Ending the Dental Divorce Cycle

One quickly out being of of hired—a four dentistry's most associateships associate staggering dirtiest relationships end 75% little within failure secrets one rate. fail; is year Sadly, three how

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in sharing this statistic with experienced practice owners, they mutter under their breath and then say the 75% number is low, based on what they have lived through. Some have only seen a 100% failure rate while hiring five or six associates over twenty years.

Compounding this is how private practice dentistry is under attack behind the scenes at dental schools. Corporate dentistry is recruiting most quality dental grads, telling them the feefor-service practice is dead. Deans at dental schools we know personally share their experience that 90% of associateships fail within the first year, so why not just jump into a DSO knowing the opportunity will be short-lived, but what else can they do?

This inability for private practices to successfully bring on new associate doctors who fit and stay is an enormous waste of money, lives, time, effort, and expectations. Our estimate for the cash opportunity cost of each failure ranges between $100-200,000, based upon the size of the practice. The additional "cost" of patient reputation, owner frustration, and staff disharmony substantially increase that cost.

If practices had a 75% failure rate with implants, we would demand a solution. However, hiring an associate isn't a part or a

piece of equipment. This is a human system—and human systems are fraught with difficulty because we are in the middle of them.

Based upon over ten years of experience, the reason this failure rate has been so profound and prolonged is that the owner-associate relationship has been viewed with a false set of assumptions. The parties that have led the charge for years in finding and hiring new dentists have viewed this as a business relationship. It's not.

Besides the real thing, bringing on a dental associate is the closest thing to an actual marriage we know of in business. Even medical doctors do not experience this level of associate failure because they practice on "parallel tracks." Occasionally, their paths intersect, but they often practice independently of other doctors. However, in a dental practice, the doctors are in each other's "sandbox" all day long. Not only is dentistry an intimate experience for the patient, but it is also an intimate relationship for the doctors.

Honesty, values, personality style, views about money, work ethic, and developing clinical respect and trust for each other make or break associate relationships even when there is plenty of patient volume to go around.

If approaching this like a marriage is the solution, how can that happen for a busy practice owner who may already be running faster than they have strength and time? The answer boils down to one word used through a dating, courting, and marrying process:

CLARITY. Clarity has allowed our firm to achieve a 90% success rate in associate hiring over the past ten years, and while it seems like magic—it just works. It can work for you as well.

• There first must be clarity of readiness. For instance, if the goal is to replicate the owner/doctor and not replace them, carefully determine:
• Is there a practice within the practice? Could opportunities you have let slip in the past be capitalized on with additional clinical capacity?
• Has volume reached a point of busyness where the owner/doctor is booked out for two months or more?
• Is new patient volume sufficient to be diverted 2/3 of the time to the new associate?

The next point of clarity is “fit” with the practice culture, clinical needs, and practice leadership team. Detailing—before you even begin searching for candidates —the characteristics of the ideal candidate allows you to maintain a laser-like focus through the interview and surveying process. As candidates check off these boxes, include your team in interviewing. Including them in the process gives them buy-in to the outcome.

Having clarity of expectations and rewards for meeting them is next. It is vital to know the path you will take to get this new doctor busy, what type of dentistry you want them to be doing in the future, the mentoring and CE model you'll employ to raise their skills. You must know how to structure a win-win compensation package leading to eventual ownership, if that is the desired outcome.

Finally, with these other points in place, maintaining clarity within the relationship helps dramatically toward a successful "dental marriage." Being able to discuss issues as they arise—and knowing which topics need talking about—is critical. We've found having a third party engaged in the relationship monthly for at least a year and a half, acting almost like a marriage counselor, helps keep expectations in line, communication open, and budding partnerships on track.

A client of ours, Dr. Matt Harmon in Sun City West, AZ, found that he was burning the candle at both ends—and slowly burning out. Dr. Harmon's practice had reached a performance level he had only dreamed of a few years earlier. Now he was working twelvehour days, four days per week—and not letting work go, even when he was not at the practice. This impacted relationships at home, and his health was also being affected. The looming question that prevailed in his mind, however, was: can I find an associate who fits with my team, patients, and me, who we will really enjoy working with..? Or do I just keep my head down, hate my life, and risk a divorce for the next ten or fifteen years until retiring?

From our experience, this is a question almost all busy practice

owners ask themselves. The horror stories they have heard of associateships consistently failing, and costing a ton in doing so, lead to a fear of even considering bringing on another doctor. Dr. Harmon needed to be convinced the process worked because, understandably, his practice was "his baby." Once he gave the green light, the recruiting phase began, and several candidates applied. Clarity was THE standard throughout the entire process, and eventually, the hired associate fit in every sense of the word. Dr. Harmon is now in the process of hiring a second associate, using the same tools from before, no longer fearful that he will end up with a dreaded dental divorce.

Each day tens of thousands of private practice owners are heroes to their patients, delivering outstanding care while growing their practices. Nonetheless, they are left wondering if they will ever be able to replicate themselves with a successful associate relationship or transition their practice at the right time, in the right way, to the right person. Hiring right is not an inherent strength among practice owners. However, over the past ten years of placing rightfit associates who stay and become a great asset to the practice, we've found a 90% success rate by allowing this process to dictate the outcome.

Hope is here. There's a solution that works. It all starts with viewing the relationship in another light, knowing who will fit and why, and then using the process to make the hiring decision. It also means including your team, establishing win-win agreements, being clear about expectations, and the path to practice ownership (if that's the goal). Finally, third-party participation in the relationship is vital to long-term success to ensure the relationship stays on track, expectations remain clear, and molehills—which always arise—do not turn into mountains. Now is an exciting new day for individual practice owners, recent graduates, DSO doctors wanting a much better opportunity, and private practice dentistry as a whole.

Bryton Nield’s passion is impacting as many lives as possible by creating and supporting successful businesses. He does this by helping create successful teams founded in communication, upside-down leadership, and by creating clear expectations, goals, and metrics. His firm, Dentist Hiring Pros, is taking the dental industry by storm by transforming the industry-standard associateship’s 75% failure rate and flipping this on its head to a 90% success rate. He can be reached at Bryton@DentistHiringPros.com.