The PERFECT time to Bring in a Dental Associate | DBTN # 8

[00:00:00] Hey everybody, welcome to Dentistry Beyond the Numbers My name is Dr. Marc Liechtung. Thank you so much for joining me today on this continuous ride and trying to really figure out our wonderful, wonderful profession. Today is an action-packed podcast that's been a question that I've been asked many, many times. They'd say, Doc, when's the right time to meet a bring-in associate?

[00:00:30] 55 and I'm 65. When do I do it? When's the right time, what type of an associate? So today I want to address a few different stages in our careers. And what would be the optimal time for us to bring in an associate, what type of an associate? Does the associate just do feelings? Do I want them to take away from my revenue? Had I incorporate them with my staff? Do I have to overlook their shoulder and make sure that ground preps are right? Do I have to call the lab? Make sure the margins on the impressions are perfect. This is what

[00:01:00] we're going to talk about today. So let's get started everybody, I'm so excited. This is probably one of the more important aspects to growing the practice. You know, a dentist, we have two hands. We can do as much as we can in our

[00:01:18] opportunities, but ultimately we are limited. By bringing an associate, we expand our ability to perform dentistry in our practice. We are assuming, first of all, in all cases we're talking about today that we have enough

[00:01:36] space to bring on an associate. So let's give that a given, whether we're three chairs, four chairs, eight chairs, we have enough chairs to bring on an associate. I want to address today, like I said in my intro, to narrowing it down

[00:01:51] to three different categories because I think those categories seem to depict exactly what I'm looking for. And what we're looking for when we go to hire an associate.

[00:02:04] Let me tell you what I'm talking about. Let me give you an example as we get started. First would be, if I'm at 35, 34, 38 year old doctor in my, the onset of my career of owning a practice, the beautiful

[00:02:20] practice, wonderful location, beautiful windows, great waiting room and I'm doing great. I have the space and the patients are coming that I want to expand. I want to grow and I want to really hit the mark, hit the ball out of the

[00:02:37] pop with my practice. But like I said, you know, the doctor knows that in order to increase procedures, they have to increase doctor schedule. So they decide at that stage in their career, they bring on an associate. What type of

[00:02:52] associate? In my green one associate that, you know, does what I do at 35 years old young doc building a great practice. He is she is looking for somebody almost there equal. They are

[00:03:06] looking to get production grow hours have two people that could operate in cases. Somebody would say bring on a specialist, but if you remember dentistry beyond the numbers when we talked about financial explanations, a specialist in today's world on a premolar or molar

[00:03:25] and who can now get 50% or more on what they're doing with those specialty procedures. An associate gets 28, 30, 32% and grow from there. Number one, somebody would say, well, it's not as good. Today we're taking that these doctors are trained and proficient in these procedures. So if I'm a younger doc growing my practice, I want somebody who could give me evening hours, morning hours.

[00:03:55] Somebody who give me the three, four days a week that I have an overage of hygiene patients. Let's say I have two day to hygienist that day. I want to start my practice with two doctors and we'll grow from there. It also gives me the ability to treatment plan with another doctor.

[00:04:13] I always feel that dentistry is phenomenal when you practice with somebody or with a group. You could corroborate and really evaluate different treatment plans that come along. A young doctor, you'll add hours and we'll add procedures because if I'm a doctor like I was when I practiced and I'm practice, I like doing restorative cosmetic some minor surgery but I was big into crannum bridge.

[00:04:39] My first associate, well my main associate was somebody who's able to do root canals proficiently, extraction and bone grafts. Things that I would hesitate or refer that person was able to capture some of the patients.

[00:04:53] So it worked out 10 years later. He's a mainstay in the practice and procedurally he's excellent.

[00:05:01] So I think the ability for a young doctor to bring on almost a pot and a rest but an associate increases revenue.

[00:05:09] Now let's look at the doctors been in practice for 2015-25 years, somewhere in the neighborhood of the mid-40s to the early 50s.

[00:05:20] They've been having really great years producing fabulous amount of dentistry quality. But they say you know I'm getting on, I want to position myself that I don't have to work two Saturdays a month or I don't have to work for five days a week.

[00:05:36] I want to bring an associate at this stage that I could slow down a little bit so I can prolong my career.

[00:05:44] By not working every Friday or Saturday, I give myself a four day work week and I bring on an associate but here's the problem.

[00:05:53] You see, I find that doctors don't want to give up the revenue. If Mary the patient comes to see me she needs three crowns, a couple of extractions, two implants and two crowns.

[00:06:04] I say wow, that's phenomenal. If I have an associate that could do those or most of those procedures in office while I'm doing other procedures, I'm increasing the revenue of the practice for the next 10-15 years of my practicing to let me have or position my practice to really being amazing to be able to sell it or to be able to transfer it or really just have the ability to bring on a cell phone.

[00:06:33] I need to bring on associates that will allow me to keep practicing for as long as I want.

[00:06:38] So the middle age doctor is looking for somebody who's really bringing on procedures that I may have referred out, shyed away from, looked for a specialist to come in but now I have an associate who's been trained in Rukinaw, does extractions and bone grafts.

[00:06:55] And I've never done in Visaline or I do very few of them now I'm bringing on somebody who's going to really be proficient and has really spent a lot of time studying and learning and doing a lot of clear aligner cases.

[00:07:09] So we have to evaluate our practice, see what kind of associate would fit into my procedures that I may be deficient or not doing.

[00:07:19] And that will allow that associate to gain a better book of business, be busier quicker by seeing patients that I may not see.

[00:07:28] So I'm not losing revenue in my hands, I'm actually gaining revenue because I'll have the ability to do things I really enjoy, do it proficiently and do it well while I'm in the other room I have an associate that I like very much doing things that he is she a very proficient in.

[00:07:45] So now I've got double guns blazing and it's phenomenal because the next stage would be an exit so if you understand we have the early hyper doctor that's looking for that really somebody who's equal with them maybe they're a little bit ahead but this is somebody who's going to add continuous continuous revenue and continuous quality to grow the practice.

[00:08:08] The second one so far is somebody that is looking to grow procedures, grow revenue allow the doctor to take a little time.

[00:08:17] So family is big in those ages as we hit our 40s they're older there we want to spend more time maybe want to travel a little more enjoy a little bit you know a weekend that's maybe a three four day weekend instead of a quick weekend.

[00:08:31] And yet the procedures that I was not doing we haven't associate that now carry the ball doing those procedures as well as others.

[00:08:41] What happens so it's really a big difference if you think about what kind of doctor we were looking for in those two different scenarios.

[00:08:50] The third aspect or the third scenario that I want to put forth today is that what happens if I'm 58 years old 60 years old I know about the groups I know about transferring in my exit but I'm a doc in a box.

[00:09:09] I'm a single doctor doing two and a half million dollars killing myself with a great hygiene program.

[00:09:16] Now big aspect if you remember what we talked about when dentistry beyond the numbers talked about EBITDA.

[00:09:24] EBITDA is formulated by taking all the things the operational costs but also calculating what it would cost to replace the owner doctor compensation.

[00:09:36] If I want to position myself and I'm 56 years old and I want to position myself for sale this associate might be totally different.

[00:09:45] First of all I would look for somebody that could take a lot of the work away from me to allow for the next two three years to be more balanced between doctor and associate.

[00:09:57] Ideally I'd be looking for somebody who within three four months can step in and do some of the things or a lot of the things me as doctor owner would do.

[00:10:06] The second thing would be that I am looking for somebody who is here for the long run whether I sell it or don't and maybe that person might be interested in taking it over so talking partnership could be a possibility.

[00:10:22] So these are different scenarios at different stages of our career to me they're all absolutely equal of importance and I being somebody who loves mentoring.

[00:10:35] I think at every stage we have to be an owner doctor and mentor because in order for doctors to be successful they need the tutelage of somebody ahead of them.

[00:10:46] They need to know that they could take those steps they could do those procedures they could take that little sort of gamble.

[00:10:55] You know I often say to my docs that work with me I often say that there's a cliff and I use this analogy in demonstrate there's a cliff in Jamaica in the grill beach it's called Cliffs bar and right outside the bar there's a little bit of a diving platform that you can see.

[00:11:15] That's one that you dive about two floors down into the water.

[00:11:21] You walk up you're feeling good you just left the bar you give all your faith to the gods and you jump in and land in the water.

[00:11:30] Dentistry when you're starting out in this associate and we will get into that down the road is very much like that you walk up to the cliff and you want to do two extractions, cure it and bone grafting and that is the time you say to yourself.

[00:11:44] If not me then who you have a doctor owner in the other room and that's so important as an associate.

[00:11:50] You want to be able to jump off that cliff as the doctor owner you want to allow your associates to be able to feel confident enough to be able to jump off that cliff.

[00:12:03] If not we will hire an associate but yet will be continuously doing all the work.

[00:12:09] So how do we incorporate an associate into a practice that's a whole nother level right now what am I looking for if I wake up Monday morning and I say I'm 50 years old I've got a fabulous practice but I'm killing myself look for an associate that's for the long hole.

[00:12:28] That does some of the procedures you might not be doing will always thought that you should be doing more I'm not talking about night gods and sleep out there.

[00:12:38] I'm talking about extraction bonewraps root canals and clearer liners I'm talking about things in my dental hamster that really elevate and and really put the practice into another level.

[00:12:52] This is such an exciting topic and so intricate in when we grow our practices what happens if we find a wrong associate these are all questions I ask you have you ever gone through that have you ever stage yourself to find an associate and after a week you're looking at your staffing is saying this isn't going to work.

[00:13:12] What do I do I don't want to revolving door great questions.

[00:13:17] These are questions that are asked every day in practices around the country what we need to do is make sure we fire the right associate make sure you're getting somebody that is congenial with your team.

[00:13:29] Make sure somebody that comes in and respects our team and then again make sure you the practice owner can work with that doctor can feel you know I'm going to tell you a little secret about something about a new york guy when I had a big

[00:13:46] practice on the west side. I would be a little bit skittish about telling people straightforward and not wanting to hurt their feelings today I feel like telling them straight up what's the problem not only helps them but I find their feelings are better because they feel I'm honest and I'm really straightforward with what they need to do to learn and get better.

[00:14:10] It's so exciting when you bring on associates I hope you look at this as some sort of a referral to what you need to do and when you need to do it because it's really important to make sure that doctor fits properly.

[00:14:23] So it's been great in review when you're first starting out you want somebody that your equal can grow together give the hours you don't want somebody who can't work on this day or comes late on that day you want somebody that's going to give you what you need.

[00:14:40] And obviously excellent dentist to produce great dentistry to grow second one somebody that looks towards the future. I'm 45 52 55 and I need somebody who's going to help me grow to the future procedures that I might not be doing and procedures that I might want to teach.

[00:14:59] And that person will grow to being a real cog in all wheel a real force in our practice and who knows where the future brings them. The third you're setting yourself up for an exit there's nothing wrong with that find the right associate let them stop producing that might require somebody with a little more experience maybe somebody who has a nucleus in town and brings with them maybe two 300 patients but whatever it is you need to be able to let go a little sooner than if that dentist is going to do.

[00:15:27] And if that dentist was a young dentist back in my 30s I hope you understand it I think it's a great topic to discuss and I want to thank you all for listening to me today again this is dentistry beyond the numbers and I want to say if you if you like it share please I would love to know topics that you're interested it there are so many topics to discuss.

[00:15:50] And remember like us on LinkedIn Instagram Facebook and any other social media platforms you see me on this is great I love talking dentistry I love talking dentistry beyond the numbers thank you very much my name is Dr. Martin I will see you on the other side all the best thank you so much.