Those of us in practice for 40 or more years know that finding an associate doctor that is a good fit with the practice can be time consuming and difficult. In my small town practice, when a candidate appears, all parties are motivated to “make it work”. However, hiring the wrong person is worse than hiring no one. Following is a list of points to consider before signing a contract. Some of this comes from the school of hard knocks and some from Bob Salvin of Salvin Dental Specialties. Bob is one of the smartest and most helpful men in the business and is a wonderful resource in the hiring process.
Winners attract winners - First and foremost, do you like the candidate and do they like you? If married do you like the spouse? If you do not feel you have the personal skills to asses this area, request that the candidate have a meeting with a clinical psychologist and let you pay for an assessment and share it with one another. This can save you huge amounts of gut lining and dollars in the long run. If the candidate balks at this request let them go to find another office. Do candidate and spouse both want to live in your area? Why? Where does the rest of the family live? When the first grandchild arrives the in-laws will push hard to have the baby nearby.
Watch, Listen, Learn - If your initial response is positive, require that the person spend at minimum, two days in your office watching how you work. Set aside several hours to listen to what the person has to say about what they observed. The ideal candidate will have many questions.
Does the candidate have a similar work ethic to yours? Do they show up for meetings and observation on time and in appropriate dress? Did they observe the personality styles of clients and staff? Do they have the clinical expertise and/or experience to understand the variety of procedures demonstrated? Do they display the characteristics of a lifetime learner? Be honest with yourself and the new doctor about what you expect. Explain the standard of care that you expect to be delivered. Create a detailed job description of the associate’s role, share it and use it as a discussion tool. Explain what will happen if the doctor does not meet your criteria. Most students will have no idea that you expect them to make follow up phone calls to patients, that you expect them to go to chamber of commerce or Rotary club meetings, how many hours per week they are expected to be in the office and that you expect them to participate in things like study clubs and continuing education on their own time. Put in writing your expectations regarding dress, internet use, texting and phone use as well as how staff is to be addressed. Assume nothing, discuss everything.
Does the candidate have a work history or are you going to be providing their first real paycheck? No work history is a big red flag. How do they feel about the workload and speed that will be necessary if they are hired? Do they understand the difference between completing the needed work to a high standard of care and completing the work in a manner that creates a relationship and leads to a long term client?
What about the money - Does the candidate have any financial knowledge? Does the new doctor understand that it is likely you will lose money employing him/her during the first year? Does the spouse understand this? If not, take a pass. Candidates just getting out of school know that corporate dental practices are paying between $120,000 and $130,000 as a starting wage in a metropolitan area. If your practice is in a part of the country where living costs are lower, does the doctor understand finances enough to know that a slightly lower wage might still be fair? Wage discussions should always include the spouse. If both parties are not capable of, or not interested in, the discussion of wages, pass on the candidate.
Don’t hope for the best - If you get this far and everyone is still feeling good and is excited to put things into a contract, don’t. Check references. Pay to have a through background check. Call every reference and listen carefully for what is not said as well as what is said. You should request permission to perform both a credit and criminal background check. Simply say, “Before we move on to creating a contract we are going to conduct both a credit and criminal background check.” “What will we find?” If there is a lack of truth at this point what can you expect in the future?
Be accountable - If you have gotten this far and things still look good, follow through. Provide a fair, businesslike contract as you said you would, when you said you would. Don’t expect miracles. Most associate positions are a money loser in the first year. Are your ready to give up patients to a new provider? If not, you are not ready for an associate. Do not expect the new doctor to generate enough clients to keep busy for quite some time. If you promise to be a mentor follow through. Create a meeting schedule where you will be available to review cases, discuss questions and quietly listen to your new associate every week for 90 days, then every two weeks for a year and then hopefully, monthly forever. Nothing except a death in the family should be allowed to violate this time. Hold your associate accountable in the same manner. Create a log of your discussions so you can refer to it in the future and not lose track of your path, have a record for legal use if ever needed.
Trust and respect – These two items will develop over time if you commit to being accountable. Just as with your client base, it takes time and commitment from both parties to develop trust and respect. We build an emotional bank account based on listening, honesty, kindness and accountability. Open ended questions about what your associate expresses as a preferred future are important listening points to assess how the process is going. Occasionally there will be withdrawals from the account. However, it the account stays positive and keeps growing you have a potential partner or practice buyer in the making. You can teach the clinical skills necessary to deliver excellent care. However, your potential associate’s character has been molded early in life and no matter what they say it will not change much over time.