Bringing on an Associate? Avoid Making These 3 Mistakes

Bringing a new associate into your dental practice should mark a time of growth, increased patient access, and a lighter load for the senior dentist. But too often, it becomes a source of stress, patient dissatisfaction, or internal conflict. Why? Because integrating a new associate isn’t just about filling a chair—it’s about ensuring alignment, training, and accountability from day one.

In working with dental practice owners across the country, I’ve seen three common mistakes surface repeatedly. These aren’t just small oversights—they’re critical errors that can undermine your practice’s reputation, team morale, and bottom line. Fortunately, each one is preventable with the right strategy.

Let’s take a closer look at these top three mistakes and how to correct them.

Mistake #1: Allowing Associates to Do Their Own Exams and Diagnoses Without Proper Training in Treatment Presentation

One of the quickest ways to lose production and patient trust is to place an associate in front of a patient without first ensuring they can effectively present treatment. This is almost always done as soon as the Associate is hired. Not only are they given the responsibility of providing treatment to patients (the primary reason you should be hiring an Associate), they are also immediately entrusted with patient exams in hygiene, or worse, new patient exams scheduled for that day.

Yes, your new associate likely graduated with honors and can diagnose periodontal disease or failing restorations. But treatment planning is only part of the equation. The other part—often the harder one—is treatment presentation: communicating the why, how, and value of care in a way that builds trust and compels patients to move forward.

Without training, even the most clinically skilled or experienced associates may struggle to convert diagnosed treatment into accepted care.

This often results in:

• Lower case acceptance rates translating into less revenue for the practice
• Confused or skeptical patients
• The appearance of inconsistency between providers, damaging trust

The fix: The initial utilization of your Associate should be limited to providing treatment already diagnosed.

Ideally, the Associate begins with more basic single unit dentistry to alleviate your treatment schedule and allow you more time to sell. Your associate should not touch exams whether for recall patients on the schedule or new patients coming in. Instead, provide structured training in case presentation before the associate sees patients independently.

This should include:

• Observation of the owner or lead dentist presenting treatment
• Scripted drills to practice key conversations
• Training on financial discussions and patient objections
• Observation of the Associate presenting treatment by the owner or lead dentist to ensure the desired skillset is achieved prior to allowing the Associate to perform exams solo
• Tracking of the Associate’s Treatment Presented vs Treatment Accepted to maintain oversight
• Regular listen-ins on exams done and treatment presented to check for additional more fine-tuned training as needed

Don’t assume case presentation is intuitive. Make it a requirement before any associate begins diagnosing or treatment planning on their own.

We offer extensive training on our DDS Success Platform and strongly recommend to all our clients that they run their Associates through the tutorials as a key step in integrating the Associate into their practice.

Mistake #2: Hiring an Associate Without First Aligning on Treatment Philosophy

Many practice owners look at an associate’s resume, personality, and schedule availability before asking the most critical question: Do we practice dentistry the same way?

Treatment philosophy isn’t just about clinical technique. It includes:

• When to watch vs. when to treat
• Conservative vs. comprehensive approach
• Preferred materials and labs
• Emphasis on prevention vs. production
• Communication style with patients and the team

If these philosophies are misaligned, here’s what happens:

• Treatment that should be done isn’t done simply because it wasn’t diagnosed or presented
• Confusion among patients who see different treatment recommendations depending on the provider
• A potential undermining of your treatment style and philosophy resulting in discord and frustration for you, your team and your patients

If your office is accustomed to scheduling comprehensive treatment, suddenly you may find that you are doing bit and piece dentistry which not only causes issues with your schedule but also cuts into your potential production and collections

The fix: During the interview process—not after—discuss clinical scenarios and see how your potential associate responds.

You can ask:

• “How would you treatment plan a cracked molar with no symptoms?”
• “What’s your approach to early periodontal disease?”
• “How do you handle patients who are on the fence about elective treatment?”

If your treatment philosophies align – great! Moving forward, and as an extension of the Associate’s treatment presentation training you should also do the following:

• Select patient cases ranging from simple to complex and share the case with the Associate leaving out your treatment plan. Ask them to lay out what they would diagnose and how they would treatment plan the patient. Then do a side-by-side comparison. Discuss any discrepancies so the Associate understands your why and can adjust their treatment planning to align with your philosophy.
• Regularly review the treatment plans made by the Associate once he or she has begun this process to ensure consistency in treatment philosophies

By doing the above with each Associate you ensure consistency in treatment planning and a greater experience for the patient and your team!

Mistake #3: Skipping Quality Oversight by Not Doing a Proper Working Interview

Too many practice owners rely on the resume, references, and maybe a casual working lunch to determine whether an associate is the right fit. But until you see how they actually work, you’re guessing.

A working interview allows you to observe:

• Their clinical technique and speed
• How they interact with the team
• Their confidence (or lack thereof) with patients
• Their diagnostic patterns
• Their adherence to your office systems

Equally important, it gives your team the chance to weigh in. Your hygienist might notice a red flag in patient communication. Your front desk might catch poor documentation or inadequate handoffs. And these perspectives matter—especially when the new associate will be sharing the same patients and support staff.

The fix: Structure a working interview that includes:

• At least one full day of patient care where you and the Associate share in the treatment of the patients scheduled for that day – from the viewpoint of the patients it’s their lucky day. They get two for one!
• With each patient, wherever possible, set it up so that you can begin the treatment and pass it over to the Associate and then be in a position to finalize treatment. A simple example would be working on a patient who needs multiple fillings – you could do the first two and the Associate could do that last two. Of course, where this isn’t possible or would be inappropriate from a treatment perspective you would not do this.
• A follow-up debrief with the associate
• Anonymous feedback from your team

The goal is not only to verify that the associate meets your clinical standards but also that they enhance your practice culture.

Bringing It All Together

Hiring and integrating an associate is one of the most important decisions a dental practice owner will make. Done right, it can boost productivity, create scheduling flexibility, and improve the patient experience. Done poorly, it can erode the practice you’ve spent years building.

To avoid the three common mistakes outlined above, here’s a simple checklist before onboarding a new associate:

• Train before you trust: Ensure they are proficient not just in diagnosis but in presenting treatment effectively.
• Talk treatment philosophy early: Align on how you practice before contracts are signed.
• Work before you hire: A working interview is your best opportunity to spot red flags and confirm the fit.

Remember, integrating an associate isn’t just a hiring decision—it’s a leadership opportunity. Take the time to do it right, and you’ll build a team that serves patients consistently, grows your reputation, and shares your commitment to excellence.

Want Help with Your Treatment Presentation or Case Acceptance?

We offer workshops and coaching to help you and your associates thrive in your practice from day one. Contact us to learn more.