Monday, April 29, 2013

What Percentage of Production Should a Dentist Pay an Endodontist?

I was hoping for some recommendations for how to pay my Endodontist. 

We are a GP practice, and for the past year we've hired an Endodontist to work a couple days a month for us. We have given him 37% of production of his specialist fees; however recently he wanted to know if we would give him 50% of production of his specialist fees.  I guess this is what he is used to receiving as an associate at endodontic offices, however I didn't know what was standard when an endodontist works in a GP office.  

He pays for no instruments, materials, equipment etc, and has his own chairside assistant at no expense to him. 


Generally 45-50% of COLLECTIONS. 

If they want payment on production make it adjusted production.

Friday, April 19, 2013

Expectations of Dental Associateships

Here is another guest post from our friends at ETS Dental.

Associateships begin and fail everyday. Why do they fail so often? A simple way to answer this is that either or both sides failed to meet expectations.More specifically, the expectations were never even laid out at the beginning, so one side was letting down the other and never knew why or that he/she was doing this.

Some common feedback I get from owners when I ask them about their previous associates is that it didn't work because that doctor could not produce enough, or that doctor did not want to buy-in, or that doctor needed more mentoring than owner was willing/able to give.

Upfront communication during the interview process could have helped a lot of associateships succeed better, or simply never start in the first place. It is better to find the right person rather than hire the wrong person and have to repeat the interviewing and onboarding process over and over again.

What the owner/practice should lay out upfront:

(simple examples, not comprehensive)

  1. Production goals

  2. Required schedule

  3. Transition plans

  4. Associate's leadership role in the practice in relation to staff

  5. Compensation

  6. Whether the associate will have any say so in equipment, office systems, and staff management

  7. Insurance accepted by the practice

  8. Particular cases or situations which must be handled by the owner

  9. What must be referred out

What the associate prospect should lay out upfront:

(simple examples, not comprehensive)

  1. Income goals

  2. Transition or practice ownership goals

  3. Skill sets

  4. Comfort level with various cases and patient types

  5. Length of time willing to commit to a practice/area

Remember not to rush into hiring an associate or becoming an associate when you still have a lot of questions or uncertainties.

Related articles by ETS Dental you should check out:

  1. Will My New Associate Be Here In 6 Months?

  2. Associate Dentist Interview Tips

  3. Can your Dental Practice Support an Additional Dentist as an Associate or Partner?

  4. Resources for a Practice Owner Preparing to Interview Associate Candidates
Carl Guthrie is a Dental Recruiter with ETS Dental. He covers the Western U.S. Region. Carl can be reached at or

For more information, please contact

Friday, April 12, 2013

Top Employer Concerns for 2013

This is a guest post from our friends at Bowie and Jensen law firm.

Many employers may be surprised to learn that their personnel policies and procedures may actually violate the National Labor Relations Act, especially if they operate in a union-free environment.  Here are the top concerns employers should be made aware of in 2013. 
Employee Manual Language
Under the National Labor Relations Act (NRLA), non-union employees have the right to engage in concerted activity for themselves or on behalf of other employees with similar concerns or complaints regarding the terms and conditions of their employment.  Protected Concerted Activity can include two or more employees addressing their employer about improving pay, workplace conditions, and safety.
This year the National Labor Relations Board (NLRB) is cracking down on the language employers are using in their employee manuals regarding concerted activity.  Language that was previously considered standard may now violate the NLRA. 
At-Will Employment Policy
Some of the common “at will” language used in basic employee manuals now violates the NLRA by discouraging “at will” employees from engaging in protected concerted activity.  Previously, at-will employees were essentially signing a waiver agreeing that their at-will status could never change and thereby foregoing their rights to advocate concertedly. 
The following two examples show the common wording that the NLRA now finds non-compliant:
“I acknowledge that no oral or written statements or representations regarding my employment can alter my at-will employment status, except for a written statement signed by me and either Company’s executive vice-president/chief operating officer or Company’s president.”
“I further agree that the at-will employment relationship cannot be amended, modified or altered in any way.”
The NLRB, however, has said that the following disclaimer language in handbooks is lawful:
“The relationship between you and the Company is referred to as ‘employment at-will.  That means your employment can be terminated at any time for any reason, with or without cause, with or without advance notice, by you or the Company.  No Company representative has the authority to enter into any agreement contrary to that employment relationship.  Nothing in this handbook creates an express or implied contract of employment.”
Those examples may appear that the NLRB is splitting hairs, but at least the agency has provided some guidance to employers which should insulate them from liability for unfair labor practice charges.
Social Media Policy
One of the biggest mistakes that an employer can make in 2013 is assuming their social media policy is NLRA compliant.  Many employers prohibit employees from posting comments that may be damaging to reputations of a company or employee. The NLRB recently found that such policies violated the NLRA. One thing employers can do is make sure their social media policy clearly states that it is not intended to restrict concerted activities.  The social media policy may include examples of activities that violate the policy and definitions of the terms used in the policy. 
Criminal Background Check Policy
Employers who frequently obtain background checks or consider arrest records should review their policies. The Equal Employment Opportunity Commission (EEOC) is aggressively pursuing compliance with its 2012 guidelines on when a criminal conviction can disqualify an applicant from employment and when it cannot.   In addition to the EEOC, the Maryland’s Job Applicant Fairness Act also regulates the use of credit and criminal records for employment purposes.
Fair Credit Reporting Act
Starting January 1, 2013, enforcement of the Fair Credit Reporting Act has been shifted from the Federal Trade Commission to the Consumer Financial Protection Bureau.  Employers will be required to use new FCRA forms.  These forms can be accessed at the Consumer Financial Protection Bureau’s website.
Confidentiality Directives during Internal Investigations
NLRB has declared that a broad statement to employees that the contents of a complaint and/or investigation should not be discussed with co-workers violates the NLRA.  Employers must now show that the need for confidentiality outweighs the employee’s NLRA rights.
It is possible that an open discussion regarding a complaint or other matter would cause a cover-up of the issue.  Confidentiality is more important in instances when an employee needs protection, evidence is in danger of being destroyed, or a testimony could be fabricated. 
Employers cannot simply prohibit discussions about internal investigations.  Each case must be evaluated by the above factors before employers can prohibit employees from discussion of an investigation with co-workers.
Implementation of an Effective PTO Policy
An effective Paid Time Off (PTO) Policy should be included in the employee hand book and outline various procedures; including how much notice does an employee have to give before taking PTO and how much of an employee’s PTO can be carried over from year to year.  Employers should make sure that paid leave is earned on an accrual basis and also address whether unused PTO is paid upon termination.  In most instances you can dock hourly employee’s pay and refuse to permit them to use paid leave if they fail to provide proper notice of an absence. In addition, there are also many situations when exempt employees pay may be docked for full day absences. 

Monday, April 8, 2013

Can a Dentist Announce That They Will Not Hire a Smoker?

Here is another guest post from our friends at ETS Dental, authored by Tiffany Worstell.

We all know the effects that cigarette smoking has on a person; it has been shown for years in the media.  We have seen the yellowing teeth, bad breath, wrinkles, and probably know individuals that have had even more detrimental health issues stemming from the activity.  More and more, smoking is being banned in public places and employers are following suit.  So what does this mean for your practice?

Can I legally not hire smokers?
A number of employers have gone on record announcing that they will not hire smokers. And, while this sounds as if it the company is promoting a culture of wellness, it can be construed as discrimination.  In fact, there are twenty nine states and the District of Columbia that have protection in place for smokers; below is a list of the states as reported by the American Lung Association. 

District of Columbia
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Rhode Island
South Carolina
South Dakota
West Virginia

If you are hiring in these states, it is illegal to base your decision to hire, or not to hire, simply on if the candidate is a smoker. You can, however, choose not to hire a candidate based on other, legal, factors.   Frankly, you may miss out of some great talent by limiting the pool based upon if the candidate smokes as the single factor as the CDC found that 19% of all American adults were smokers in 2010.
What can I do as an employer?
As an employer, it is within your right to ban smoking on your property.  While this will not stop the smokers completely, it will deter the activity on company time and in front of your patients.
It is also worthwhile to look into cessation plans for your employees.  If your dental practice currently offers an EAP (Employee Assistance Program), look into the benefits that it provides and encourage your staff to take advantage of the services.  

Another option to consider is a having cessation program available. The American Lung Association endorses its own program, Freedom From Smoking, as an option for employers to provide to their staff; it allows the employee different options to cater to their own lifestyle such as online support, a hotline, and one on one support.  For more information, check out this site: Freedom From Smoking.
With the right resources and encouragement; you can make a difference in promoting a smoke free workplace while retaining quality staff.  Monitor the results of your efforts and listen to the feedback of the staff members.  It is possible to have a happy, healthy staff.  A happy staff is a productive staff; and that is not just “blowing smoke.”  

Contributed by Tiffany Worstell, Dental Staff Recruiter- Nationwide. 

To Contact Tiffany, call 540-491-9112, or email at

For more information, please contact