Tips for Entering Your First Practice

You are out of school, and it’s time to begin your dental career. Where will you start? Have you found a place to work? As multiple questions run through your head, let’s discuss some tips that will help you navigate through the “what’s next” phase so you can start in the right direction.

Gain Experience

Working for an existing practice will help you gain the experience you need to develop your skill sets as well as well help to build relationships with patients without the concerns or challenges of a business owner.

Do Your Research

When researching the best place to practice your associateship, it’s important that you take your time so you can find a practice that is a good fit.  Don’t rush into an agreement if there are any uncertainties. Here are a few examples (not comprehensive) of what you should be discussing during the interview process:

• Clearly communicate your income goals
• If you’re interested in purchasing the practice down the line, share your intentions
• Be honest about your skill sets and comfort level
• Inquire about the mentoring dentist’s clinical philosophy. Will you be expected to follow his or her guidelines fully?

In order to find a good fit, open communication is essential. After covering your key areas, the mentoring dentist should also clearly communicate his or her expectations. Such as production goals, required schedule, transition plans, compensation, as well as the role you are expected to play in relation to the staff. Again, these are only a few examples; you should seek as much clarification as you need to confidently make a decision.

Begin Your Journey with an End Goal in Mind

Do you plan to own your own practice someday? Speak with your potential employer about the possibility of buying into or purchasing the practice in the future. Negotiate a guaranteed salary when you begin work at the practice.  After nine months discuss basing your salary on the amount of business you bring to the practice.

Take Time to Consider Location

Pay attention to the location of the practice in which you are considering for your associateship. Ultimately, of you plan on owning the practice, its location will determine your future patient base, and how your revenue stream will look.

Develop Your Team

Begin relationships with bankers, CPAS, investment broker, attorney, and insurance agent as well as dental brokers. It’s never too early to establish a strategy with a team of advisors that can help you elevate to the next stage of your career. Also, building relationships with other employed team members can be beneficial later on in your career.

Have a Plan

The key to successfully transitioning out of dental school is to have clear vision of the direction in which you want your career to go. With any professional journey, obstacles are inevitable. By having clear goals and a long term plan in place, you will remain on track for a successful future.

For more information, contact our office at 844-DENT CPA (336-8272) or info@dentalcpas.com 

Note: The content is accurate as of the date published above and is subject to change. Please seek professional advice before acting on any matter contained in this article.

Dental Associate Agreements

Here is a guest blog post from our friend Carl Guthrie from ETS Dental.

Associate Agreements (contracts) can suffocate us at a time we should be reveling in a new opportunity.  However, many dentists don’t understand what is in their contracts, in turn complicating the process and turning this joy of new opportunity into a whirlwind of anxiety and trepidation.

This article is not intended to be legal advice.  

ALWAYS consult an attorney or legal expert in your jurisdiction.

Here are a few points to pay attention to when reviewing your Associate Agreement:

1. Employee or Independent Contractor:  Regardless of the debate on what is technically legal or acceptable by the IRS, make sure you know which status you are agreeing to.  If taxes on income are not paid correctly, it could come back to bite both the associate and the practice.   Consult a CPA or Attorney on what is correct for your situation.

2. Compensation: Are you going to be paid on collections or on production?  These two do vary, but don’t get stuck in the mindset that production-based income is the only way you will accept to be paid.  Keep in mind that even if you are paid on production, many practices will adjust your future paycheck if there are any unpaid patient balances or write-offs.  In essence, you are being paid on collections anyway.

3. Notice Period: The length of termination periods are widely becoming 30 or more days long.  We’re seeing more and more asking for 60 to 90 days notice.  Understand what is required of you to terminate your employment with a practice.  

4. Restrictive Covenants and Non-Compete Clauses: Dental practices will protect their interest by requiring you to agree to some sort of restrictions upon the termination of your employment.  They will restrict you from practicing dentistry in any capacity within a certain distance for a specified length of time.  There will be other language that restricts you from soliciting patients or staff for a specified time period.   Distance varies upon geography.  For example, rural areas can have 20 miles or more of a restricted zone, while a metro area will be 2 to 5 miles.

5. Lab Expenses:  Most practices are paying these costs; however, make sure to ask if you will be paying for any lab expenses.  There is no real standard on this in the industry.  Practices will have associates pay for half or an amount equal to the Associate’s percentage of pay.  Also, make sure you understand the formula for calculating your pay with lab expenses.  You want the lab expense to be deducted from the total production prior to calculating your percent of pay.  {Pay = % of production * (Production – Lab expense)}

These are just a few of the “biggies” that develop in contract negotiations.  Again, refer to your attorney for precise legal advice.

Posted by Carl Guthrie, Senior Dentist Recruitment Consultant with ETS Dental. To find out more, call Carl at (540) 491-9104 or email at cguthrie@etsdental.com.

Making a Dental Associate A 50/50 Equity Partner

Lately we have been hearing from dentists and associates about the feasibility of creating a 50/50 partnership. Before this is contemplated there are some questions to be answered and considerations to be weighed.

Here are a few that we feel are important:

•   Is your practice large enough patient base wise for two full-time doctors?
•  Is the physical space larger enough for two doctors to work at the same time or will you be doing a split schedule?
• Is your business house (the practice systems, processes, etc.) in order?
• Is your personal house (any legal issues with either party such as pending divorce) in order?
• How long has the associate worked with you and are you comfortable with his/her practice style?
• Why did you hire the associate in the first place? Was it simply for coverage so you could cut back, or was it to have an in-house buyer when you are ready to retire?
• How does the associate’s patient base compare to yours? In other words has the associate been given insurance based patients and smaller/routine cases compared to your fee for service bigger ticket cases.
• Is the associate going to be a 50% owner immediately or over a period of years?
• As the original owner allowing a 50/50 partnership, are you willing to give up or share control of the practice you built?
• Is the associate capable or willing to take over any administrative duties you currently perform?
• Does the associate get along well with your staff and patients?
• Has the associate added to the growth of your practice?
• How will you share the new patients?
• Does the new doctor perform any procedures that the seller doesn’t and vice-versa?

For further information, please contact our friendly and wise Dental CPAs at (800) 772-1065 or info@dentalcpas.com

How to Find an Associate Dentist Job

Here is another guest post from Morgan Pace of ETS Dental.

Whether you are a dental student, an exiting resident, or just returning to the job market, the task of finding an associate dentist position can be daunting. This is an attempt to provide a centralized resource to help you land a job. For more updates, tips, and helpful information, follow up on our Facebook fan page, Twitter, or on this blog.

Step 1. Make a Plan.

As outlined in the following blog link, the key is to be flexible. It is best to determine what your options are before narrowing your focus on the best fit. Job Hunt Tips.

Obviously location is important, but don't waste the crucial first years of your career in order to live in the heart of the city. Here is an overview of area limitations on a job market: Where are the Jobs?, and a real-life example is outlined here: The Grass is Always Greener. If you absolutely have to live and work in a saturated market, here are some strategies to help you land a job: Saturated or Difficult Markets.

Step 2. Prepare Your CV and Cover Letter.

Generally speaking, CV/resumes are overrated, as are cover letters. Still, they are a necessary evil when breaking into a job market. It is important to stand out from the crowd, but make sure that it is for the right reasons.
Here is an example of a well-written cover letter: Cover Letter Sample.
And here are instructions on writing your CV/resume: Resume for Dentists.

Step 3. Applying.

Here are several online sources for dentist jobs:

• ETS Dental Job Listings
• Indeed.com Job Listing Aggregator
• Careerbuilder
• DentalTown Classifieds

Step 4. Interviews.

The Telephone Interview:

• Return your phone messages and emails promptly. It speaks to your motivation, interest, and courtesy. Don't let returning phone calls or emails become an issue or an obstacle to getting an interview. Even if you don't think you will be interested in an opportunity, return the call. On more than one occasion we have seen a candidate get a call from Practice B when he was already talking with Practice A. The candidate puts off returning the call to Practice B. Two or three weeks later, the opportunity with Practice A does not work out and now Practice B will not consider the candidate because no calls have been returned.
• Your main goal in a telephone interview is to get a face-to-face interview.
• Ask for the interview. Take the initiative to set a time. Say something like, "From what you have told me, I would be very interested in meeting with you and coming to see your practice. When would be good for you?"
• Smile- even on the phone. You really can tell when someone is smiling.

Here is some additional reading on phone interviews: Tips for Phone Interviews.

The Face-to-Face Interview:

Don't go in blindly. Be sure to prepare in advance. Look over this article the night before:Preparing for the Interview.

• Treat the staff with courtesy and respect. A practice owner often feels like his or her staff is like a family and will listen to their opinions, especially if they are negative. On more than one occasion, we have seen excellent candidates not offered an opportunity because they treated a staff member poorly.
• Smile and show some enthusiasm. More candidates are hired because of their personalities and positive attitudes than because specific clinical skills. One high-end cosmetic practice told us they had interviewed six different dentists. They hired the candidate who smiled and appeared to truly enjoy being a dentist, passing on more experienced candidates with less personality and enthusiasm.
• Show sincere interest in the hiring dentist's situation. Understand that the dentist needs to solve a problem. Maybe the practice just lost a key associate or partner. Maybe the practice is growing and cannot keep up with patient demand. Maybe the dentist needs someone to take over the practice when he or she retires. You need to get a clear understanding of the dentist's true motivation for adding an associate. Once you truly understand the needs of the hiring dentist, you can mutually determine if you are the solution.
• Send a thank you note after the meeting. Here is a great example of a post-interview thank you: Thank You Note.

Still nervous? Here is a full blog post on interviewing: Interview Tips.

Step 5. Reviewing Contracts.

A good overview of contracts may be found here (the most relevant information is on the last page of the article): Compensation Considerations.

Step 6. What Can You Expect to Earn?

• There are several good sources covering realistic dentist earnings. Here is our own: How Much do Dentists Make?
• The Levin Group publishes an annual survey in Dental Economics. The 2012 version can be downloaded here: Levin Group Survey.
• The ADA puts out its own numbers, also: ADA Income and Gross Billings.

Step 7. Plan Your Relocation.

If you need to relocate, be sure to plan it ahead of time. Here are a few key points to ponder as you plan: Relocating Tips.

Finding a job can be an intimidating process. I hope these resources will help make the process easier. Please feel free to call us should you have any questions. We are always happy to help.

Posted by Morgan Pace, Senior Dentist Recruitment Consultant with ETS Dental. To find out more, call Morgan at (540) 491-9102 or email at mpace@etsdental.com.

For more information, please contact info@dentalcpas.com

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Interview Tips for Dental Associates and Specialists

Our friend Carl Guthrie of ETS Dental has kindly allowed us to share these valuable interview tips for dental associates/specialists. If you are looking for a dental practice to join, your first call or email should be to Carl.

Be open to a variety of opportunities. Go to every interview you can. It never hurts to talk, and an opportunity may turn out to be more than you expected. You can learn from each interview even if it doesn’t lead to a position.

Be open to other locations. The Law of Supply and Demand applies to career and practice opportunities. Typically, the farther you get away from a Dental School, the better the opportunities. Many of the best opportunities are located in great communities just forty-five minutes to three hours away from major Dental School cities. Typically you can increase your earning potential from 10% to 100% by settling in a city or community that is underserved.

Get your references ready. They can be former employers, co-workers, or teachers. Contact them to let them know to expect some calls. Have all their contact information in one place.

Have your production numbers ready. If you do not have production numbers, then have something that will give the hiring doctor a good idea of your skill set, speed, and experience. If you are just getting out of dental school or a residency, your procedure log may be a good substitute.

Consider preparing a "Proof Book" containing:

• A current CV/Resume
• Case presentations
• Before and After photos
• Production numbers or equivalent
• Accomplishments
• Treatment plans
• Letters of Recommendation
• References
• Blank paper for notes
• Questions for the practice
• Blank Thank you notes

You may never have to open it, but it demonstrates preparedness and professionalism; this will set you apart from other candidates the practice may be considering.

The Interview

Because you are looking for a long-term position, it is as important for you to interview the prospective employer as it is for them to interview you. It is good to have some questions prepared. This will show interest and give you information you need, as well as take some pressure off the interviewer.

Questions for your interviewer:

Note: Do not lead off with questions about compensation.

• What are your treatment philosophies?
• What would be expected of me as an employee; what role would I be expected to fill; would I be limited to certain types of cases, such as endo or pedo, etc.?
• Tell me about your patient base: families, geriatric, pediatric, etc.
• What demographic changes have occurred with your practice in the last ten years? What changes are on the horizon?
• Do you actively market or depend on referrals?
• What kind of equipment do you use?
• What about your practice are you the most proud of?
• Where do you see the practice in five or ten years?
• What are your personal and professional goals?
• What are your goals for the practice?
• Are you referring a lot of certain type of case out of the practice?
• What specific things are you looking for the new Associate to bring to the practice?

The telephone interview

Return your phone messages and e-mails promptly. It speaks to your motivation, interest, and courtesy. Don’t let returning phone calls or e-mails become an issue or an obstacle to getting an interview. Even if you don’t think you will be interested in an opportunity, return the call. On more than one occasion we have seen a candidate get a call from Practice B when he was already talking with Practice A. The candidate puts off returning the call to Practice B. Two or three weeks later, the opportunity with Practice A does not work out and now Practice B will not consider the candidate because no calls have been returned.

Your main goal in a telephone interview is to get a face-to-face interview.

Ask for the interview. Take the initiative to set a time. Say something like, "From what you have told me, I would be very interested in meeting with you and coming to see your practice. When would be good for you?"

Smile--even on the phone. You really can hear when someone is smiling.

The face-to-face interview

Treat the staff with courtesy and respect. A practice owner often feels like his or her staff is like family and will listen to their opinion, especially if it is negative. On more than one occasion, we have seen excellent candidates not offered an opportunity because they treated a staff member poorly.

Smile and show some enthusiasm. More candidates are hired because of their personality and positive attitude than because of specific clinical skills. One high-end cosmetic practice told us they had interviewed six different dentists. They hired the candidate who smiled and appeared to truly enjoy being a Dentist, passing on some more experienced candidates with less personality and enthusiasm.

Show sincere interest in the hiring Dentist’s situation. Understand that the Dentist needs to solve a problem. Maybe the practice just lost a key Associate or Partner. Maybe the practice is growing and cannot keep up with patient demand. Maybe the Dentist needs someone to take over the practice when he or she retires. You need to get a clear understanding of the Dentist’s true motivation for adding an Associate. Once you truly understand the needs of the hiring Dentist, you can mutually determine if you are the solution.

Ask for the job! If you are interested, let the owner know you are interested. At the close of the interview say something like, "I just wanted to let you know that I am very interested in this opportunity and I am ready to take the next step, whatever that is. How should I proceed from here?" This doesn’t mean that you will accept the job with no further discussion. It simply shows you would be sincerely interested in discussing contract terms or meeting with other partners, consultants or staff members as needed.

After the interview

Thank you notes. Always send a Thank You note after an interview. Buy Thank You notes prior to going to the interview. Make sure you get a business card from everyone you speak with so you can verify the spelling of their name, their title and the correct address. Immediately after the interview, drive to the local post office or collection box, write a brief Thank You and mail it immediately. Do not put it off. If your timing is right, the practice will get the Thank You note the next day. Even if you don’t want the job, it is professional and impressive to thank your interviewer for his/her time.

Call the practice in two or three days. If you don’t hear anything from the practice after a few days, call them and let them know you are still interested. You will never loose out on an opportunity because you acted too interested.

Working Interview.

Offer to do a one- or two-day working interview.

Send your questions to Tim Lott, CPA, CVA at tlott@dentalcpas.com

For more information or to sign up for our newsletter, please contact arose@dentalcpas.com

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Why does becoming a dental associate have such a bad rap?

Here is a guest blog post from Dental Tranistion Specialist Joe Spencer.

It all comes down to trust. New dentists often don’t have any idea how to find a practice to join. They call look over the classified ads and call on them, only to find that a great majority of them lead directly to brokers. The brokers, of course, are happy to have them call so they can talk with the senior dentists in their area hook the new dentist up with a senior dentist (and collect a 10% fee for doing the transition legwork).

Here’s that problem: If a broker is involved, the senior dentist is the one that pays the fee. The senior dentist is the one who has representation. The broker is working for the senior dentist. It is in the broker’s best interest to get the contract in place as quickly as possible so the upfront portion of 10% fee can be collected quickly. This may lead to a lack of full disclosure by the selling dentist’s broker.

Another reason is that having a middleman between the two prospective partners makes it difficult for the parties to grow trust. They don’t talk directly with each other from the start. The broker might say that the work of screening applicants is too much for most dentists to put up with. With innovation, they drag can be reduced, and the benefits of personal contact will outweigh the convenience of having a third person in the middle of the relationship.

See, associateships are a special kind of partnership. They should be a bit like a master Jedi teaching an eager young Skywalker. The master teaches the young Jedi the inner workings of the business side of dentistry. There is no more efficient way. Years of dental school teach the clinical side. The business side must be learns from journeyman.

The difficulty is when some senior dentists feel they want to offload all the drill and fill to the new dentist. The new dentist gets the low margin unexciting stuff. That is the way of an apprenticeship. The difficulty is that the relationship is not well defined. Expectations are not clear.

Building trust is the answer. Openness is the answer. Clear expectations put in writing are the answer. Build trust with your potential partner from the start… In a recent FastCompany article, scientists have proven that interaction through electronic means can build trust as if interacting in person. OnlyTheBestPractices facilitates building trust from the start, through openness and defining expectations. No matter if someone uses our tools or not, if clear expectations were well defined (in writing) through spirit of apprenticeship, associateships could once again be seen as a great option coming out of dental school.

The question is… are senior dentists willing to bring someone in for a period of time to teach them the best practices in running the business? Would senior dentists prefer to just practice up to a date certain and walk away? If that becomes the norm, owner-associateships will fade into history, and only employee-associateships will remain. At some point the word associateship will probably just fade out too.

This first appeared on OnlyTheBestPractices.

Send your questions to Tim Lott, CPA, CVA at tlott@dentalcpas.com

For more information or to sign up for our newsletter, please contact arose@dentalcpas.com

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