Last week’s webinar, How Mentorship Can Enhance Your Career – No Matter What Phase You’re In, sparked so many questions that I couldn’t get through them all during the session! You can now watch the on-demand video.
During the session, I referred to our popular What Went Wrong blog series that looks at common mistakes during the practice transition process (and offers tips on avoiding those errors).
A few people asked how much it costs to buy/sell/join a practice through ADA Practice Transitions. See our full pricing – and submit your profile by the end of the year to lock in these pilot rates.
Read on for an extended Q&A.
What questions should I be asking potential mentors/mentees?
My colleague Dr. Sara Makary has some great insights into this. She recommends first determining what YOU want to get out of the relationship.
If you are a potential mentee, do you want to learn/perfect a certain skill? Perhaps you are interested in eventual ownership and want to learn how to run a business. Do you need to build confidence in interacting with your patients?
If you are a potential mentor, are you looking for someone who can eventually take over your practice? Do you want to teach a specific treatment?
Once you have set some goals, keep them in mind as you talk to potential mentors/mentees. Look for someone who shares your perspective and someone that you feel comfortable talking with. You don’t need to agree on everything, but you should be willing to listen to (and learn from) each other. A great way to test this is to discuss a complicated case.
And of course, if you are approaching potential mentors, ask if they have the time to devote to the relationship. Some may say they don’t. If that’s the case, respect their decision and ask if they know of anyone who might be interested.
I am a newly graduated dentist, and I have realized that my working speed is concerning to potential employers. How can I communicate to them that I will improve my speed, if they are willing to be patient and give me a chance?
Be upfront and honest – but also make sure you are always striving to deliver excellent care. Ask for two short one-on-one meetings a day with the owner: one first thing in the morning to prepare for the day’s cases, and a second to review the day and plan for the next.
And set periodic check-ins (weekly, at first, tapering to quarterly with time) to discuss how you are progressing. You should be able to demonstrate that you are increasing your speed.
Perhaps most importantly, once you get your chance, be sure to be on time and 100% present when you are in the office. Employers value conscientiousness and willingness to learn, and will help you with your speed if you show a solid work ethic and desire to improve.
How soon is too soon to begin looking into a mentorship and transitioning into a practice? I am in my D2 year, but I want to hit the ground running as soon as I graduate.
Your D2 year is the perfect time to start exploring all the paths your dental career might take! This is when you should talk to all kinds of dentists, in all kinds of practices, while keeping an open mind.
Talk to doctors working in practices large and small, urban and rural, general and specialty, at various phases in their careers. (Your local component or alumni network are great places to start these conversations.) Ask what they like (and don’t like) about their current situation and what they would do differently.
With that information, you can start forming a better picture of which path sounds right for you.
How do you go about finding a mentor during dental school, outside of faculty? What should you look for, since you may or may not have plans to work at that office?
Go to your local component meetings and talk to the dental leadership there. These doctors are usually very happy to talk to students and share their expertise! I recommend talking to several to get a range of perspectives and see who you “click” with. And once you find one, ask if you can review a complex case with them or meet them at their office. You certainly are not committing to working for them. In fact, many are not set up for an associate, but they are generally thrilled to have someone to talk with about the successes and challenges they have faced over the course of their career.
Is it advisable for a private solo practitioner to search for a new dental graduate for a 5-year associate position, with the expectation of purchasing when the owner is ready to retire in five years?
Sure! This can be a win-win for both sides and pose a great growth opportunity for both the practice and new dentist, while giving the owner peace of mind that their patients will be cared for by someone hand-picked to deliver continuity of care.
This associate-to-owner scenario is a bit longer than typical (they’re often closer to three years), but still very reasonable, especially with a new grad who will need a few years to afford financing a purchase. I would recommend a few key points:
Understand that it will take some time for that new grad to gain speed and efficiency
Put all your plans in writing and involve a lawyer. Especially with a five-year plan, make sure to establish how the practice will be valued, both now and in five years at the sale
Make sure the practice is ready for an associate! Do you have sufficient space, staff, and patients? How will you share patients, or will you need to attract new ones? Think this through and discuss it together. I cover all this in a blog post, What Went Wrong: The Practice Wasn’t Ready for an Associate.
Is there a standard non-compete clause? Is it different for specialists?
Non-competes, also called restrictive covenants, vary tremendously, especially between urban and rural areas. Part of this is because a non-compete is based on what is “reasonable” for the local market, and that can differ.
This post, My Restrictive Covenant Was Too Restrictive, covers some of the key points to consider when negotiating a non-compete that’s fair to both sides.
As an owner, is it advisable to consider mentoring a current dental student with the plan to eventually hire them for an associateship?
You absolutely can! As mentioned in previous answers, you may want to offer a dental student the opportunity to shadow you in the office to help them gain some mentorship and first-hand exposure to a real-world practice.
I would avoid promising a future associateship until they have reached their D4 year – any earlier than that can put too much pressure on the relationship, especially if a dental student is still (wisely) weighing all their options. Rather, offer to be their mentor. Give them a place to observe and ask questions and learn. As you get to know each other, if it develops into a positive working relationship, that’s a great time to start talking about an associateship!
I am an older dentist with an interest in retiring soon. I’m concerned that if I mentor an associate with plans to eventually sell, I run the risk that they may decide to leave the practice – and take with them a share of patients and staff. How valid is my concern?
This scenario does happen, unfortunately, but it’s almost always when the two sides have stopped communicating. Open, honest, and frequent communication about expectations and plans can help keep both sides aligned towards their mutual goals. If the relationship starts to falter, be honest with each other about why that’s happening.
Either way, you should definitely put all your expectations and discussed plans in writing in a formal contract at the start of the relationship. If you plan to retire in three years, put that timeline in writing, and stick to it. If they plan to buy the practice in three years, put that in writing, too, along with details about how the practice value will be calculated. The ADAPT platform provides guidance on how to structure these agreements.
What expectations should we have of a new grad so that both parties aren’t disappointed in progress and growth?
As described above, work together to set milestones and check-ins to track the new grad’s growth. Start with weekly and, as you two start feeling comfortable with each other, space them out as you see fit. But, most importantly, make sure that you are working together frequently, beyond those check-ins! Two quick daily meetings can help ensure that your new associate is thinking through cases while they’re fresh and give you the opportunity to offer your guidance and experience (and course-correct any looming problems). These quick touch bases should be just between the two doctors, and should be very focused on opportunities and challenges that the new grad faces as they integrate into the office.
Make sure you project full confidence in your new associate to staff and patients, as this will set the right tone in the office.
Any advice for taking a son or daughter as an associate with plans to transition into a sale?
With a family relationship, I would still make sure everything is in writing. Spend the time to create a written plan that ensures neither one of you is surprised (or blindsided) by the other’s expectations. By talking things through, you will learn to communicate with each other as professionals, not just family. This can be a very tough transition, but it can also be very rewarding. The resulting dynamic will help you work together and present a united front to staff and patients.
Even if the contract ends up in a file cabinet and is never needed, this is one time when the process is just as important as the result.
How long do you recommend to stay in the practice to provide a sufficient transition to the new owner?
This can vary. Ideally, if the office is set up for two doctors and both are excited to have the seller stay, the seller would stick around for a year or two, but that can take many forms. If the seller is gradually transitioning to retirement, you might structure an associate-to-owner transition in which the seller sticks around as an associate beyond the sale, decreasing their hours with time but still offering advice and mentorship.
However, sometimes the seller is simply done with clinical dentistry, especially if a health or family issue has cropped up. In that case, I suggest the seller find a buyer with a bit more clinical experience so that the buyer can jump in all at once, while the seller remains available for an occasional consult on the business itself.
I am a current D4 and just beginning to look for job opportunities. How would you recommend building a dental network and becoming involved in organized dentistry, especially during this COVID era?
Local components and state societies provide great networking opportunities throughout the year. Because of COVID, many of these events in 2020 have gone digital. Simply by showing up, you can begin building these connections. Look for a “new dentist committee” or similar to begin getting involved in organized dentistry. This can be a great way to meet peers just a few years ahead of you, who can offer advice as you navigate your job search.
Also look to your school’s alumni network. Some alums are very active and eager to interact with the next generation of dentistry.
I am about to join a private practice and the owner, who is willing to be my mentor, does not want to write a contract. What do you think about working as an associate without a contract?
Don’t do it! A contract is essential to protect your interests! Even if the owner seems great, you need to look out for your future. Scenario #2 in this post, What Went Wrong: 3 Contract Issues That Got Expensive, covers exactly this point, and we have an entire eBook, What You Need to Know Before Signing That Contract.
If the owner refuses to write a contract, capture everything you have discussed in an email and send it to them with a read receipt. At the very least, this should include:
How you will be compensated (including bonuses)
Any restrictive covenants or non-compete clauses
How you will divvy up coverage and other responsibilities
I never see listings for practice owners looking to mentor or hire for an associate-to-owner path. What’s the best approach to find these owners in the Bay Area, or any very competitive area?
As above, start with your local components and simply talk to owners in the area. Express your goals and ask if they might be willing to mentor you, or if they know a colleague who could be interested in an associate-to-owner path.
I would also recommend creating an ADAPT profile! Every day, I talk to owners who are planning ahead for retirement. Once you join, we might be able to find the perfect fit for your goals.
Given the industry dynamics, especially the rise of Corporate, Franchise, and DSO-powered practices, what is the future of solo or small group dental practices?
There is no doubt that the DSO model is here to stay, and it has been an attractive model for some patients and for some dentists. But many consumers express a significant desire for the "feel" of an independent solo or small group practice. And as mentioned during the presentation, fully 86% of surveyed D3s and D4s want to own within the next ten years.
I think the best corollary is in optometry. Solo optometrists almost disappeared but now you see them coming back because consumers were not universally satisfied with what corporations offered. I think that the solo practitioners will begin to form small groups in order to leverage purchasing power and equipment utilization. This is an interesting discussion and you can probably find answers all over the board, even within the ADA. In fact, the ADA Health Policy Institute is co-hosting a webinar with the Harvard School of Dental Medicine on December 17 to discuss how dental care is changing, especially in light of the COVID-19 pandemic.
At ADAPT we are committed to supporting independent practices and helping them thrive – particularly in rural areas where DSOs typically do not participate and the financial and quality of life benefits are unparalleled.
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