Whether you just graduated from dental school, finished a residency program or specialty training, the majority of young dentists begin their careers as associates. The road to becoming an associate is full of variables, and knowing the ‘lay of the land’ can help you make wise decisions. The journey begins with choosing the practice that is right for you.

If you want to join a practice as a full-time associate and have adequate patient volume for yourself, you need to join a practice that is “saturated.” Saturation means that the owner is working at optimum speed, practicing optimum hours, is scheduled fully, six to eight weeks in advance, and has more new patients in the practice than can be cared for.

By joining a “saturated” practice, you have an immediate opportunity to gain clinical experience and enhance your income. Additionally, saturated practices afford greater opportunities to build a patient base. A saturated practice may also offer long-term opportunity in the form of an equity interest or potential buy-out.

Usually, general practices with more than 1,700 active patients are at the saturation point. An active patient is one who visits the practice at least once during the past 18 months for a recare visit. The degree of saturation, or the number of excess patients in a practice, will determine the actual opportunity for you to work as a full-time or part-time associate. For example, an efficient and skilled owner who is servicing 1,700 patients with a full-time workload may want to reduce hours and transfer patients to a part–time associate. Generally, practices with 2,500 or more patients present excellent full-time opportunities for new associates.

Therefore, if you are considering a full-time associateship, be sure to inquire about the size of the active patient base.   

Snyder, DMD, MBA, Tom  (2009, Summer). Becoming an Associate…What You Need to Know. the NEW DENTIST™ Magazine, 20-21.

I started my practice from scratch about five years ago. Right now, I have two days of hygiene per week and I want to build this to four days. I also want to increase my new patients. I used to get about 18-20 new patients a month, that’s dropped to about 14. Thankfully, I don’t think I’m losing my existing patients. But how do I know? I’m starting to worry.  Midwest DMD

Hey Sally,

I was very impressed with your New Dentist publication, especially the aspect of establishing a “green” office. One thing that even the green movement does not realize yet is the aspect of mercury vapor hygiene in the dental office. I am the vice president of the International Academy of Oral Medicine and Toxicology (www.iaomt.org). We have been advocating proper office ventilation with filtration and personal protection for patients and employees for 25 years. OSHA has a maximum PEL limitation exposure of 50 micrograms of mercury per cubic meter of air in an eight hour day and 100 micrograms in a single exposure. When my assistant opens up the back of the dental chair to clean out the trap we have measured mercury vapor levels as high as 600 micrograms in the air. I use a Jerome mercury analyzer which can detect levels as low as 3 micrograms in the air, much like a Geiger counter. We also use an air filter with carbon filtering masks to reduce employee exposure. We are hopeful that the allopathic dentists will begin to realize this danger and then all offices can become more green. In addition we advocate the use of mercury separators in order to reduce dumping it into the environment. If you have any questions feel free to ask.

Thanks…Dr. Matt Young

I am looking into entering an associateship that could possibly lead into a buy-in. I would be interested in hearing suggestions about how to structure my compensation.

Dr. S.C.

TN

Help! Recently, one of our dentists sold the practice to a younger dentist and she kept us all on as staff.  This may sound just great, however, there no rules, no accountability, no structure, and no punishment. I’m the office manager and I don’t know what to do. This is a great practice that she’s purchased and it’s going downhill fast.

Florida Office Manager for New Dentist Owner

I live in North Carolina, and am considering going out on my own in private practice. Ms. McKenzie had said it was possible to roll over the fee from the Start Up Program into the loan for the practice. Another thing I’m considering doing, before actually opening the doors, is going to a Spanish language school in Latin America for about four months or so. There are a lot of Hispanic people in my area and I think this would be a great practice builder. Could I roll the expenses for this into the loan as well?

Hi Sally,
My name is Dr. Orjiekwe and I am a general dentist.  I just read a response you posted in December (@ the new dentist website) for a new dentist that was looking for a job without success in California.  I think that new dentists make a terrible mistake by jumping right out of dental school and think about associating or much worse starting a practice right away.  We should stop advising them to do so.  I strongly believe that every general practitioner should complete at least one year of general practice residency in a hospital or an advanced education in general dentistry (AEGD) in a dental school.  New dentists need to gain valuable experience treating patients.  Dental school does not prepare anyone for the type of care and speed needed in private practice.  Medical students do not graduate from medical school and start associate positions or even yet open their own practices.  This is insane.  After dental school, I did a general practice residency and associated for 5 years before setting up a very successful practice.  I am only 34 years old and I would not do it any other way.  New dentists need experiences beyond what dental schools offer.  My recommendation is that the dental community and the new dentist magazine/website should stop encouraging new dentists to go from dental school and get associate positions.  Worse yet, new dentists should not open up practices right after dental schools in order to avoid making a potentially huge terrible mistake.  THERE IS NOTHING LIKE GAINING A VALUABLE EXPERIENCE.  WHAT IS THE RUSH?
Dr. Ogonna Orjiekwe

I recently graduated from dental school in Nevada. I moved to California and have a California dental license, but I cannot find a job. I am looking for a position either part-time or full-time as an employee or associate. I have searched for a job in virtually every California city for almost two months. I’ve looked at CareerBuilder.com, Craigslist, The Dental Trader, and other websites, but I can’t find anything. At this point, I’ll work as a hygienist if I have to… can you help?

-Newly Graduated DMD

Hello Dr. Snyder,
I read your article in new dentist this past month and I have a quick question for you.  You wrote, “lab charges are usually made against your compensation at the same percentage of your commission.”  Does that mean that if the associate is getting paid 35% of collections that the lab bill is deducted from the 35%?  Or is the lab bill deducted from the associate’s total collections and then 35% is taken from that?  Thanks for your time.  great article!
Jayson

I would like to know how I can be sure the dentist needs an associate and what I can do to make patients want to schedule appointments with the “new dentist.”

Dr. S. C.

TN