Finding the Right Associate Doctor For Your Practice

If you’re a GP who is getting a healthy flow of new patients and retaining a decent amount with continuously growing recall, you will eventually run into a good problem: You need more help.

At some point, one doctor just isn’t enough.  There’s only so much one person can do, no matter how efficient they are. And if recall keeps growing, you’ve got two full-time hygienists and need a third. And then your schedule starts to get booked out, weeks or months in advance. Assuming you’re scheduling yourself efficiently – you’re going to hit a point where you need another doctor. It’s not a preference thing – it’s a math thing.

It’s time for an associate.

And depending on who you hire, and how you structure it, bringing in an associate can be one of the best or worst business decisions you make in your career.

The right associate can help you grow, improve service, expand treatment capacity, and even open the door to additional locations or partnerships.

The wrong associate? Get ready for the potential patient confusion and upset, possible clinical issues, staff conflict, and a financial mess.

And keep in mind, I’m using the words “right” and “wrong.” But…an associate who’s right for your practice situation may be the wrong associate for the doctor down the street.  So, it’s not a matter whether your potential associate is “good” or “bad,” it’s more a situation of how that particular associate fits your situation.

So, with all this in mind, if an associate is possible in your future or you are somewhere in the hiring process, what steps should you take to ensure it comes off well?

Table of Contents

• Step 1: Get Clear on What You Actually Need
• Associate Agreements
• Step 2: Decide What Skills They Must Walk In With From Day One
• Step 3: Build the Compensation Plan Before You Speak With Candidates
• Step 4: Get Prospects, and Be More Aggressive Than Most Doctors Are
• Step 5: You’re Hiring an Employee, Don’t Skip Your Normal Hiring Process
• The Bigger Opportunity

Step 1: Get Clear on What You Actually Need

Before you start looking for associates, you need a crystal-clear concept of what kind of associate setup you’re trying to create.

This is where a lot of doctors go wrong. They know they’re busy. They know they need help. But they haven’t properly defined what the associate is there to do.

And that matters a lot, because the type of setup you want determines:

• The type of doctor you’re looking for,
• How you’ll pay them,
• What skill level they’ll need from day one and,
• How they’ll fit into your long-term plans

Generally speaking, how you set your associate up falls under four primary models:

1. The Traditional Associate

This is the classic setup.

You, the owner doctor, want to keep doing higher-end work or the procedures you most enjoy, while the associate handles more of the day-to-day dentistry:

• Single crowns
• Fillings
• Maybe kids
• On-call coverage
• Bread-and-butter treatment

This can work very well, especially in a mentorship environment.

2. The Production Doctor

This is different.

In this model, the owner doctor shifts primarily into diagnosis, treatment planning, case presentation, and sales. The owner/doctor sees the majority of new and recall patients.

You diagnose and present treatment. Then the associate delivers the majority of said treatment you present. You may wish to keep some of these cases for yourself (i.e. large implant cases, FMR, etc.) and spend a little bit of time clinically every week. Really up to you. I know some clients who do and some who are full-time on diagnosis, treatment planning and presentations.

This setup works best in a higher volume office with strong flow, because one doctor selling treatment can often keep two production doctors busy. Why? Because in 99% of instances, the time it takes to sell a case is drastically less than the time it takes to actually perform the case clinically.

You might spend 30 minutes presenting a case that takes four or five clinical hours to complete. This is a powerful model when done correctly, which includes a) having the volume to justify it and b) having the right associate.

3. The Satellite Office

Let’s say you’ve purchased a second (third, fourth, etc.) location.  And this is a “satellite”, you’ll primarily operate out of your main practice. Well, you’ll need a doctor in this new location – which is the satellite setup. Different setup, different demands, different level of independence.

4. The “Quasi-Specialist” Associate

This is where things can get dangerous.

And to clear I’m not referring to bringing in a true dental specialist (i.e. Oral Surgeon, Endodontist, Periodontist, etc.), one day a week. That can work just fine. You’d also pay these doctors differently – which is a completely different conversation. To that end, you can always email me about this if you’re looking to bring in a part time specialist.

What I’m referring to here is bringing in another GP to do procedures you don’t or cannot do. For example, you don’t place implants and have no intention of learning how to do so. So, you hire another GP to come in and place them on your patients.

That can create problems financially and operationally if you structure it wrong. I’ve seen practices put a lot of marketing spend (money) toward those procedures, bring in another doctor to do them, pay them too much, and make less profit less than they were making prior to bringing in the associate! Sure, overall revenues are up, but they were more profitable when they used to just refer these out to the periodontist or oral surgeon and have the patient back to restore them.

So we have these four models. Which one are you looking for? You’ll need to clearly define your vision before your quest to find an associate begins!

Associate Agreements

Do you plan to use one? I’ve done podcasts about these, mentioned it in seminars and have also had many one-on-one discussions about the virtues of having a solid associate agreement. So, yes, I am a believer – to that end I feel an associate agreement is a critical item that protects both you and your associate.

I would get an agreement hammered out early on in this process. Obviously, you don’t have to settle on the exact compensation, hours, etc., until you finalize a deal with a new associate, but the general agreement should exist and be ready to go as soon as possible!

To that end, I have a 12-Page sample agreement available for download by clicking here! And remember it’s a SAMPLE. You’ll need your attorney to review, change etc. to fit your situation and locale, as laws vary state to state.  If anything, it covers a lot of bases and can act as inspiration for creating the ideal agreement for your practice!

Step 2: Decide What Skills They Must Walk In With From Day One

Once you know your setup, the next question is: What must this person already be able to do?

This is not the time for vague thinking.  You can always train someone to do more later.

But what are the non-negotiables on day one?

Do they need to:

• Be competent at bread-and-butter restorative?
• Do molar endo?
• Place implants?
• Work at your speed?
• Be able to produce at a high level now?
• Operate more independently?

And obviously the set-up/use-case for the associate (traditional, satellite, production, etc.) will help handle many of these questions.

If it’s a traditional mentorship-type position, you may have more flexibility. If it’s a production doctor role, you need someone seasoned enough to come in and go to work now – and they will be doing a lot of what you’re currently doing. So that’s a different candidate.

So I would make a real list:

• Bare minimum clinical requirements and,
• Ideal additional skills.

You need clarity before the interview process starts.

Step 3: Build the Compensation Plan Before You Speak With Candidates

This is another big mistake owner doctors make. They start interviewing before they’ve really worked out the pay structure.

That’s backwards.

You should know ahead of time how you want to set this up, and you also have to ensure it works for your practice! Things you’re going want to look at are:

• What percentage?
• Guaranteed weekly/monthly base? Per diem?
• Any Benefits?
• Are you contributing to their malpractice insurance?
• What’s your lab fee policy?
• What are acceptable production thresholds?
• Any long-term incentive or buy-in opportunity?

I’ll explain this below, but I have a comprehensive video on associate pay plans that you’ll find below. It covers exactly how to structure based on your specific situation.

In a nutshell, for a traditional associate or satellite setup, you’re usually looking at around 30% of collectible production.

That’s the key phrase: collectible production. Not fantasy production. Not some inflated number you never collect. If you finance a $10,000 case and the practice only ends up netting $8,500 after financing costs, you don’t pay 30% of $10,000. You pay 30% of what was actually collected ($8,500).

Now, can you structure a guaranteed base?  Sure. But however you do it, the formula has to make sense for you.

If the associate wants a high guaranteed monthly base, you are taking more of the risk. That means the upside should kick in later.  If they’re accepting a lower base, they’re taking more risk with you, and I’d be more generous on when incentives would kick in.

The point is: do the math before you make the offer. Not while the person is sitting in front of you.

And if you’re hiring a true production doctor, where you do the diagnosing and presenting and they do the dentistry, I would not pay them like a traditional associate. You absolutely can’t as they are now the practice’s main producer.

The number for a production doctor needs to be lower. Think more like 22.5% to 25%, depending on the setup. Why?

Because they’re not having to diagnose, present or sell their own treatment. They’re stepping into a productive, busy, schedule. They show up, wash their hands, put on their gloves, and go to work.

That’s a different financial model.

Now, when you throw out numbers like “22.5%” you may get laughed at! After all the DSO down the street offered them 30-35%.

Well, ask them how much they are expected to produce for the DSO. $40,000 a month? OK – 35% of that is $14,000/month or $168,000 a year. As your production doctor, they’re going to come and deliver high quality dentistry all day long producing $100,000+ per month and making $250,000 plus per year – again doing the type of dentistry (comprehensive) that you they’ll love. Many come around when you show them the reality.

If anything (again not to mention it too much), I cover all of this in the video below.

RELATED VIDEO: 🎥 How to Pay an Associate Doctor:

Need help structuring associate compensation?
This video breaks down how to pay an associate doctor properly, including percentages, guarantees, risk, and how to avoid compensation setups that look good on paper but create problems in the real world.

Step 4: Get Prospects, and Be More Aggressive Than Most Doctors Are

Once you know who you’re looking for and how the compensation will work, you’ll need candidates. And this is where I’d tell you something simple:

If you really want to find the right associate: you absolutely can. But…you may need to work harder at it than you thought.

Start with the obvious steps:

• Ask your staff, colleagues, study club, local dental society, supply rep, or other industry contacts if they know anyone,
• Post on various job sites (i.e. Indeed, etc.) And as an aside, do paid ads on Indeed.
• Post in dental Facebook groups,

That’s the first layer. If that doesn’t work, expand geographically.

If you’re in a rural area with a low supply of dentists, and can’t find people locally, advertise in busier metros in your state. Why?

Because some people in those cities may actually want out. A dentist in Miami may love the idea of moving to Tampa or Tallahassee.

A dentist in Manhattan may love the idea of upstate New York. A dentist in Los Angeles may be ready for something quieter and more affordable.

You don’t know until you ask. And if that still doesn’t work, go broader.

Depending on licensure reciprocity, (assuming it’s not too difficult), you may be able to advertise in nearby states as well. A lot of doctors artificially limit themselves to a 20-mile radius and then conclude no one exists. That may not be true.

Also, if someone is coming from farther away, do as much of the process virtually as possible before you fly them in.

• Interview them.
• Review cases.
• Check references.
• Talk philosophy.
• Get as far down the road as you can before travel becomes part of the equation.

Step 5: You’re Hiring an Employee, Don’t Skip Your Normal Hiring Process.

This is one of the most overlooked points. Doctors tend to treat hiring an associate as if it’s fundamentally different from hiring any other employee. And to a degree this is true, you’re hiring a doctor. But nonetheless – in most cases an associate will also be an employee and part of the team.

Which means they should go through your normal hiring line, they should be vetted properly and onboarded as you would with anyone else. In other words, just you would with a new front desk, assistant or hygienist, they should learn your office policies and understand how your practice works

Do not skip this because “they’re a doctor.” This can become a big source of confusion.

When evaluating a potential associate, there are a few “deal-breakers” you’re going to want to get a handle on quickly.

to get a handle on quickly.

I. Clinical Philosophy

This is huge. You need to know how they diagnose, treatment plan, what materials they use, how they think clinically and whether they’re in general agreement with how you practice

You don’t want to hire someone only to find you have vastly different treatment philosophies.

A great way to test this is simple: Take a few real cases. Remove your treatment plan. Show them the diagnostics and ask:

“How would you treatment plan this?”

If they are broadly aligned with your thinking, good. If they’re wildly off, especially in major ways, you may have a problem. Because again, the last thing you want is:

You diagnose and treatment plan a case and patient accepts treatment. And then, your associate walks in to see the patient and says, “I don’t think we need a (procedure name) on this tooth.” Or something of that sort. That is a disaster.

II. Clinical Skill

This matters far more than whether they’re outgoing and communicative.  Communication can be taught. Sales can be taught.

Unacceptable treatment is harder to recover from and can badly damage practice goodwill.  And after all, this associate will be working on your patients.

If you wouldn’t let them work on you, don’t hire them.

III. Long-Term Alignment

What do they actually want?

• Do they want to work for you a year and move on?
• Are they looking to associate (assuming it’s a good fit) for years to come?
• Are they looking to go off and buy a practice at any point?
• Are they looking for a path to partnership?

Your plan and their plan don’t have to be identical, but they can’t be completely incompatible.

IV. Partnership Expectations

If partnership is even remotely on the table at some point, do not leave it as a vague handshake idea. Spell it out. You’re under no obligation to offer them anything. But if there’s the possibility if things work out, you should explain how it might work (again, assuming things work out as an associate).

• What are the benchmarks?
• What’s the timeline?
• What triggers the conversation?
• What are the expectations?

Because if you leave it vague, six months later you’ll have unnecessary tension.

V. Once They Start, Maintain Oversight

Let’s say you hire them. Now what? First, I would not just drop a full schedule on them on day one.

Orient them. Let them see how your office runs. Let them get familiar with the environment. Remember: what feels normal to you is brand new to them. You may even have them assist you, or you assist them, for a short period.

I had a client recently tell me she assists all new associates herself at first, and I thought that was brilliant. It lets her see how they work up close. Because again, she’s going to let them loose on her patients!

Once your associate starts with a normal schedule, you’d still maintain oversight.

Meet with them regularly in the beginning. Weekly if needed.

And, a big one: Check their work.

Not in a demeaning way. Not in front of patients in a way that embarrasses them.

But check it.

These are your patients. You are ultimately responsible.

You might do some variation of: “Hey Patient Susan, I see you’ve met Dr. Smith. We’re so glad she’s here. Let me take a quick look… wow, looks great.”

That lets you validate the associate, reassure the patient, and maintain oversight at the same time.  If the associate can’t handle that? They’re probably not the right fit.

🎧RELATED PODCAST: All About Associate Doctors – Part I

Thinking about bringing on an associate, or already have one and it’s not going the way you hoped? In All About Associate Doctors Part I, Jeff and Sabri Blumberg break down the fundamentals of making an associate relationship work: when you’re truly ready, how to know if you have enough production, how to structure the relationship, how to onboard properly, and where practices often go wrong.

The Bigger Opportunity

Most doctors think about hiring an associate as a defensive move. You’re too busy, need help, are overwhelmed, etc.

That’s part of it. But the bigger opportunity is this: The right associate is not just extra labor. They’re a teammate.

And if the fit is right, this can open real doors:

• More clinical capacity
• Better access for patients
• More growth
• Additional locations
• Partnership
• Mentorship
• Eventual ownership opportunities for them
• And a stronger private practice model for you

That matters even more now, because many young doctors are not buying practices like they did twenty years ago. The ownership rate among younger dentists has been dropping steadily since 2005 Which means a strong private practice with a good owner doctor and a real path forward is more valuable than ever.
The right associate doesn’t just help you. You help them too.

And if you do this right, you can, together, build something a lot bigger.