Taking on an associate dentist requires some foresight in both your business practices and marketing. How should you approach it?


Podcast Highlights:

  • The role of owners vs. associates
  • The time period that should pass before an associate dentist buys in
  • Who is supposed to promote?
  • Pre-appointments: when is the right time to take an associate
  • Pre-appointing misconceptions
  • Opposites attract! The best associate traits to look for
  • Capacity: What numbers show you are ready for an associate?
  • The new patient formula to follow
  • What marketable attributes does a new associate dentist bring?
  • Solving staff vs. associate problems

Podcast Transcription:

Hello, and welcome once again to the Dental Marketing Mastery series. This podcast is brought to you by Dental Web Content dot com and New Patients Incorporated. I’m Howie Horrocks, the founder of New Patients Incorporated, along with me once again, is my friend and partner and the president of New Patients Incorporated, Mark Dilatush.

Howie: Hello, everybody. We are here once again. We’re glad to have you guys out there in our audience. Hello, Mark you’re way far away, aren’t you?

Mark: Hello, Howie. I’m in the intergalactic northern headquarters of New Patients Incorporated. I’m in a little tiny place called Lincoln, Maine.

Howie: Yes, yes.

Mark: Where,

Howie: I remember that place very well.

Mark: Yes.

Howie: Wonderful up there.

Mark: Yes, we’re 60 miles north in telephone pole stop. So. Then you got another four hours ago. So yeah, so there’s bugs, the dragonflies are just hatching. So the black flies are still out. And you know, it’s just the normal. Every year, we come up and open up the cabin, just to get it ready. So.

Howie: Yeah, yeah.

Mark: But you know, we do want to stay on our podcast schedule. And we do want to produce these for our Dental Marketing Mastery members, by the way, folks, if you’re listening to this, and you’re not a member of Dental Marketing Mastery on Facebook, there’s a group there. It’s a closed group, it’s, you know, you just go in and ask to be invited in and that’s it.

I mean, it’s not hard. But our goal there is to take at one of our goals there is to take these weekly podcasts and expand it. Expand the discussion, beyond Howie and I, out to real dentists with real situations, with real challenges, or real successes, or whatever. And just expand the learning beyond the podcast, basically. So Dental Marketing Mastery is a Facebook group. Go ahead. And we had a lot of signups this weekend. Something happened this weekend. But there was a I had to approve like 30 people today. So yeah, I don’t know. Anyway.

Howie: We don’t know what that’s about.

Mark: Yeah. Well, welcome, everyone. So what’s our topic today Howie?

Howie: We are going to discuss adding an associate dentist. The perils of, and pleasures of adding an associate to your practice?

Mark: Hmm, okay, wow.

Howie: We’ve talked about this once in a lecture, and we just kind of started to go off on ad lib on it, and turned out to be a very popular, interesting topic. So we thought we’d revisit it at this point.

Mark: Okay, well, um, well, then let’s start with the very, very basics. Because there’s two perspectives here. There’s going to be the owners perspective, “how do I bring on an associate dentist?” And let me, we’ll focus primarily on that one. But for all the associates out there. And all the owners, I will tell you that in the last 15 years, you know, people fill out an online survey of questions, and have us build dental marketing plans, not a secret, right on our website.

And in the last 15 years, I would say we have received minimum 300 of those surveys filled out by associates. Which leads me to the conclusion that while it’s nice for an associate, to want to build their side of the practice, and it’s nice for the owner, to look for an associate dentist who would be willing to put forth the energy, time, money, whatever they’re willing to put forth to build their side of the practice. It is at the end of the day, the owners practice. You know what I’ve never received? I’ve never received a survey from a hygienist.

Howie: Yeah.

Mark: Who is just as much of an employee as the associate. There’s no difference here.

Howie: Yeah.

Mark: Okay. Unless you’re in a buy in arrangement. If you’re already in a buy in arrangement, then you know, we can change the subject a little bit, you know, now you’re now you’re an associate dentist, but you’re also you know, you’re buying in. Right? You got some got some skin on, on it on the table, right? So here’s the bottom line there. If you’re an associate, it’s not your job to grow his or her practice. It’s your job to do great dentistry, treat people well, maybe get some referrals.

But your focus should be on your skills, your speed, and your relationship with the patients you treat. And in, in those manners, you can really help the owner. Okay, at least at first, at least until you start buying in. Now, from the owners perspective, how many, probably not as many as associate client surveys, but I know I’ve gotten 100 client surveys from owners who are complaining that their associates don’t do anything to help build their practice.

Howie: Yeah.

Mark: Doctor, it’s not their practice. It’s your practice. You were supposed to promote, you were supposed to think ahead, you were supposed to plan, and you were supposed to know the numbers before you ever brought them on board. Okay, that’s not their failure. That’s your failure. I know that sounds harsh. But sometimes you get to pull the band aid, right? Yank it off, scab might come with it some hair may come with it, but you’ll be better off down the road. Right?

So, if you’re an owner, and you realize “hey, man, you know, I think I’m busy enough, I’m not sure.” Because we get that question a lot. And yeah. Yeah, right. It’s a capacity issue. Right. And you see it on Dental Town, you see it on the other Nexus forum, you actually on our own Dental Market Mastery forum, those questions, I think, I get to add days, I gotta add hygiene.

Okay, so here, let me give you a really quick snapshot of how this happens. Most of the time. Most of the time, you have a solo GP, nice market. Probably a slightly under served, or maybe they’re really good at marketing, okay. And they get busy. And of course, somewhere, somewhere near Mount Rushmore, somebody carved in the side of a mountain, you must pre appoint hygiene for the rest of your life. Okay, no matter what Mark Dilatush from NPI says, you must do it. So the dentists reads that on the side of the mountain, and they keep pre appointing all their hygiene patients pre appointed, reappoint, and pretty soon, hygiene looks so far out there that you think you have to expand. That’s the first thing that happens.

The first thing that happens is pre appointing fools you. Best 70% of those people booked out into the future are going to stick with that day and that time, at best. Trust me, it’ll be lower than that for most of you. Okay, so 30% of what you’re looking at is total garbage. Okay, it’s it’s a pipe dream. It’s an illusion. And you make business decisions based on an illusion. That never makes any sense. Okay, so that’s the first thing you look at, “Do I pre appoint almost everyone?” If the answer to that is yes. Okay, now we gotta go look at your overdue recall report.

Just run it for the last year. And if you see 400 500 600 people on it, and you compare that to your new patients for the same year 400 500 600. You’ve already stagnated your practice, you’re the last person on earth who should be going out and getting an associate dentist. If you have the same number of new patients coming in, as are going out, you’ve already stagnated your practice. Does that make sense? Howie?

Howie: Oh, sorry. Yes, it makes perfect sense.

Mark: Okay. All right.

Howie: They’re not ready, that they’re.

Mark: No, no, yeah, you’re not ready. Gotta fix something first. Okay, so normally, here’s what we do. We say, “Dr. Owner, I’m going to encourage you, before we do a bunch of marketing for you. Really seriously, we have these conversations, before we go do a bunch of marketing for you, we have got we have got to expand capacity, we have got to get your re-care your back door, managed in such a way that we can actually measure the difference between the truth and what you see in your hygiene schedule, because it’s not real.”

So once that’s done and normally takes a week or so figure it out with reports and stuff. Once that’s done, then you can sit down and you can say, “Okay, Doc, well, you know, what kind of dentistry do you want to do?” “I want to do more of the fun stuff.” That’s normally what we hear. And I want my associate dentist to handle maybe all the people who have insurance and all the, you know, drill and fill stuff, and if I see another two surface composite, I’m going to stick a pencil in my ear. You know, we normally have that kind of a conversation with dentists. So basically, all right. So you want the associate dentist, to take over, you know, the families, more of the family side of the practice the drill and fill stuff.

Howie: Right. And that’s normally where the big mistake comes in. Doc wants to go out and find somebody just like him or her.

Mark: Right. Yeah. Why don’t you talk about that, Howie?

Howie: What’s that?

Mark: Why don’t you talk about that?

Howie: Yeah, I mean, that that’s, that’s a critical error that we’ve seen. The truth is, you should get somebody that’s just the opposite of you. You know, you don’t like kids anymore? You don’t want to treat kids? Fine. The associate dentist you’re looking for should love to treat kids. It’d be best if she was a female too because they’ve got a lock on the whole compassion thing. And that would be ideal. You don’t like molar endo? Well, your associates should love it. You see what I’m getting at? You can expand your reach into your community, expect a lot more arrows in your quiver, have a lot more to offer. If you just find somebody that is not exactly like you.

Mark: Yeah, basically look for any female dentist willing to work with children who does straight wire ortho?

Howie: Oh, yeah.

Mark: And, and doesn’t mind working some evenings.

Howie: Exactly.

Mark: You’re done. You’ve found your associate dentist. Now I’m, we’re obviously we’re being a little facetious here. But, but in most cases, we’re not, most cases, we’re saying, “Hey Doc, what do you want to do? What don’t you want to do? Well, whatever you don’t want to do is the list of things you want the other person, Right?

Howie: Right.

Mark: So once you do that, then you say, “Okay, well, what’s your new focus? What are you excited about? What makes you get up at however early you get up and drive to work? Um, you know, what is it, sleep apnea? Did you take an implant course? I mean, you know, are you doing Invisalign now? What is it? What is the thing that really, that you believe you get the most, you know, professional satisfaction from?” So then we make a list.

Um, you know, you should probably go through that list. I mean, most dentists, when they bring on an associate dentist, will want to back off a day, give the associate a day and that doesn’t really change capacity at all. There really is no reason in that case, to do a hell of a lot more marketing. But if the owner dentist has the space, and the two dentists are actually going to work there at the same time, or the hours are going to expand within the same space. Now we’re adding capacity. And that brings us to the second or third I forget which mistake we’re on. But the really the second or third biggest mistake that dentists make is they will bring an associate dentist on into the existing capacity, run out of patients and not know why.

Howie: Right. I think we’re we’ll continue this discussion on the other side of a break here. But when we come back, don’t go away, we’ll be back we want to finish this topic it’s, it’s kind of fun.

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Howie: Okay, we are back. We were covering the mistakes that dentists often make in bringing on an associate dentist. Mark, we were just talking about one.

Mark: Well, yeah, it’s when you do your measurement of “Am I busy enough?” That’s every almost every dentist as an associate. That’s one of the first measurements. So let’s say you did that, you know, appropriately. Um, and they say, “Okay, well, I’m still going to work my four days a week, and I want the associate dentist to work two days a week.” Okay, that’s a 50% increase in capacity. So if you were getting 30 new patients a month before, how many do you need now, in order for the associate and the general and the owner, to be as busy as they are right now? If you’re getting 30 new patients a month now and you increase capacity by 50%? How many new patients a month are you going to need after the associate starts? The answer is 45. It really is.

And I’m not going to say it’s easy, but it really is. It’s math at that point. That’s where the owner and associate relationship sometimes, I mean, there’s always that period where the associate is getting used to the office, the team, teams getting used to them, the schedule, then there’s a situation where none of the existing patients want to see the associate, they all wanna see the other guy. Okay, then there’s a situation where, okay, now we’re getting 40 new patients a month but um, but now the owner Doc is, you know, he’s gonna get a little jealous, because, you know, his schedule is not as full or not as booked out as it was before the associate got there.

See, and then you start playing games, then the doctor owner goes up to the front desk says, “Give me all the new patients. Just leave, you know, the associate with, you know, whatever emergencies at you know, 2am on Friday nights.” okay. And pretty soon what you have is you have owner associate disharmony. And you have an associate that leaves a practice. Nine times out of 10, the associate will say the same thing. They’ll say, “Well, there wasn’t enough patient flow for me to make a living.” And nine times out of 10, the owner says “We just had clinical, we have clinical issues between us.” We couldn’t.

Howie: Creative differences.

Mark: We had creative differences, right? Clinical differences, okay. The answer is always the same, right? So this is all avoidable. It’s all avoidable if you measure your capacity correctly, plan for it. If you measure um, if you measure the additional marketable attributes that the associate brings to the practice. There’s something an owner can expect. If the owner is selective in the associate, they hire, that is something that you can you know, hang your hat on.

If you don’t like doing molar endo and your associate does you can add molar endo, to your production. It’s awesome. If you don’t like doing straight wiring, never done it and they do. God bless America. Okay. Those are things you can expect from your associate, and you those are things you can look for before you hire your associate. And those things will absolutely positively help you. Associate-ships that run into ownership. Very rare, it’s very rare for us to run into a situation where and a new associate walks in and begins to buy in right away.

There’s almost always that usually about two years, about 24 months of working on the job, making sure everyone understands everyone, making sure that clinical things are taken care of, making sure the staff and the associate there’s no disharmony there. Now from one of the things I can tell the owners is, um that’s an incredibly bad position to be in as an associate.

You are basically at the mercy of the rest of the staff. And as the owner, you need to keep your eyes wide open. And make sure that your staff does not take advantage of that. Because they a lot of times they will. And it will look like to you the associate is being unreasonable, when pretty soon, like how many dentists’ owners on here have ever heard from another dentist that said, I’ll never get another associate ever again. I’ve had three and none of they all suck.

Howie: Yeah, that’s actually pretty common to hear that.

Mark: It’s very common to hear that right? And when we hear it, we don’t look at the associates. We look at the environment. What made them all stink? Right? Is it something you we’re doing? Is it someone at the front desk who believes he or she owns the practice and can just run roughshod over everybody? Gee, never heard that before. Right? So it’s not easy. It is worth it. You do have choices. You can be selective.

The right one will be potentially, maybe even a partner at some point, and maybe even the person who buys you out as you retire down the line. So it’s definitely worth it. Um, just plan for it properly. Oh, one of the other. This is a capacity issue but this just hit me in the head. One of the other things we’ve seen is we’ve seen dentists attempting to do insurance transition, in other words, trying to get out of all their insurance plans and simultaneously bringing on an associate.

Howie: Oh, man talk about juggling plates. You’re expanding capacity on two fronts there and you

Mark: Exactly.

Howie: Just oh boy, that’d be a nightmare scenario.

Mark: And yeah, and you’re decreasing patient flow automatically. Okay, so nobody, nobody in a reputable marketing firm is going to say, “No, if you know, if you stop participating in insurance y, and you have 200 patients on insurance y, then none of them are going to leave you.” I mean, that would be irresponsible for any marketing company. So, don’t expand capacity into a to a shrinking patient base. That almost never make sense, unless you’re in just an incredibly under served dental market. With a really robust market, that’s the only way that you should even attempt to do that. Um. So the stories that we hear, we’ve heard them for, well, 15 years now, they’re all eerily similar. And they almost all take the same path.

And it almost always begins with measuring properly at the very beginning, even before, even before you even contemplate bringing on an associate, before you even think about the hours, or opening up another day, or talking to your staff about maybe working another day or an evening or an early morning or any of those other 9000 details. If you’re a solo GP owner, and you’re thinking about maybe someday maybe getting an associate, the number you’re looking for is eight work days. If a new patient, non emergency cannot get a new appoint, an appointment in your practice, for eight work days, that’s your signal.

Anything over that and you’re probably either ready, either you should expand capacity and absorb the production yourself, or you know what, might be time for you to start thinking about it. And I know I’ve got at least 50 dentists listening to this right now, who are, I know, who are in exactly that situation because I yell at them. I don’t yell at them, really. But the online dental appointment scheduling, I see them and I see them like what’s today? June? Yes, patients making appointments in July already. So I know you’re three weeks out. So if you have an expanded capacity, you might want to think about it. Right?

So anyway, this was a good topic we could do, we should do a, you know, a fireside at some point. Talk about some of the stories that, some of the horror stories that we’ve you know, usually, usually not usually, many times, dentists, they’ll come to us after they’ve made all those mistakes. And it’s a lot easier to have this conversation with them.

If they’ve already gone through them and, you know, when you’re having that conversation, they say, “Yeah, yeah, yeah, I did that too.” I say, “Okay, well you shouldn’t have done it.” You know, they’re learning by doing I mean, that’s how I learned almost my whole childhood growing up. You know, I drove my bike over the cliff and I got hurt. And, you know, okay, well, guess I’m not going to drop my bike over the cliff anymore. So, you know, not making fun of anyone. I’m just saying there’s there are ways to do this right. And if you know a dentist that’s done it right, chances are, they did those steps, right.

Howie: Yeah. Well, everybody, thank you again for listening. We’re going to leave you now but we’ll be back soon. Thank you again. Bye. Bye.

We hope you’ve enjoyed our podcast today. You can find more podcasts on our YouTube channel, on Stitcher, and iTunes, also on our websites, dentalwebcontent.com and newpatientsinc.com.