A few months ago, I was talking with an associate dentist who was interested in opening his own practice in the near future. His problem with the practice where he worked was that his income was limited by the number and types of patients the marketing targeted.
"I'm thinking about promoting myself independently of what the practice does," he said. "I'm just afraid that I'm going to be stepping into a briar patch."
Fortunately, we found a way for him to keep his skin intact and still promote himself.
As an associate dentist at the mercy of the practice's marketing, you're likely able to relate—you get the patients the practice brings in and assigns to you. If your schedule is full, you're probably pretty content; after all, you're making money and you don't necessarily have to pay out of your pocket to get patients. But if your schedule isn't full—or if you aspire to greater things, or if you're looking for higher-value cases—then you're probably not content. The question is, what can you do about your situation?
The answer for some associate dentists is to engage in self-promotion with the goal of getting more new patients, and higher-value patients, on their schedules. If you're not ready to jump ship or open your own practice, you've got some thinking to do. My experience is that associate dentists who don't carefully plan every step of their self-promotion campaigns are looking at a very thorny path.
Associate dentists work in different kinds of practices, under different kinds of dentists and under different financial agreements. What follows should cover the different aspects of self-promotion that you'll need to consider. Tailor this discussion to your situation.
Based on conversations with many associate dentists, I've identified five areas—the Five P's—that you'll need to include in your self-promotion planning. We strongly suggest that you have firm ideas about how to handle each area before ever broaching the subject with the practice owners. And once negotiations are complete, be sure to have a written contract vetted by your attorney to cover all eventualities.
Dentists are people, and people are funny. Some practice owners believe that having an associate dentist is strictly a business arrangement: If the associate produces, bills well and does good work, then the principals are happy. If your idea to self-promote makes good business sense, you're unlikely to face much pushback.
Other dentists view having associates as giving newbies their big break. If you're facing what your boss sees as a debt of loyalty, that can seriously complicate your plans to self-promote. One client who had attempted to self-promote as an associate ran into this situation: He was faced with the choice of giving up his efforts or leaving the practice. He decided to leave, because he believed that his future with the practice would be constrained.
Spend some time thinking over what you know about the owner or owners—and don't forget any other staff member who wields influence within the practice. Your initial approach must anticipate and account for their possible reactions, which may be irrational. Egos may be bruised, and you could face unfounded charges of disloyalty.
As with all radical ideas, consider taking a more gradual and suggestive approach to self-promotion to allow the different personalities to get used to the idea.
There will be several financial variables to consider, including whether the principals are open to co-promotion with you and the practice contributing a share of the cost. While that might not be in your plans right now, it's a mutually beneficial option to keep in mind.
An important consideration is whether the practice compensates you on production, or on collections. It makes sense that if you pay for marketing out of your own pocket, you should take a larger share of the financial rewards. That's particularly true if you're furnishing your own equipment and dental assistant, and that's a strong argument in your favor. Have other points ready at hand if the practice disagrees with the idea of you receiving a larger share.
I've seen time and again that the financial aspects of self-promotion can be a major sticking point.
"These people are crazy," one associate told me. "They're fine with me doing promotion, but they want a larger cut for the patients I bring in. Their rationale is that I'll be making more, so they should be making more. They don't care that their cut, plus my marketing outlay, is going to more than cancel out any gain I can realize."
Crazy people notwithstanding, you'll almost certainly need to create a financial plan that benefits both you and the practice. Be prepared to be somewhat flexible in terms of who gets how much, and why, but have a point that you simply won't go below. Keep that a closely guarded secret. After all, you're proposing something that will enrich the practice as well as you.
Financial negotiations may take a while (and cooling-off periods may be required), so be patient. Patient associate dentists succeed far more often than impatient ones.
Once you begin promoting yourself, you'll face a different set of challenges. With successful marketing, you'll have a full appointment calendar and possibly a waiting list of patients. At some point, one or more of your prospects with urgent needs will wind up being seen by another dentist in the practice. You need to plan the financial arrangements before that happens.
Also consider the likelihood that some prospects who were attracted by your marketing will decide that they don't want to wait, and will request to see a different dentist.
Any issues with the new patients that your marketing brings in can spill over onto the practice. An unhappy prospect is an unhappy prospect, and most new patients won't differentiate between you and the practice. Any negative online review will implicate the entire practice, justified or not. You and the principals will need to have discussions up front and have a plan in place for dealing with negative reviews.
If yours is a multidisciplinary practice, you'll also need to consider financial arrangements if a patient of yours needs a procedure you don't perform, and another dentist in the practice completes the procedure.
Once you reach the point that you decide it's time to open your own practice, you're facing the potential stumbling block of who gets your patients.
Again, this is something that's best negotiated in advance. Don't be surprised if the practice principals insist on a clause that allows you to announce that you're leaving but prohibits you from actively soliciting your patients to follow you to your new practice. The current practice may well have added additional processes and personnel to handle the increased patient flow. Your leaving means that the practice still has those expenses, but with a reduced number of patients.
Once you begin self-promoting, there can be some buyer's remorse about the original agreement, either on your part or the practice owner's. That's why it makes sense to build review points and change mechanisms into your original contract. If that's unacceptable to either party, you'll need to think twice about whether self-promotion is right for you while you're in that practice.
The path to self-promotion as an associate dentist can be thorny, but our experience shows that it doesn't have to be. With enough planning and a flexible attitude toward negotiating, you can integrate your self-promotion into the practice's efforts with minimal problems. And, just as importantly, with good feelings all around.
the right way to market
SmartBox founder and CEO Colin Receveur discusses more details of successfully marketing a practice during his latest appearance on Dentistry Uncensored with Howard Farran. To listen or to read a transcript, click here.