“… it was all great fun and a professional challenge working with you to adapt what I knew about physicians and other providers to the dentists which you represented. We had a ball working together, didn’t we? Thank you, Randy, for (your) kind words. It’s what I always hoped my adjunct teaching position would accomplish, and you should be very proud of how you picked up the ball and ran with it.” L. Edward Bryant, Jr. writing to me recently. Ed is a long-time friend, mentor, colleague and my all-time favorite professor during my LLM in Health Law at Loyola (Master of Laws in Health Law). Recently, at a wonderful breakfast near Evanston, we talked about old times and new, and I thanked him for his comments. I share those comments here in part because they mean a great deal to me and in part to hopefully inspire new LLM’s to follow their interests in developing their health law career and to have fun while doing so. Ed was honored for his early and significant contribution to health law development and transactions when the Beazley Institute for Health Law and Policy established the L. Edward Bryant, Jr. National Health Law Transactional Competition.
Most practice owners and prospective associates want to find a fair compensation approach. The devil, of course, can be in the details and that ticklish word “fair”. What is fair for the practice owner is an associate providing the best care he or she can and participating with staff in the life of the practice, including marketing / social media or practice management. Regarding what is “fair” for the associate is a compensation format where the owner identifies the normalized practice overhead (adjusted to true expenses not including those that are discretionary or tax driven), any additional expenses related to bringing on the associate, and the profit hedge desired based on the associate’s anticipated collected gross. Associates should have an understanding of the process the owner used and can evaluate the offer against their own break-even analysis given their comfort level with the anticipated collected gross the owner has arrived at. Here at Berning & Affiliates we have applied all of the above and have well developed cash flow worksheet that assist owners and prospective associates to arrive at a fair associate compensation.
As a practice owner you may be thinking that now is the time to hire an associate. Assessing the option of adding an associate can originate in a wide set of situations from having a growing practice and wanting help to a semi-retired doctor with excess time on a schedule. No matter your situation the suggestion is to list
1) the personality, capability and maturity a candidate must have to successful fit into your practice. Way too many practice owners miss this thoughtful assessment and end up with a good looking or great qualification candidate that does not fit.
2) Write out your philosophy of care and put it in front of the candidate and ask, “Can you accept this and live it?” Remember, it is your attitude toward ethics, choice of treatment methods, and practice building that must rule. If you don’t tell it, then you may have a big disconnect later!
3) Determine if you want a “pair of hands” to do dentistry or need a candidate with an interest in management and practice administration.
A lot of practice owners have be smart building their practices. They need smart younger doctors to fit in and keep building. Quite different are the doctors that tell me they do not what anyone messing with how the practice runs, “so find me an extra pair of hands”. Take some time and reap the benefits of these three must do steps. Call if you want to schedule a Tackle It! Consulation to talk it through for your practice!
Most dentists are interested in how to have a successful practice relationship with another doctor. Yet when presented with a prospect too few have prepared ahead.
My view is that it is in the preparation that solid long term partnerships can be built. For the practice owner at the early point of considering a dental partnership here are a few tips: #1 consider your objective(s) is it to have one or several partners and for what reason (expand practice or open satellites etc.), or to plan an exit path for the founder or something else? #2 do you want to have control even with a partner(s)?, #3 what would your ideal candidate be like? Now seek out an advisor, practice transition consultant, accountant, attorney or your significant other and talk through these early considerations. If you are not clear on these you will have difficulty later when it comes time to structure the transaction.
Way to many practice owners who start looking for an associate jump the gun. What do I mean? In short they have not prepared. Here is a suggested preparation list to get
you thinking. First, have a clear statement of your philosophy of care. You can’t talk about what is important for you and your practice if you haven’t or worse can’t articulate your philosophy of care. Second, be prepared to discuss, to the degree you are comfortable, your practice performance, including new patient flow, type of procedures, demographics and need for an associate as it relates to each of those items. Third, lay out your vision for the practice and why you are looking for a compatible personality and character in a new associate to join with you. This format has worked wonders for us at Berning & Affiliates and will help you to build a successful relationship.
Way too often Doctor CEOs and I talk about the sometimes clue less behavior of younger professionals seeking associateship, partnership or practice purchase opportunities. Here is an example. Practice owner pays for the airfare for a candidate to visit the practice, pays for the hotel, pays for two days of meals and takes time away from family to meet and interview the doctor. Many, many days after the visit the prospect texts, “Thanks again for the weekend visit! By the way could you help me out and send me some materials we discussed?” WOW! Anyone heard of a personal call as a follow up, or an email, or a note saying thank you? What about asking for a favor in the first communication? Anyone heard of building a relationship before asking for a favor? Maybe not. But I’m telling you to wise up. Your great clinical skills or the good program you came out of does not mean much if you lack basic courtesy. Remember, there are a lot of other candidates in line for a position!Consider reading this The Etiquette Advantage in Business: Personal Skills for Professional Success.
The Associateship publication is published by the ADA and is in revision! I am pleased to once again have the opportunity to help develop the updated text for the publication. I have been a co-author on the publication for each of the revisions, 1992, 1996, 2001, 2005 and now in 2013.This is a wonderful resource for both owners and those entering practice as an associate with discussion on important planning topics, compensation worksheets and illustration agreements. It is great to have the opportunity to revisit the material and update it! I’ll keep you posted!
I often talk to Doctor CEOs about the model of their practice or the model they desire for their practice. In many cases we at Berning & Affiliates act to strengthen practices, clarify vision and mission and help implement a practice transition. Recently I had a doctor indicate that what he wanted was to have an aspiring practice, one that everyone from staff, suppliers, professionals guiding the practice and doctors held one goal, to do their part better. It is a very interesting way to think of what is usually an operational discussion. In this discussion the operations were important to this doctor but not the most important. What was desired was an investment of caring by all involved to continuous improvement. It was a fresh take and one I thought would be interesting to share.
Many Doctor CEOs use practice advisors, some use one person or firm for many years while others switch frequently. One of the most interesting aspects of doctors using advisors is whether the doctor follows the advice provided! Most recently a doctor recounted the number of advisors he had used over many years. He indicated after each name he always ended up doing things his way and so did not value what the advisors suggested. Here at Berning & Affiliates we have hired our share of advisors over the years, for example for web site development, tech issues and marketing. We, of course, are also hired by Doctor CEOs as advisors. Our view on using advisors, based on our dual experience, is if you have an advisor and the suggestions resonate as reasonable and practical follow the advice! To do otherwise or to have serial advisors none of whom you follow is a waste of time and money.
Just returned from providing a lecture on practice transition to the Orthodontic Alumni Association of Illinois held at the ADA Building. One of the attendees had a great question during break, namely, should a CEO take on a transition if their life is “very fragmented“? We discussed for some time the pressures on a contemporary doctor leading a practice in this difficult economy as well as juggling other non practice business, family and personal affairs. By the end of the conversation it was apparent that the load of items in the doctor’s life at the current point in time was significant. The whole discussion was indicative of what I am seeing more frequently these days with heavy burdens and time constraints on Doctor CEOs. The suggestion I offered was to look at timing; only taking on transition planning and implementation when there would be an apparent wind down on various activities and in process items. The key, after some time freed up, would be to throttle back and not take on other larger objectives until moving forward with the transition planning and likely implementation.