The Associateship Rollercoaster

Well, here I am! In the midst of a global pandemic, searching for an associate dentist position! 🙃

In all seriousness, my search for an associateship was nothing like I envisioned. For starters, it takes a LONG TIME to be fully licensed and registered. I completed my CDCA board exam on 7/2/2020 and was first eligible to work on 10/27/2020. It took nearly 4 months to receive my state license, state DEA registration, and federal DEA registration! To learn more about this process, see my post, Job Search Timeline.

One of the biggest surprises I encountered during my job search was the dichotomy between timing. In my experience, either an office needs an associate yesterday, or it may take months to begin working! 

In dentistry, rarely do you interview and receive a job offer. Instead, it’s a drawn-out process. The owner dentist usually wants to get to know you, and ensure you share their philosophy of dentistry and vision for the office. They may ask you to shadow, or even perform a working interview. This is also an opportunity for the owner to make sure you jive with the rest of the team. Next, you will discuss contract terms. The owner dentist will have an attorney draft a contract, then you will review that contract (ideally, with your own attorney) and negotiate as necessary. 

By the way, that whole thing about “philosophy of dentistry” and “vision for the office”…honestly, I thought that was bologna at first. BUT, it’s actually really important that you understand what type of patient population you will be treating, and the owner’s treatment planning philosophy (i.e., how conservative or aggressive they are). I recommend visiting the practice to get a feel for office dynamics, how busy you will be, and what procedures you will be expected to do.

My Job Prospects

June-July 2020

  • Opportunity: Associate position in multi-doctor office
  • What happened: Office needed an associate pronto; they couldn’t wait. Also, I had no clue at this point how long it would take to become fully licensed!

July-August 2020

  • Opportunity: Partner with seasoned dentist to purchase a practice
  • What happened: Partner backed out of purchase. This was a blessing in disguise! I was excited about the prospect of building equity, but in retrospect, this wasn’t the right opportunity for me.

August-September 2020

  • Opportunity: Work solo in a high-end FFS office (multi-location practice)
  • What happened: Owner rescinded the contract after my lawyer approached them to negotiate terms. This was really disappointing, but again, a blessing in disguise. An owner should stand behind his/her contract and negotiations. Continue reading for Associate Contract Red Flags below! 

September-October 2020

  • Opportunity: Work solo for an out-of-state owner in a newly purchased office (DSO startup)
  • What happened: Purchase of the new office took too long. Communication was lacking, leadership was disorganized, and I felt strung along. 

October-November 2020

  • Opportunity: Associate position for large DSO
  • What happened: A large DSO opened a brand new office one mile from my house. The owner is spectacular and ultimately I accepted the offer! 

What a journey! From a prospective partnership, to a rescinded contract, to visiting an out-of-state DSO startup! Although the process felt like a rollercoaster, it ended up being an incredible opportunity to explore different dental practice models. 

Ultimately, I signed on with a large DSO that opened a brand new office one mile from my home. Between the ridiculously easy commute (seemingly impossible for the DC area!) and hitting it off with the owner, this was an easy decision. To top it off, corporate agreed to the daily minimum I requested, making me feel valued!

Job Search Advice

A few pieces of advice that I have gleaned along the way:

Stick to a protocol: Use an attorney to negotiate contract terms as necessary. Don’t shy away from negotiations…you want to work for someone who recognizes your value. I stuck to my guns, and ultimately, the offer I accepted was the strongest financially!

Ideally, your attorney should have specialized experience in reviewing and negotiating associate/employment agreements. As you search for a lawyer, consider using Phil Bogart (contact info below), who regularly counsels new dental grads!

Baltimore, Maryland 21202-1636

t: 410-347-8710

m: 410-852-9380

Compensation: Do your homework to determine what’s fair. I contacted a Dental CPA to find out what the average daily guarantee for a new associate was in my area (see the upcoming Resource Directory for more expert advisors). I also spoke with classmates about their daily guarantees and percent production/collection. Using this information, I provided my prospective employers with a range. Together, we used this range to devise a mutually agreeable compensation package.

Ask the right questions: A regional owner revealed that I asked the best questions he ever received from a prospective associate! [They were really quite simple!] I asked: What is your vision for the office in 5 years? What makes your top associates successful, and how can I emulate them? For established practices, consider asking: Why are you hiring an associate? Have you ever had an associate before? [One owner I spoke with had 4 associates in 5 years! 😳] Why is that associate no longer with the practice? Do you have enough patients to support another dentist? 

Keep all options on the table: I had MANY interviews that did not materialize into a job. Until you sign a contract, you should consider multiple employment opportunities. 

Below is a list of associate contract red flags that I wish I knew about earlier! I compiled this list with the help of four colleagues, who also began working immediately upon graduation.

Associate Contract Red Flags

  • Draw: Clarify if your offer is a daily guarantee or a daily draw. If you’re paid on production/collection, sometimes you will be offered a daily draw. A daily draw is a set amount of money you receive each day (usually in the form of a bi-weekly paycheck). Once your actual production/collection is calculated, you will receive a paycheck that settles the difference. In other words, you may actually produce more or less than your daily draw. Upon reconciliation, you may owe money (in the event you did not produce enough to meet your daily draw) or be owed more money (in the event you produced more than your daily draw). 
  • Hours: Be sure you are compensated per workday, not simply clinical time. I have heard horror stories of offices that stack patient appointments in the morning, and then tell associates to go home in the afternoon. Then, you are only paid for 1/2 day.
  • Compensation after Termination: This can be a source of contention; however, you are entitled to your share of production/collection after you leave. To avoid disputes, you may ask for an explanation of billing/collections. Upon termination, request a current accounts receivable report showing all open accounts for your work.
  • Termination of the Contract: Know consequences of quitting, besides the restrictive covenant. For example, if your contract is for one year and you quit before the year is complete, do you owe your daily guarantee per day that you are no longer working with the practice?
  • Restrictive Covenants/Non-Compete: Try to negotiate a shorter time frame and smaller radius, if possible!
  • Re-Work: Look closely at how re-work is handled (i.e., dental work that you completed but needs to be re-done after you leave). You do not want to be financially responsible for re-work years down the road. Nor do you want to pay a premium for re-work!
  • Leave: Consult an attorney to ensure that the proposed leave follows state/local law. My county requires employers to provide a certain amount of paid sick leave.
  • Indemnity: Try to get rid of this clause! Indemnity means you will pay the losses, damages, or liabilities incurred by the practice if they are sued. Consult your lawyer for more information.
  • Anything that contradicts what an owner told you in-person: The written contract trumps all verbal agreements! 
  • Some additional thoughts: Who gets paid for radiographs? How much does an associate generally make here? What types of appointments will you be seeing? (If it’s primarily emergencies and hygiene checks, you’re agreeing to a losing battle in terms of your growth as a dentist and paycheck!) If you are paid solely in terms of production, how will the office account for variables out of your control, like marketing and scheduling? 

I hope my crazy journey to secure an associate position provides you with the clarity I was lacking after graduation. Dental school does not prepare you for this! Rather than stumble along, check out the Resource Directory for a curated list of experts to help advise you after graduation.

What other questions should prospective associates ask during an interview? What are additional contract red flags? Comment below!

DISCLOSURE: This is a sponsored post by Phil Bogart, Esq. of Whiteford, Taylor & Preston, LLP. All reviews and opinions expressed in this post are based on my personal view.


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