The Million-Dollar Associate Dentist – Your Associate is More Important to Your Business Than You Think

In every dental practice, the owner dentist is the big cheese. They are the most important person in the practice but can also be the weakest link. If something happens to them, like an injury to their back or hands, that’s it. Game over. The practice has to shut down while the dentist goes on the mend; and if healing isn’t in the cards, long-term considerations need to be made. When this happens having a dentist associate on your team is so important. But whether the practice-owning dentist knows this or not, the associate dentist might be more important to their business than just filling in when the owner needs time off, sharing the patient load, or taking patients the principal dentist doesn’t want to work on anymore.

During a recent podcast interview, I visited with Chris Sands of the dental CPA firm, ProFi 2020. Chris provided some extremely useful advice that I thought should be shared.

When we talk about scaling a dental practice, it means maximizing the value of each dental associate in your practice. The more your practice can invest in your associates, and the more productive they are, the more revenue you can generate per operatory chair. Associates are the one asset a dental practice can rely on to scale their business.

As the office manager, you and your owner dentist’s first goal must always be to maximize your facility. A good metric to use is “revenue per chair.” Sands recommends anywhere between $35,000 to $40,000 per chair per month. It doesn’t matter if the dentist or hygienist is operating out of the chair. We can use the example of an office with ten operatories:

• $40,000 x 10 chairs = $400,000
• $4000,000 x 12 months = $4,800,000 of the revenue capacity of your office space.

There are many available avenues to create this maximization, but I will focus on how your associate dentist should be viewed as the “secret to practice growth” as well as what the office manager can do to aid in the development.

 

Three Reasons Why the Associate Dentist is the Secret to Your Practice’s Growth

• Associate dentists can be a lot of things to a successful practice. One role they play is risk diversification. It should be the mission of the practice manager and business owner to develop million-dollar-a-year associate dentists in their practice, which means they are producing anywhere between $80 to $85K a month (based on working 52 weeks annually).
• Associate dentists can be your debt payment plan. View this as what the owner dentist produces, plus the profits of what your associate dentists are producing. Anything above what it takes to pay for overhead (rent, paychecks, supplies, etc.) can go straight toward paying down the debts of your practice.
• In terms of the ultimate asset of an associate dentist, it is what they represent to a third-party buyer of the practice. Having an associate dentist diversifies the risk by creating some clinical duplication. If your practice only has one owner dentist, buyers see your practice as the riskiest business to buy. Much like the above statement about the solo dentist practice, the solo practitioner is the strongest employee and the company’s weakest link.

 

The Million-Dollar Associate Roadmap

For an associate dentist to become a million-dollar-producing dentist, we need to break down what it would look like for a weekly and hourly production goal.

Let’s assume your associate dentist takes four weeks off each year and works 32 hours per week.

• 48 weeks divided by $1 million = $21,000 net production each week
• $21,000 divided by 32 = $656.25 an hour in net production.

Three of the biggest opportunities to ensure that your dental associates are successful:

• Investing in your associate dentist’s clinical skill set.
• Weekly time set aside for dentist and officer manager mentorship.
• Work with them to increase their case acceptance percentages.

Office managers have a lot of influence and ability to help develop associate dentists. Here are just some ingredients for the secret sauce recipe:

• Always partner your new associate dentist with the strongest assistant in the office.

I can hear owner dentists everywhere gasping at the thought of this idea. Office managers, you might need to be the voice of reason on this one. Often, dentists are reluctant to give up their strong dental assistant(s) for a new dentist. But think about this for a moment; does it make sense to put a new practicing associate dentist with a new or inexperienced dental assistant and expect them to perform at the highest level of an effective, efficient team? Show your owner dentists the numbers and potential for growth if you give your best resources to your associate dentist. This is a great opportunity for your owner dentists to mentor a less experienced dental assistant and train them up. It is not forever but I do recommend a minimum of three-to-six months.

• Managers should dedicate several hours a week to shadowing and coaching their associate dentists during their new patient and re-care exams. Listen and coach the following areas:
  • Do they spend the first few minutes of the exam NOT talking about dentistry? The first 3-5 minutes of the exam is for them to build a connection and establish a relationship with the patient. Trust builds relationships. Trust increases case acceptance.
  • Listen for how many “minimizing” or “qualifying” words they are using during the exam and give them feedback on what you are hearing.  Coach them by giving recommendations to replace or omit those words.  Some examples of minimizing words that can be removed are:
    • Take a quick peek/look…
    • Little cavity/crack…
    • Just a…
    • I think…
    • Maybe…
    • Sort of…

• Listen to see if they are limiting diagnosis based on insurance coverage, or their perception of a patient’s pocketbook.
  • Help your associate dentist understand that insurance is nothing more than a form of payment. Insurance shouldn’t be considered during the diagnostic process.
  • Are they diagnosing and charting everything they see in the patient’s mouth?
  • Are they asking the patient’s permission to share with them everything they see?
  • Teach them to never judge a book by its cover.  You never know what is most important to a patient until you ask great questions and listen to their answers.

• Managers should be tracking all of the dentist’s diagnostics and case acceptance metrics. If you are not tracking these metrics, I highly recommend you start.  Some important numbers to know are:
  • What dollar amount each of your providers is diagnosing/presenting in treatment to patients each month?
  • What dollar amount of treatment presented was accepted (scheduled) each month?
  • What are their monthly case acceptance percentages?

• Office managers, sit down with your associate dentists monthly (at a minimum) to help them understand their metrics, and how you are measuring growth and success in delivering comprehensive care.

Take the time to talk through their gross and net production numbers. Explain the difference between gross and net numbers. Share with them examples of different types of credit and debit adjustments. Define the office policies around these and how the dentist can work to minimize them through proper documentation, end-of-day audits of the procedures they performed, and review the adjustments that were posted out to them for accuracy. Review their lab expenses and other overhead items they have control over, such as dental supplies. Share with them your office’s benchmark percentages in your variable expenses. Review their case acceptance numbers, what they diagnosed vs. what treatment was accepted. Talk through some of the new patients they saw that were not scheduled back for treatment and identify the areas of opportunity for growth.

The bottom line is, the more your associate dentists are encouraged to take on a leadership role in the business’s success, the more engaged they will be in helping you achieve your overall goals.

Having an associate dentist on your team is more than just a way to cover for the owner/dentist when they need time off. Associates are the secret to your practice’s success. You can maximize the value of each operatory chair to increase productivity and revenue while diversifying the risk in your practice and paying down debt. You must invest in your associate’s clinical skills, set time aside for mentorship, and work on increasing their case acceptance percentages. Don’t forget to partner your new associate with your strongest assistant and dedicate time toward shadowing and coaching them during patient exams. With the right approach, your associate dentist can become a million-dollar-producing dentist and help take your practice to new heights.

 

---

About the Author

Joanne Miles is one of Production Dentist Academy’s investment-grade practice business advisors, sometimes referred to as the Swiss Army knife of dentistry. As an experienced dental practice growth leader with decades of experience nationwide, Joanne is passionate about sharing proven methods that help dentists and their teams grow. In addition to business operations, she strongly focuses on team building, patient experience, and leadership development.  Joanne is a Lifetime member of AADOM and received her Mastership distinction in 2021.