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1.18.08 Issue #306 Forward This Newsletter To A Colleague

Will the new Associate Dentist End the Perpetual Pandemonium?
by Sally McKenzie CEO
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Would you buy a car if the salesperson said to you, “It’s really a great vehicle when it works?” Of course not, you would turn and walk away. You’re not going to pour thousands of dollars into something you cannot depend on. Unfortunately, that seems to be how many associate relationships turn out. Lots of money is poured into them, their track record of success is generally weak, but when they work, they’re great.

Why do so many fail? Oftentimes, it boils down to unclear or mismatched needs and expectations. The hiring dentist may feel he/she is so busy that another doctor is warranted and he/she believes the new dentist will stem the tide on the perpetual pandemonium. Or the senior doctor may be nearing retirement, and wants to offload the less pleasant work to the new dentist so she/he can focus on other things. In some cases hiring dentists view associates as extensions of themselves. They assume that the new person will come in, fall in line, produce, and keep their mouth shut.

The associate doctor, meanwhile, is likely entering practice with a huge amount of dental school debt –as much as $250,000 in some cases. The economic realities are such that most new dentists are not in a position in which they can take many risks. They require profitability and security. Therefore, they are looking for an established base of patients. They want to work with a trained staff that functions well as a team. And they’re looking for mentoring from the senior dentist in the management of the practice as well as in the diagnostic and treatment aspects of the dentistry. There’s a lot riding on this opportunity and they want to get the most out of it. And that is often where things start to fall apart. The associate has specific needs while the hiring dentist may have very different wants.

In the “too busy” practice, the hiring dentist convinces him/herself that the new dentist can just step in and help control the chaos. Unfortunately, as I’ve said before, the “too busy” practice is too often an indicator of key management systems run amok rather than too many patients to treat.

The associate, looking for a stable environment in which she/he can grow as a professional, walks into swirling mayhem. The office is operating in a perpetual state of crisis because the senior doctor will not address the problems, refuses to delegate, and wastes valuable production time on tasks that the assistant should be handling, and so on. The senior doctor isn’t too busy; she/he’s too inefficient. Aside from trying to put out fires, there’s not enough real work to keep the junior dentist busy.

In other cases, the senior dentist has been cutting back in preparation for retirement. The doctor might have had a thriving practice that was bringing in $800,000 a year, but whittled it down to $300,000. However, overhead remained unchanged, and the senior doctor mistakenly believed that the associate would boost revenues right away, an expensive and incorrect assumption that neither could afford.

When it comes to determining the need for an associate it has to be the hard data that drives your search for another dentist.  You must know without a doubt that there are enough patients to not only keep doctor and associate busy but support the two of you as well as the practice. You have to know that there are more patients than you can handle – not just think that’s the case.

How much is enough? Generally speaking, industry data recommends that for a solo practice to remain healthy it should have a monthly new patient flow of 16-25, and 85% of those new patients should be accepting treatment. And practices that are eyeing the resumes of potential associates should be seeing new patient numbers in the area of 30-35 per month before the practice is ready to make the investment in a full-time associate.

The industry’s general indicator is that a solo general practitioner should have a minimum of 2,000 active patients – not 2,000 patient records in the system. And just because the patient has a sticker on their record indicating that they’ve been in during the past year doesn’t necessarily mean that they should be counted in the ranks of “active” patients.

Next week, before you hire an associate make sure you understand who your “active” patients really are.

Interested in speaking to Sally about your practice concerns? Email her at sallymck@mckenziemgmt.com.
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