor fails to recognize the need to turn over
existing patients to the associate, then the associate will be
frustrated in his or her efforts to produce dentistry, earn a salary,
and improve skills.
The best method of introducing a new doctor to the practice is
through the hygiene program. At the end of every hygiene appointment,
the hygienist informs each patient: “Dr. Senior has requested that Dr.
New see as many patients as possible to familiarize you with our new
doctor.” The recall examination is an effective and non-threatening
method of introduction.
Upon entering the examination room, the new doctor repeats the same
story: “Mrs. Smith, Dr. Senior has requested that I check as many of the
hygiene patients as possible so that you are familiar with me and I
with you. This way, in the event that I am the doctor on call and you
should have an emergency, you will not hesitate to call me to obtain the
needed relief. After all, we will already be familiar with each other.”
This method of introduction has proven to be highly successful.
If the new doctor has diagnosed needed dentistry, the scheduling
staff member gives the patient a choice of an appointment with either
doctor — with no bias. The choice of doctor is left entirely to the
patient, not the doctors or staff. Historically, 50% of patients will
choose an appointment with the next available doctor or the appointment
time most convenient for the patient, regardless of who the doctor will
be.
For the other 50% of patients seen by Dr. New in the hygiene room,
approximately 25% state that they really liked the new doctor and they’d
like to be treated by Dr. New. The other 25% state that Dr. New was
really nice but they want to see Dr. Senior for treatment. This choice
is noted in their patient file, so the determination is already made as
to which doctor the patient prefers during the introductory period.
After a few months of seeing as many recall patients as possible, the
new doctor’s schedule will begin to fill quickly. Eventually it will
reach a point when the senior doctor notices that his or her schedule is
slowing down. At that point, the doctors will begin to share recall
exam responsibilities.
5th Way: Team Support
The best method of introducing a new doctor to the practice is through
the hygiene program. At the end of every hygiene appointment, the
hygienist informs each patient: “Dr. Senior has requested that Dr. New
see as many patients as possible to familiarize you with our new
doctor.” The recall examination is an effective and non-threatening
method of introduction.
Upon entering the examination room, the new doctor repeats the same
story: “Mrs. Smith, Dr. Senior has requested that I check as many of the
hygiene patients as possible so that you are familiar with me and I
with you. This way, in the event that I am the doctor on call and you
should have an emergency, you will not hesitate to call me to obtain the
needed relief. After all, we will already be familiar with each other.”
This method of introduction has proven to be highly successful.
If the new doctor has diagnosed needed dentistry, the scheduling staff
member gives the patient a choice of an appointment with either doctor —
with no bias. The choice of doctor is left entirely to the patient, not
the doctors or staff. Historically, 50% of patients will choose an
appointment with the next available doctor or the appointment time most
convenient for the patient, regardless of who the doctor will be.
For the other 50% of patients seen by Dr. New in the hygiene room,
approximately 25% state that they really liked the new doctor and they’d
like to be treated by Dr. New. The other 25% state that Dr. New was
really nice but they want to see Dr. Senior for treatment. This choice
is noted in their patient file, so the determination is already made as
to which doctor the patient prefers during the introductory period.
After a few months of seeing as many recall patients as possible, the
new doctor’s schedule will begin to fill quickly. Eventually it will
reach a point when the senior doctor notices that his or her schedule is
slowing down. At that point, the doctors will begin to share recall
exam responsibilities.
Rhonda Mullins, CEO, RHO Global Inc and Dentrepreneur Solutions, LLC
Ready to Start Building A Practice Within A Practice? Contact Rhonda Today! Email | 404.445.7730