EIGHT Considerations for Associate Jobs After Dental School

In dental school, I learned a lot of things. How to land a good job was not one of them. The toughest first challenge exiting training programs other than making sound clinical decisions and operating autonomously is how to secure a stable, well-compensated position. There are several opportunities for general dentists and specialists but oftentimes it is difficult to differentiate which one is the right one. I know as a relatively recent graduate I certainly did not know what questions to ask of my future employers. I also didn’t know how to objectively evaluate the terms of my employment offers. From my experiences, here are some important considerations before signing that contract.

 

1) Practice Philosophies

Conservative? Aggressive? Review treatment plans and clinical methodologies together to determine practice philosophies. Also consider work environment, patient management approaches, dental instruments/materials and staff personalities.

While philosophies may not have to match, they certainly should be complementary. In my experience, compatible practice philosophies make day-to-day operations substantially less stressful, more enjoyable and most sustainable. Additionally, healthy collaboration often translates to improved patient care.

 

2) Short and Long-term Goals

This may seem obvious, but knowing whether you plan to pursue partnership in the current practice or operate in the same area can prepare you for employment negotiations.

If partnership is in the picture, discuss how many years before that’s possible. Also consider how the “buy-in” is to be structured. In other words, is the expectation for a one-time lump sum or a percentage of profit for X amount of time or X dollars? Additionally, know if there are other partners involved, whether partnership is equally divided and consider having the practice appraised before the employment term. The years of associateship/sweat equity have value that should be considered and agreed upon prior to the start. And whenever possible, put the agreed upon terms IN the contract.

 

3) Pay Structure

Notice, pay structure was not listed as the first or second consideration. While compensation is certainly important for employment, I whole-heartedly believe new graduates should prioritize long-term goals and practice philosophies over the short-term bottom-line.

I, of all people, understand the need to make more money (see the post on how much money I owe). But simply pursuing the highest paying job, in my opinion, is short-sighted. Especially early on, expanding clinical experiences and knowledge base under a qualified mentor or investing time in a practice that could yield future partnership opportunities can be provide more benefits in the end.

With that being said, negotiate a pay structure that is fair for your region of practice. Determine if your preference is for a daily rate or a percentage of production/collection. Best case scenario, pursue a hybrid structure where associates receive a daily minimum or a percentage of production depending on which is higher.

 

Notes on pay structure:

  • If being paid on a percentage of collections, ask for the office’s collections rate for a better idea of expected reimbursement.
  • If paid on hybrid structure, ask for clarity regarding whether percentage calculations are made daily or on an average of the month.
  • Always stay on top of daily production numbers to track growth contributions for the practice. This information is important for justifying future raises/partnership.

 

4) Categorization: Employee (W2) or Independent Contractor (1099)

If employee/W2, you should clarify whether there are benefits (rare in the dental profession), paid time off, sick leave, gym membership, etc. While the employer is generally responsible for tax withholdings (social security, state/federal income tax, employment tax, etc.) there are generally less benefits from a tax filing standpoint.

If independent contractor/1099, there is often more flexibility in how you file and status could be important when considering whether to incorporate. This is where you can take advantage of certain write-offs depending on your practice (i.e. food/entertainment, insurance payments, office expenses, etc.). Keep in mind, with independent contractor arrangements, you must be more responsible with spending throughout the year (set aside money for Uncle Sam), but could warrant a higher percentage or improved pay structure with your employer.

 

5) Non-compete Clauses

Depending on where you plan to practice in the future (if not at the current office) really pay attention to the non-compete clauses. While in many instances these clauses are difficult for employers to enforce, it may save future headache to negotiate the terms upfront. In most contracts, non-competes are written based on a certain radius distance from the existing practice. It certainly does not hurt to map out the exact number of miles closely before signing. Also, many of these non-competes are intended to be effective for 1-2 years after the end of employment; some may be longer so be aware.

 

6) Patient Demographics

This category includes evaluating the socioeconomic statistics and accepted insurance plans of the office location. This consideration is more important for associates employed under a production/collection pay structure, but will generally reflect the type of services/procedures/dentistry performed in the office. In the end, the patient demographics will also help to determine reimbursement amounts.

 

7) Practice Growth Outlook

As a new associate, you want to feel optimistic about an office’s potential for growth. When evaluating the practice, you should know how many patients are being seen each day for what types of procedures, but maybe more importantly, you should know how many NEW patients are being seen each week/month. Also, know if it is the intention of the current practicing owner dentist to allow you to see some or all of those new patients to expand your patient pool. Further consider, how the existing patients and procedures are generally divided among practicing doctors.

 

8) Ability and Willingness to Communicate

Most important for any job is having open lines of communication. While some offices ensure productive workplace dynamics with daily morning meetings, others utilize weekly or monthly evaluations. Regardless, this allows for improvements in the day-to-day operations of the practice. As an associate, knowing the owner dentist, office manager and staff are willing and able to communicate effectively in the workplace provides an additional level of confidence in the team.

 

Ultimately,

 I have learned over the last several years that while compensation is an important determinant in any work opportunity, practice philosophies, career goals and workplace communication are crucial for maintaining a more rewarding and sustainable position.

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