are you looking for a podcast where you can hear from real people regarding their real dental drama if so then
0:09
you've come to the right place join hosts Bethany Penny and Dr reena Kuba as
0:15
we dive into the solutions we've created and the mistakes we've made while
0:20
managing dental drama let's get started hey lady what's up what's up guess what it's April and
0:28
our that means our April content is now available through the subscription and
0:33
so I feel like our theme is really cool because it's all about if your practice is isn't doing what you wanted it to be
0:40
doing this year all those dreams that you had in January then April's the month to get back on track so we got a
0:46
ton of good content so my concern when you say that is if it's not doing what
0:52
you needed to be doing and how the hell do I know that i I don't even know if
0:58
I'm where I need to be or I haven't even stopped to think about if I'm there or
1:04
not or what I need to be doing yeah I know that's why you need the April Digest which is chocked full of where to
1:11
go what reports to pull what to do to get going so I don't think there's any
1:16
reason that people should wait april has marketing content it has reports it's
1:21
got team building like you got to go check it out it's phenomenal this month so I'm excited about it okay i'm going
1:26
to go do it okay now I got to shift gears because we've got a great topic
1:31
for today which we're going to come back to this topic of associates because you
1:38
I know you've kind of been through lots of associate type conversations lately i've got clients that are going through
1:44
things but I kind of want to focus on what I would call maybe the yucky side
1:50
of associate ships the messy part that can get kind of the drama the drama how
1:57
about we dig into that today so when I say the yucky side of associate ships
2:02
what are some of the first things that come to your mind i guess I think about like the associate
2:09
um what if their dentistry is not up to par and you're having to have a conversation about
2:15
um you know I've been looking at your crowns and they're not like how do you have those conversations like that is my
2:22
number one yuck factor right there i think I think the other thing that pops to mind is
2:28
um you know how do you coach and correct with if there's things that they're not
2:34
doing from a staffing standpoint like you know getting in the way of your systems or flows or your staff stuff I
2:42
think about you know are they secretly planning their own office or their exit and taking my stuff like
2:50
my systems or my paperwork or my staff
2:55
been there done that right so um I think yeah all of those yucky things oh the
3:02
other thing like compensation if they're starting to question and wanting more or think they
3:08
deserve more um I know one thing that I always hate is when we get into the nitty-gritty of like who do the sealants
3:16
go under who do the X-rays go under who do the you know like how does all of
3:21
that work um splitting up you know how how to
3:27
divide the treatment stuff because I think I think where because I've I've
3:33
again been there done that um where it's well you know I'm I'm the one who's
3:40
saving you from having to do this treatment that you don't want to do and I'm like the hell are you talking about
3:47
like you're not doing me a favor um you're doing your job what you were
3:54
hired to do um well you don't like doing
3:59
you know anterior composits so I've just been taking all of those you don't like
4:04
doing sedations so I've been uh No that would be me allowing you to do those
4:11
things so that you can Anyway all of those yucky things that's
4:18
Did I Did I hit any of the ones you were thinking gosh you hit all of them i'm like this may have to be two dang
4:23
episodes because it really is these are all the shady sides the dark sides and I
4:29
would say digging into this content I do hope is going to be relevant for both practice owners and associates because I
4:37
think there's associate are hard on so many levels they're beneficial absolutely but
4:45
there's so many icky points that you just brought up that both parties care
4:50
passionately about and because they're so passionate about their stance it's can sometimes create a either a
4:58
dissolving of that relationship or the associate deciding this is not the place for me and I want to move on but I think
5:04
that's a lot of practice owners too don't bring in an associate for all of these reasons they're like this is not
5:10
worth it and uh I can absolutely see that absolutely i'm still in camp
5:15
associate um but I think that ties back to my own personal goals and philosophies of why I
5:23
even got into ownership so I think it definitely is unique to each individual owner
5:28
um I I think to and this may or may not quite fit in but then you add the extra
5:34
onion layer of now with corporates all over the place um it it's it's made it
5:40
much more difficult for us mom and pop because there are these other jobs where
5:46
the associate can kind of have their way in that you know I want full benefits i
5:53
want this I want these hours and corporates a lot of times are going to meet those demands and so it really has
6:00
become even more like a needle in a haystack trying to find the right fit uh having said all of that I'm still in
6:06
camp associate um but again that that's very you know I think that's that's an
6:12
individual how which pile of beep smells worse to you you know
6:19
what I mean like would you rather be on your own and have to do everything and manage all the brunt load of all the
6:24
patients and all that but have full control and and deal with all of those
6:30
stinky piles of that come up or do you want to have the associate and deal with the associate piles of that
6:35
come like either way you're going to be like kneede and dung but which one which
6:41
texture is more suitable to you I guess is where I'm which smell which smell is
6:46
worse yes yeah i think you're hitting the nail on the head and I think it
6:53
takes mindfulness on the part of both the practice owner and the associate to
6:59
me to the point that you make there's plenty of corporates out there that from a compensation standpoint are going to
7:06
be able to look at that associate and go "Okay great here's some guaranteed income great here's health benefits hey
7:12
you want retirement we got that too you you know want a certain schedule we can
7:18
accommodate you on that but it's going to come with the dark side of corporate
7:25
which is you're going to work your tail off there can be some miscommunication
7:30
that occurs between ownership and associate there can be um expectations
7:37
clinically to perform at a certain standard which may mean you're pushing the bounds of your ethics on certain
7:43
things and um so while corporate can often
7:49
times give the associate what they want from a compensation standpoint or a package standpoint they can't usually
7:55
give the environment that the associate would prefer to work in the um clinical
8:01
autonomy that ultimately the associate wants and so there's some definite downsides to that corporate so for
8:08
associates to me when you're wanting to link arms with a private practice owner
8:14
there's going to be some compensation things that have to register differently
8:19
you can't you know the phrase have your cake and eat it too you can't have your cake and eat it too unfortunately you've
8:26
got to be able to make some compromises when you go with corporate you're compromising
8:31
on the team environment the sometimes the ethics side of things that you
8:37
struggle with when you go with private practice you're going to compromise a little bit on the compensation side of
8:42
things cuz most private practices can't truly compete with what corporate offers
8:48
but I think what happens a lot of times is associates can get in with a private practice they love the environment they
8:54
love that direct access to the owner they like working side by side with the owner from time to time and then it's
9:02
almost like that becomes the norm and they forget that in the corporate land
9:07
that's not the norm but they hear about the corporate benefits and the
9:12
compensation and then some of that starts to weave into their expectations
9:18
and that can start to dissolve some things well I'm going to pick on the owners too then you can't have your cake
9:23
and eat it too yeah you know so there there's mindful things that you've got to do and and remember the value that
9:29
this associate is bringing to you um and a lot of times you see that value and
9:34
other times you're like wh why just let's part ways i got this on my own this is not worth it um so it's like we
9:42
forget too why we brought the associate in to begin with um and so having to
9:47
remind myself and go you know like Yeah for when when the times get where it's like my head is hurting now why am I Why
9:53
am I Yeah dancing this dance and um but there's a reason yeah so I think it'd be
10:00
helpful to talk through some of the examples that you gave when you had that list of the icky side of associate ships
10:09
do you have one that's that you I don't even know what I just said so why don't you start with because you you brought
10:15
this up with like you've been dealing with other offices with um you brought it up for a reason it's some of your
10:21
clients are dealing with this so yeah this is I'm going to make you Yeah so I'll say then let's start with I think
10:28
probably the ickiest part that we get into which is the nitty-gritty of compensation i do feel like this comes
10:35
up repetitively not only when the actual
10:41
contract is being signed but oftentimes the nitty-gritty of compensation the the nuts and bolts of it are in the contract
10:48
but as far as who's getting sealants oh the assistant did sealants but the doctor was quote unquote supervising
10:55
those nitty-gritty type details usually are not unpacked in the actual contract
11:01
so that's the stuff that develops on the back end a client of mine has been
11:08
um the way that they have done some of their accounting in the actual practice management software isn't clear that the
11:17
associate is actually I I'm advising my client the practice owner like we got to
11:23
change this associate is banking off of false numbers because all of the
11:29
adjustments are being routed under the practice owner rather than under the associate so
11:36
the associates getting this production percentage off of fake numbers it's the
11:42
because of all of the adjustments being tracked incorrectly under the practice owner so now that contract is needing to
11:47
be revised can you make that even more clear like so for example if your Let me see if I've I'm following you here if uh
11:55
the office fee is a h 100red bucks insurance paid 80 bucks so
12:01
$20 but the associate got paid on a h 100red even though the practice didn't get a h 100red the associate got the 100
12:09
the practice took the hit on the 20 and so that's clearly unfair yeah and um so
12:16
now the practice is taking like kind of this hit a hit because they had to pay the associate but also pay them on the
12:24
full not on the adjust not the amount they actually got which is why I do a percentage of collections um because I
12:31
don't think that that's fair to me to and even with our bonus system like we went back and forth with our bonus system because we do something that's
12:37
you know the overall production and I'm like but did I get paid on that right um
12:43
so for example if if you know we said oh let's do you know 15 sealants or whatever it is we're doing permanent
12:49
primary and uh you know or the couple of preolars whatever it is 15 is not the
12:55
right number but what you you see what I'm saying but the insurance only paid for permanent mers and so now because we
13:01
made that mistake we didn't whatever so now we're writing off all the primary sealants but if we're doing bonus based
13:08
off of that day it looked like we made 400 bucks on sealants but we actually only made 150 because we had to write
13:16
off the rest but now the team's getting bonused because it looks like it's 400 that clearly math doesn't add up there
13:23
exactly um so same concept though with the associate if if they're getting So that so this was this is what was
13:29
happening so it's in favor of the associate it was in favor of the associate and of
13:35
course this associate now has kind of been living under this beautiful
13:40
contract and really to me inaccuracies in accounting documentation in the
13:45
practice management software so to me that's solution number one that we've got to actually fix the way that
13:52
we're documenting write offs and things like that so I think the icky part of
13:58
this is if you haven't always been a super detailed person with those adjustments especially if you're just
14:03
pulling on an associate one of the first things that you need to do is make sure that your
14:09
accounting is correct so every practice management software has multiple
14:14
adjustment codes right like when you were in network there might be a MetLife adjustment code a Delta Dental
14:21
adjustment code an Etna adjustment code which is good the more detail on
14:27
those adjustment codes the better friends and family discount is another one or employee discount which is
14:33
different from friends and family so be detailed in those adjustments but you've got to make sure that those adjustments
14:39
are being the software can usually put those towards production they can put those
14:47
adjustments towards collections or they can put those adjustments in their own category of adjustments but it's got to
14:54
hit if you're paying off of collections for example then my recommendation the
15:00
cleanest way is to make those adjustments go against collections because then the associates numbers are
15:05
going to be correct if you're going off of adjusted production which is another common payment method um that the
15:12
associate can get paid off of adjusted production then you need to make sure that when you're setting up those
15:17
adjustment codes that those are going against production so that when you pull
15:23
that associates production numbers it's actually adjusted production so that if
15:28
you don't discover that until halfway into the associates's contract well now we got problems because this associate
15:35
was being paid off these beautifully inflated numbers and now 6 months into the contract you're like "Holy crap I've
15:42
shot myself in the foot now I'm having to go back and make these changes." Well that can cause obviously a lot of
15:48
problems so even down to like everything you just said i know I knew that stuff
15:54
once upon a time ago probably about 12 years ago I used to you know for the first three-ish years of the practice I
16:02
did all of my own accounts receivables and I was doing all those adjustments so somebody must have taught me how to do
16:08
that because it's sounding vaguely familiar but then when I hired my AR person I've never looked at that again
16:14
so all those nitty-gritty details are there courses people can take to figure out like who and adjustments and
16:20
adjustment codes and all of that like I don't even remember to me this is a very
16:25
um a category that is not well discussed so which which the reason I'm bringing it up is because now if my AR person
16:33
were to retire and then now we're onboarding a new person this is where I'm going maybe
16:38
you as doc understood it at one point like me maybe you never understood it maybe but with turnover is what I'm
16:46
thinking about and now new people are in there and if they're not I'm Is that what happened with this one is what I'm
16:51
betting that somebody you know like the doc's assuming Yeah because we're not the ones putting these we're not the
16:58
ones posting payments um and that which is a whole other point so the setup is
17:03
one category like are is everything set up correctly but the second category is
17:10
does your team know how to appropriately utilize those adjustment codes what if
17:16
the associate doc brings her kid in to do treatment and they call that an
17:23
insurance adjustment right and then you're like "Oh wait a second that's not an
17:29
insurance adjustment that's free so we actually need to put employee discount and then $0." So even that there's so
17:37
many inconsistencies that I see just from a bird's eye view when I'm looking at ledgers when I'm with my clients that
17:43
I'm like these adjustments don't make sense or I can't I can't formulate a
17:49
line of thought when I'm looking at a particular you can't track it like if you're going back and looking at an EOB and kind of going this is where this
17:55
it's not clear and easy to track and figure out where these came from which again talk about a yucky topic like I'm
18:02
like oh god I don't want to deal with any of this but this mad matters in so many ways when you're trying to go back
18:08
and if you're later going okay should we drop this insurance should we not do this and that and if you're like oh no
18:13
you know Medlife pays us great we we look at this and then now you're if you really looked at it and if the
18:18
adjustment codes had been applied correctly you could have gone oh my god we're actually not getting paid right
18:24
like this affects a lot and this is the nitty-gritty that as as doctors even
18:29
those that are good with math and good with details we don't have time to worry about this stuff like it's all we can do
18:35
to please Mrs smith in the chair and make sure that the contact we put in was appropriate like th this is stuff that
18:42
it's like this is the gray dark hole that this is why we don't go up to the front desk like we don't want to deal
18:47
with this stuff right so I think this is um uh another I'm going to task you with
18:54
sorry ma'am but I'm like maybe this is another um podcast like for our subscribers like
19:00
a separate um uh what do you call it a separate like you um you know cuz our
19:06
our for our subscribers our bonus that's the word I'm thinking of our bonus episodes are far more detailed and far
19:12
more like practical tips and this is what you need to do like it's not just me bantering we've got you know um it's
19:21
it's less drama and more like here's how to and don't forget to so the feedback
19:26
we've gotten from our subscribers is those are super helpful to actually uh take something from talking about it to
19:33
actually doing it and then of course we've got the um playbook tips in the digest that kind of go hand inand with
19:39
that but I might task you with if if you're telling me that this is not cuz I'm trying to think how would I have
19:44
known all these codes and that too was like you know almost like 15 years ago
19:52
where insurance wasn't near as complicated as as it is now so now when I'm thinking back on it I bet you how I
19:58
knew how to do that i'm putting knew how to do it in quotes would probably been the dentric trainer that came in was
20:04
fantastic and she probably set up a lot of that for me and told me what to do and then I probably reached out to my
20:11
current AR person who I knew from another office so if you haven't made friends in other offices and now you're
20:17
owning your own and you don't know this stuff like who are you you know that that's why even like lasers when I was
20:23
starting now there's a million classes for laser dentistry for pediatrics and all that when I got my laser there was
20:28
nothing right and I was like well I'm going to do water lays because my buddy who's writing the guidelines for the
20:35
AAPD laser she's the only one I really know who's got this in a systemized
20:41
fashion she's got a water so if I'm going to have trouble I'm going to need troubleshooting i'm going to call her
20:47
why did I incorporate dentrics because that's what I knew from the other office and all my buddies that's what they knew
20:52
so if I needed to phone a friend that's who I was going to reach out to so um
20:57
anyway it I guess now this is eye opening for me to go if there's no real good because there's a million in one
21:04
coding classes you could take at dental conferences but they don't get into this level of nitty-gritty of Yeah they
21:11
really don't and we've got fantastic dental CPAs like there's so many awesome
21:19
groups but they are limited in their understanding of the practice management
21:26
software like the dentrics or the Eaglesoft or Open Dental they're they're
21:31
going off the data reported to them by the doctor so there's only so much that
21:36
they can ultimately see from their side of things and so much that they can navigate through that i think they're a
21:42
great resource it's definitely worth reaching out to dental CPAs but to me this is an area that's that's really
21:50
vacant um I wouldn't say vacant i think there's uh
21:56
very light resources out there that could help um okay i'm tasking you lady
22:02
i'm tasking you this is And by the way um I know you were going to talk about
22:07
it later so I'm sorry i'm going to steal your thunder here now but um we are I
22:12
think you said by the end of April like all of our resources and playbook tips cuz there are people that are now
22:19
jumping on the bandwagon like "Oh my gosh I just heard about Jaw subscription oh my gosh I missed the oh my gosh can I
22:24
go back and get October's playbook items?" Uh no that ship has sailed but
22:31
uh you are creating a uh portal or a hub or something that's going to have
22:37
everything available for purchase so for somebody who was a late subscriber and
22:42
you're going "Oh my gosh I need that resource that walked me through how do I
22:48
onboard this or how do I do that?" you'll be able to go back and purchase that which you know subscription is
22:55
always going to be cheaper but if you just need the one or two documents to get you going um so I'm going to maybe
23:01
challenge you this may be a you may have to create something to guide people through these codes yeah we'll
23:07
definitely have that on the resource section so I'm super excited about this portion of our new platform that we're
23:14
building cuz we do feel like there's even if it's been in a former month of
23:19
our subscription um it may not be something that they need the whole subscription for they may
23:26
just need to go buy this one particular document and so we have put hours and
23:32
hours and hours of effort into building a really good resource section so that
23:38
as people are looking for kind of random things i mean there we've got all kinds of topics on there you know a hiring an
23:45
offer letter what does that look like okay great you don't have to go reinvent the wheel just go download the one that
23:50
we have available you can purchase that one or um like you're talking about how do I set up my codes appropriately my
23:57
adjustment codes appropriately there will be a document for that and this will be a living breathing thing that we're always adding things to but I
24:04
think we've got over a hundred things that will be available at the end of this month for purchase so it's going to
24:10
be a great resource for sure i just gave you more homework i I will get it done but I do want to
24:17
really focus in May um for May content on this category of not only adjustments
24:25
but also collections as well is going to be heavy emphasis in May so all of that's coming down the pipeline but I
24:32
think from an associate standpoint these are the nitty-gritty things that are going to come up then so it's like okay
24:38
do we have the the accounting correct beyond that then it's like who gets paid
24:44
for what hands down every single time when I'm talking to an associate they want to
24:49
know where the X-rays go or the X-rays going to the doctor or the X-rays going to the practice owner um application of
24:57
fluoride like if they're doing hygiene with an assist with a RDA not with a
25:02
hygienist who's getting that fluoride credit so to speak um who what
25:08
about sealants okay if I do that inoperative is that counting towards my
25:14
production what if I'm doing hygiene and the assistant does it for me do I get
25:19
the sealant credit then you take it to even more complex waters which is like
25:25
I've got some pediatric clients that do some appliances in their office and so
25:32
then there's that monitoring after you do an appliance they might be coming the patient might be coming monthly well
25:38
what if the associate sees that essentially ortho kit what if the
25:44
associate sees that ortho kit the initial credit or production for that ortho went to the owning doc so how is
25:52
then that associate being paid for that ortho visit which is like or even in a
25:59
in an adult practice i was just talking about this with a client of mine who's bringing in an associate and they're
26:04
like "Oh we do a clear aligners how does that work?" like they can't get 35%
26:10
production off of the clear aligners when the lab bill is a third of that
26:16
means the practice literally made nothing on this particular patient even though my assistance my sterilization my
26:23
room my practice is being used my scanner my yeah yeah so all of those
26:29
things if they're not fully thought out before the associate signs on they can
26:36
create drama So then what do you suggest for all that even now like even now it came up the other day something and I
26:42
knew somebody was about to ask me where does this get credited to i walked out
26:48
before they could ask just I was like I don't know even now I don't know how we handle those sealants i don't know how
26:54
we like I don't know i'm like talk to AR person and talk to Bethany i that is
26:59
beyond my um I I don't want to deal with that yeah um so I don't but um and
27:06
luckily you know again this goes back to I've got my current associate is very um
27:14
fair like he's very reasonable it's not like he's going I need but he he's also
27:21
not going to be like no never mind Kuba you take all the X-rays he's very fair and so we can come to a fair agreement
27:29
on that which when he asked me early on I was like I don't know man because I can see how we could do it this way and
27:35
this is fair to this person and that's fair to that person and then I sent him to you and AR person i don't know what
27:41
y'all decided and I've not looked back um but you go back to when I was an associate and and I had a hygienist like
27:48
I I you know I worked for this gentleman four days two days I had to do my own hygiene two days I got one of the
27:53
hygienists and I had to pay towards the hygienist i don't think that's a thing anymore is it it's a you know I mean get
28:00
with the times Kuba but part of me goes well I'm bitter like you know like you're not paying for your hygienist and
28:06
so anywh who fair is a is a very tough uh
28:11
topic and I think fair is subjective each person can have their
28:18
own opinion of what fair is that's what I'm saying yeah it's a it's its own topic unto itself so I'm going to task
28:25
you with again uh maybe maybe you're doing two bonus episodes in May um but
28:31
getting into the nitty-gritty of like you could use my office if you want to but what did you advise this client for
28:37
the aligners what did you advise the client and like how did you help them come up with their compromise what did
28:43
you come up with for my office for my associate because I don't know i still don't know i don't want to know um
28:49
I don't so I should just avoid commenting now and say "Hey catch it in the bonus episode i'll tell Coopa not to
28:55
listen." Yes yes i will skip that episode because I don't want to know but it's it's coming up again because maybe
29:02
that's what it was maybe it wasn't my current associate but maybe in my mind going as we're looking for our new
29:08
associate because current one's going to be heading out at some point here soon um how do I have these conversations
29:13
with that person so to me that is the point you have to have conversations we
29:19
want to you know sign on the dotted line get this relationship going and then just
29:26
assume that it will work out and that's just a very bad plan so to me the more
29:32
clear the conversations can be ahead of time the more you're going to know ahead
29:39
of time can I is our version of fair similar enough that we can actually get on the same page with this because the
29:47
last thing you want is drama 3 months into this contract and then life is
29:52
miserable for you and that associate while you finish out this contract we don't want to have the associate feel
29:59
like they've been gotten you know haha you signed on the data line and now I'm not paying you for anything but your
30:05
treatment that you do well that's not fair so to me you've got to have these conversations ahead of time and it can
30:13
be something as simple as if you've always had an associate or you've had an associate for a while you can say "Hey
30:18
this is what we've always done regarding x-rays regarding sealants
30:23
regarding clean liners or aligners." I mean our appliances you can say "This is what we've always done are you agreeable
30:30
to that?" And they're like "Yeah well the only one I'm can I can we talk
30:35
further about whatever?" And then at least the conversation is being had now
30:41
if you've never had an associate before that's a little bit harder to do because there is no history to it and so that's
30:48
where you again lean in on your resources figure out what is truly fair and then you put together your list and
30:55
go okay you know before we move further in this conversation and get to the contract I want to talk through some of
31:01
the nitty-gritty these are going to be some of the I think sticky points that we need to kind of work through this is
31:06
what I would like to do how do you feel about that so it's the same kind of conversation you just don't have the
31:12
history behind it i would say when you're building that list of what's fair
31:18
talk to the right people don't talk to the the guy on the street that everybody knows as the shrewd fox that is you know
31:26
conniving everybody out of their money don't use his example because what he
31:31
deems as fair is probably not fair talk to reasonable people about what they
31:37
what their rules of the arrangement are with the associate and use that as the
31:42
content this is where again lean in on your resources like if you do have a good dental CPA they may have some
31:48
opinions or they can at least get gather information for you on what's reasonable
31:54
from not only who gets the credit for what but what is a reasonable arrangement
32:00
dental lawyers are a great resource because they have looked at thousands of
32:07
associate contracts and they know what's typical in your particular area so you
32:12
need to build out a fair offer and I would say on the heels of that too you
32:18
don't need to be bitter about that offer if you're going to be bitter about it you do not need an associate if you're
32:24
gonna be mad about all the credit that he or she is getting for certain things or oh lucky you you get to use the laser
32:31
when I paid for that laser it's not going to go well for you if that's your mindset so you've got to
32:38
be okay with the terms as well and if you can't get okay with the terms it's not worth moving forward in my
32:44
opinion anything else compensation wise that you can think of no that was yucky
32:50
what else yeah other yucky stuff is going to be
32:57
um so this can some sometimes be related to
33:02
compensation but I think it's different who gets what i can't tell you how many times I'm in an office and all of a
33:10
sudden the um because the doctors the owning doctor's production has dipped
33:16
down all of a sudden the associate doctor isn't getting any new patients
33:21
like oh sorry my production dipped i got to you know this month I you don't get any any new patients what the heck that
33:29
is not fair at all i get it from a practice owner standpoint you're like I got to protect my own but your associate
33:36
is part of protecting your own and so we've got to be careful at making
33:41
knee-jerk decisions like that whatever the system is that you guys set up from the beginning if you're like "Hey I'm
33:49
really going to help you out in the first 90 days and give you all new patients." That's understandable and that's a good strategy if you're
33:55
planning to change that past the 90 days that needs to be said from the beginning for the first 90 days I'm going to give
34:00
you all the new patients and then once we get past the 90 days you're going to take 80% and I'm going to take 20% and
34:08
it'll be randomly assigned by our business team um so
34:13
conversations like that on who gets what or I diagnose the treatment but associate is taking the
34:21
treatment or vice versa associate diagnosed the treatment and owning dogs like oo a mouthful of crowns i'll take
34:27
that thank you you need to come up with okay what's our rule of diagnosis and treatment if
34:35
it's just fully shared and we know that we can do that fairly great if it is the
34:42
doctor is handpicking the treatment that they like eventually there's going to be bitterness over that and so that's where
34:49
that that uh my favorite like it's got to be a win-win and so if if I guess to
34:54
me that's where I'm like if I was the associate how would I feel right now if I'm the one who's here to see all these
35:01
limited exams and I'm the one who's treatment planning you know the fullmouth IV cases and I'm the one who
35:07
had to spend 45 minutes in there with that family and then I had to answer all those questions after oh but then Kuba
35:13
is the one who gets to go and go do the cases and she never lets me do them um
35:18
eventually I would leave yeah and so uh I think that's where now on the other hand if it's like now the owner doc's
35:26
not doing you know it is what it is it's the owner doc if they are at a point where they're like I don't want to do
35:32
this treatment anymore that's kind of why you were hired associate so you know uh at some point that will evolve but
35:40
it's got to be a win-win yeah and I think for the associate to be you know like oh well I should get to do all my
35:46
own treatment and I should get all the new patients and I are you sure about that like make sure you're in check with
35:53
your own you know both parties need to be uh looking at it as if I was in the
35:59
other's shoes how would I want this yes I think that is so critical
36:05
and to me that's the appropriate mindset in this associate relationship it really does need to be both parties have a
36:12
level of trust that they're they're both working for each other um speaking of
36:18
new patients you uh when you said that I was like "Oo this is another thing that I've seen come up and I want to really
36:24
challenge our associates out there on this there cannot just like the owning
36:30
doc can't be bitter about the production that they're giving to you you associate
36:36
doctor cannot be bitter about the expectation that you're there to help grow the practice can't tell you how
36:43
many times I hear little rumblings of well why in the heck would I go out go
36:49
out and do this community event or go out and meet our referring partners why
36:54
would I do that if it's only going to benefit the owning doc's practice because you want a job and you want a
37:02
job where you have enough patience to see and you want a job where you can actually earn income the every so just
37:11
to make this clear when a practice owner
37:16
is bringing in an associate this is what I tell all of my practice owners that bring in an associate there's going to
37:22
be a period of time sometimes three months some sometimes a year where their
37:27
pay is cut so the practice owner chooses to take a pay cut in order to bring on
37:35
an associate there's not usually enough money in the bank off of a one doctor
37:41
practice that's now adding an associate even if that's one day a week they're adding an associate there's usually not
37:48
enough income in the practice to fully pay for that associate there's a little
37:53
bit of a gap that they're having to jump to get to where the practice is viable
37:59
enough to pay for two doctors so it's always mindblowing to me when the
38:05
associate is resistant to helping out with those practice growth ef efforts you were brought
38:11
in to help the practice grow to grow it to be a two doctor practice so why there
38:18
would be resistance or bitterness over having to help the practice grow is absolutely mind-blowing to me i've heard
38:24
that too and I've I think for me that it it's such a piss poor attitude like why
38:30
would I build up your practice what what are you talking about um and I think a
38:36
lot of times too it's not realizing I guess it depends on how it's structured to begin with so if it is structured
38:42
like you are going to be getting your own new patients and so so I think I I
38:47
don't like that for the associate because to me I'm like how can you especially if you're only there one or two days a week how can you be expected
38:55
to fill your schedule and make a income if you're just starting off by yourself
39:02
floundering and you're having to build up your own patient base correct that doesn't make sense but then at some point yes owner doc is giving you the
39:11
opportunity to produce and to do all of that and I think that's where I've seen
39:16
some of that go off the rails where the associates like "Oh look what I'm doing for you i'm seeing these patients." And
39:24
my advice always is they're going "Uh owner doc." Yeah i mean maybe they
39:30
went on a couple of extra vacations they they didn't get to go on but it's still a hit to the practice and they're
39:36
looking at the big picture going "Okay but I am still here producing some." Um and then you've got some owners that
39:42
don't want to produce but the point is still you were still brought on to help
39:47
the practice grow and I think that's where associates that come in with that me mindset
39:54
um you're going to have a really hard time being successful long term as an associate and and maybe that's your goal
39:59
maybe you just wanted to come in and and get your feet wet and then your goal was to go start your own or do whatever but
40:05
I think it's a really uh lousy strategy it's a very selfish
40:12
strategy i think once the owner docs get wind of that then that's when they're like "Oh okay well if you're just the
40:19
associate and you don't want to help grow help market help coach team members
40:25
like you're just here to get your paycheck that's more of a corporate mentality maybe you should go on to
40:31
corporate exactly um because for small practice owners it's like the the
40:36
thought is this was supposed to be a camaraderie of sorts now same for the practice owner that's not allowing the
40:43
associate opportunities or opportunities to grow and you're just cuz I I hear that too there's owners that like you
40:50
know the associate is just doing the grunt work for me but no I'm going to go get all the new patients i'm going to go
40:56
do all of this and then you just do what I tell you to do you're shooting yourself in the foot that's also a very selfish strategy and associate's going
41:02
to leave and you're like well yeah I just needed that no it's expensive to bring on an associate and to incorporate
41:08
them in your practice and in your community yeah and the revolving door diminishes the quality that you can
41:16
ultimately give the patient um so it definitely needs to be both parties um and I I will say I feel
41:25
like this I've said it before and y'all are going to hate me and tune me out but I do feel like we're we're at a
41:31
generation that's a very me me from both sides actually for the associate coming in and going "Well look what I'm doing
41:36
for you." And I'm like "Hold up now." Yeah hold up um and then also for the
41:42
owners that are like "Me me me." Like I'm bringing in an associate so that I can go on vacations don't they know that
41:50
it It's a dumb mentality a long-term mentality it's It's not smart exactly i
41:55
think we've got to approach no matter what the associate arrangement is going to be we've got to approach it with a
42:02
level of respect and not with a level of bitterness or me
42:07
focus none of it none of this can be me focused to be perfectly honest in order for it to work well we've got to have a
42:14
mutual appreciation for one another that associate would not have a private
42:20
practice environment where they're learning they're growing they've got good collaboration with the owner doc if
42:26
that owner doc wasn't bringing in an associate and that owner doc would not have some of the freedoms that he or she
42:31
has um if it weren't for the associate and so there's it really is a mutually
42:37
beneficial arrangement and I love when a practice owner can bring on an associate that's a real mark of success in my mind
42:46
and it buys a level of freedom that I think is so helpful to practice owners so I really am in the camp of associates
42:53
i just think we've got to have the right mindset towards it we've got to have clear communication
42:58
um before and during the contract period of time and then there's a ton more subjects that I think we could get to
43:05
this but we're out of time for today's episode so we gota we got to cut it here and say we'll come back up yeah yes
43:13
thanks for joining the conversation today we hope that you are comforted in knowing that you are not alone but we
43:20
also hope that you're walking away with some really great tips and tricks to try in your
43:25
practice we value your feedback so please take a few moments to rate and
43:31
review the podcast finally we want to make sure that we're covering the topics
43:36
that matter to you so track us down on Facebook Instagram and Twitter and let
43:42
us know what topics you want us to cover as always please know that we are
43:47
rooting for you today as you manage your dental drama