Business in your dental practice is good, but you think it could be better. Maybe you’d like to eliminate scheduling delays, or maybe you’re thinking about expanding your office space or services, or maybe you seem to have plateaued in revenue. Adding an associate might be the answer to boosting your practice growth – if the circumstances are right.
Is adding an associate the answer?
The first step in solving any problem is to define exactly what the problem is. For example, the problem might be that your practice struggles to schedule patients for biannual hygiene appointments in a timely fashion. The second step is to identify the root of the problem. If, in this example, it’s a matter of inefficiency, poor communication or inadequate practice management systems in the office, adding an associate won’t help. However, if it’s because your patient flow is overwhelming your capacity for hygiene appointments, then hiring another provider (and associated hygienists) may be a logical solution.
Crunching the numbers
In fact, says Anthony Fruehauf, regional president southeast of Patterson Dental, this scenario is the prime indicator that your practice might benefit from bringing on an associate. “Every practice gets to a point where, however many dentists you have, you’re just limited by the number of hours in the day,” he said. “When you get a certain number of new patients coming in, and you already have a book of business, you end up having to schedule patients out so far that you could lose them because you just don’t have enough people to do the dentistry. Then you have to think about how you can serve that growth.”
Because it’s expected that a practice’s finances will temporarily decline after hiring an associate until the new doctor gets up to speed, a few rules of thumb exist for assessing the feasibility of making a new hire, even if it seems like the right thing to do. One includes the ability to subsidize 6 to 12 months of the associate’s salary. Another is a minimum 85% patient retention rate for hygiene appointments. But each practice must take its own unique situation into account.
“There’s always been an idea that when you hit a million dollars in revenue, you need to start thinking about a new associate,” Fruehauf explained. “But that isn’t always true. You could do a million dollars in revenue because you’re doing a lot of really high-dollar cases, but you’re not necessarily that busy. That’s why we look at new patient flow as the true indicator. That drives the twice-a-year hygiene recall schedule that generates treatment plans for whatever they find during those exams. That’s the better indicator than just straight dollar revenue.”
“Adding an associate too early is not good,” Fruehauf continued, “because they have an expectation of what their income is going to look like. So if you bring an associate on and you don’t have enough patient flow, you’re just giving away some of that income that you normally would realize. You have to really thread the needle on making sure you understand the opportunity for both parties.”
Finding the right fit
Once you’ve determined that hiring an associate is a sensible approach to growing your practice, the question turns to one of finding the right person. Who, exactly, are you looking for?
“The biggest thing to look for in a candidate is whether they are a good fit for the practice in terms of personality and practice culture,” Fruehauf said. “Do they have the same thoughts that you do around patient care? Do you see this person fitting in not only with you, but with your patients and your staff?”
Fruehauf also highlighted your comfort level as the practice owner. When you’re not physically in the building, you should feel comfortable that they’re providing the patient care and communication you’ve spent years establishing. Fruehauf suggests asking yourself, “Are they going to be a good steward of my money?”
Of course, making sure that your practice is compatible with the associate’s goals is also key to a successful – and profitable – relationship. Whether the associate wants to mentor under a senior doctor for a certain length of time, wants a short-term position in pursuit of a bigger plan, or is interested in eventually buying the practice in whole or in part, you want to be clear from the beginning that their needs align with yours.
“You really need to do a deep dive at your first meeting,” said Fruehauf. “What their goals are, what their education has been, what their experience is, what type of dentistry they’re interested in practicing. Do they potentially want to buy into the practice? If you can help create an ownership mentality even before they’re an owner, that helps you feel comfortable that they’re thinking about the business of the practice when they show up to work.”
Looking for a skill set that can expand the practice’s services can be a real bonus. For example, if you consistently refer a significant number of endodontic cases every year, seeking an associate who can potentially keep them in-house will give your practice an extra boost.
Meeting the challenges
Finding the perfect match can be a challenge, of course. Fruehauf recommends networking with a trusted sales rep as one approach. “Reps play a big part because they generally have their ear to the ground,” he pointed out. “They know associates who may or may not be happy in another position, or they have relationships with dental students who are going to be graduating and coming into the market.”
Another challenge lies in ensuring that you have sufficient staff support, office space and equipment. “The hygiene market is very competitive right now,” Fruehauf observed. “And if you have only three operatories in your practice, you probably can’t bring someone else on. You also want to make sure that your practice is up to date with technology and equipment that makes it attractive for somebody to join.”
Reaping the benefits
As complicated and demanding as the search and hiring process can be, if it’s undertaken with everyone’s goals and practice culture in mind, the results can be rewarding not only financially, but also personally. Successfully adding another doctor to the practice can help you build more flexibility into your scheduling, create the potential prospect of an exit strategy to retirement and pump a new infusion of energy and perspective among your staff members.
“But the real benefit in adding an associate,” Fruehauf concluded, “is that you can continue to see the patients you’ve cultivated over your career and also add new patients, which obviously yields revenue for the practice.”
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This article was originally published in the summer 2022 issue of Advantage by Patterson Dental.