This article is for DSO and group practices that would like to retain associate dentists. If you rely on associates to be in charge of your practices then the following principles will help you keep them happy.

For many DSOs, they want to bring associates in, pay them on their production, and see the practice grow. That’s the dream but the reality is a little different. Here is a brief list of common problems I have seen inside these practices:

  • No clear vision of success for the practice they are working in.
  • No organizational structure for that particular office.
  • Elevated expectations.
  • No mentorship.
  • No leadership training.
  • No staff buy-in.
  • They are the wrong fit.

Let’s dive deeper into each of these issues.

Define a Clear Vision of Success

You may have created a clear vision for the organization but does each individual practice have one. Do the doctors and staff know this vision? Do they share it? This is the most crucial step for your organization. This isn’t setting a production goal or an increase in revenue goal. This is understanding this practices’ why. Why does the associate want to work there? Why does the staff want to come in every day?

As owners, you need a vision of success but the practice needs to share one with you. One that I saw recently was the organization had a vision that they would be viewed as a partner to the communities they serve. On the practice level, they wanted to create an atmosphere that supported the community through convenience, comfort, and confidence.

Keeping those three items top of mind gave the entire staff focus on patient care. In our goal to become a referral practice that’s the number one factor.

Create an Organizational Structure on the Practice Level.

Most DSOs have an organizational structure but do you have that in each office? It would seem logical that you could set the same structure for each practice. In some instances that might work but size and personnel can have an effect on this.

For example, you may have a great office manager that likes to be in charge. If you hire an associate that also likes to be in charge then you are going to have conflict. When we talk about hiring right we discuss using DISC profiles to understand the strengths of leadership and possible conflicts.

Generally, an associate who doesn’t want to be in charge isn’t going to be as eager to walk out the door to start a new practice but that doesn’t mean they won’t find a new employer. In contrast, one that does want to be in charge will look for their first opportunity to leave or start a practice of their own.

Set your practices up for success by doing DISC profiles on the staff so you can create the right organizational structure and hire the right associate for the job.

Create Realistic Expectations

Expectations can come in many forms but there needs to be clarity around what is expected. This comes from both ends. I tell clients to let the associates interview you. You can get a great picture of where their head is at by listening to their questions.

If they are expecting ownership at some point and that’s not something you ever plan to do then don’t respond with “Depending on how you do we can discuss that down the road.” Many people want to hire a great associate so they will keep things vague. A better answer would be “We provide leadership training and best in industry resources so you can run this practice and be the success you want to be.”

This can also relate to production. Don’t sell them on possibilities. “Once this practice is seeing 50 new patients a month you will be at the salary you want.” Be clear on how you are going to help them grow so they can raise their production.

Mentor the Associate

In most cases you have set-up a 90-day evaluation period or as I like to call it “a window of opportunity.” During this time one of the owning dentists or senior dentist leaders in your organization needs to have a presence in the practice. They should be shadowing the associate or vice versa.

In addition, don’t pack their schedules full. If they leave exhausted every day in those first 90 days they will probably want a change of pace.

Invest in Leadership

I could go on all day about the importance of leadership training. Having a solid leadership training program sets them up for success working with management, their team, and the patients they serve. This is the number one complaint I hear from associates. They still have to be great producers but they have never been trained to manage teams and deal with the human elements of running an office.

Most DSOs push back on this as they feel they are investing in someone who will take the training and leave to start their own practice. This can be very shortsighted. Think about great head coaches. It’s probably a hassle for them to have to hire new offensive and defensive coordinators. But it makes hiring the next ones easier when you show them what working for you can bring them.

Great leadership builds a great practice culture. Once you have that you have a referral-based practice that patients love coming to regardless of the associate. This builds more stability than creating ownership for a doctor who will want more and more control of their practice every day. Invest in leadership!


Click Here to Get Started With a Leadership Plan for Your Associates!


Generate Staff Buy-In

In reality, your staff is what your patients care the most about. If the staff truly likes and respects the associate as a leader that will reflect to the patients. Confidence from your patient base is key and not having staff buy-in can be detrimental to the growth of the practice.

Do communication workshops shortly after a new associate is hired so the team and associate both buy into the practice vision. It also makes it hard for an associate to leave if they truly like the people they work with. The “grass is always greener” mentality dissipates the more they love the practice they are working at.

Find the Right Fit

I can’t stress enough finding the right person for the job. I teach clients how to cheat at this to be successful. We use the DISC to evaluate behavioral styles and values.

For example, if you look at Doctor A’s DISC profile and it shows a high S and C then most likely they will be great with patients and great with details. That would seem like a great hire but if they are a low economic and a high altruist they could very well end up giving away dentistry or not treatment planning what they should. Conversely, a high D with a high political will want to be in charge. If you have a high political and high D office manager then you know you are going to have problems.

I’m certainly not saying the DISC is the only tool you should use but people are good at selling themselves these days so it’s nice to have a neutral tool to help understand them.

In conclusion, your associate dentist needs you to lead them. Do not throw them to the wolves and assume they will get it one day. Train them on your culture and give them the level of responsibility that best suites them. With leadership training and the right support staff, you will help them build a business they love. That will make it hard to leave.



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