Myths, Mistakes, and Red Flags of a Transition

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Myths, Mistakes, and Red Flags of a Transition

If you have made it this far and you have poised your practice for growth, interviewed and found a likely candidate, or you are the young doctor almost ready to pull the trigger on taking that job, then allow me to give you one more quick look at things you may have forgotten. I want to take time to go back and remind you of some of the myths, mistakes, and red flags in the process of taking that new job or hiring that additional doctor.

I won’t go back and repeat what I have already said in previous articles, but rather, take a slightly different look from a different perspective. As before, both the young doctor considering the job or the senior owner doctor about to hire that new doctor need to make sure that they both are educated in the process and hold no limiting beliefs before you commit to this transition. Never short cut the process. That can be an expensive outcome.

Let’s begin with a hard and fast fact: There never has been, nor will there ever be, a perfect transition for a hire or job. This is unrealistic and if your perspective is that there is a perfect match, consider that marriages have over a 50% divorce rate. An associateship, sale, or partnership fails much more often than that. In fact, the average associateship rarely exceeds 15 months. I would like to make this a study in expectations and reality when hiring or taking that “ideal” job.

There are going to be fundamental facts that you must accept. What is your tolerance level when we compare ideal to acceptable? Is acceptable, just ok, or is it something more? If failure is inevitable at least 50% of the time, what are you willing to do? Knowing that perfection is not an option, what is acceptable?

Here are a list of facts, mistakes, and red flags that should give you pause.

  1. Never hire from desperation. Never accept a job from desperation. It will always turn out poorly. That is not to say that there won’t be times as a young doctor when you are just trying to find a job that allows you to make some money and get a little experience. For the senior hiring doctor, some hires will be just a short-term solution to a long-term problem. These are not ideal but know the difference and plan ahead.
  2. Young doctors should always look for the benchmarks that would give you the best chance of improving your competence and confidence while being extremely busy. Senior doctors need to align and ready their practice by getting darn close to the practice benchmarks I wrote about in a previous post before beginning a search for that new doctor. This type of practice needs to have at least two hygienists for each doctor, 40-60 new patients for each doctor, overhead below 63%, a wide range of services offered, as well as a wide range of ages of patients coming to this practice that reflects the demographics of the area you want to work in. They need to have a consistent historical growth of at least 15% a year. Most practices that bring in an associate are ill prepared, and in a perfect universe would not even be an option for either party.
  3. Remember that this will most likely not be your forever job and the young doctor will probably not be your forever employee. Life and perspectives change. Both of you need to be flexible and build your relationship with one another with integrity and engagement in the process. Take the time and learn how to communicate with one another.
  4. Both the new hire as well as the seasoned doctor/owner need to partner with their team in the selection process. Young doctors need to accept the fact that just about every employee will know more than they do about dentistry. Be patient and work as a team. Young doctors need to understand their place in the office until they thoroughly embrace the culture and are accepted as a teammate. Up until that point you will be considered a “provisional outsider” that is either part of a solution or part of a problem. Existing team members will always find a way to vote you off the island if you become part of a problem.
  5. You both should be looking to find a connection with a strong culture that is designed to create consistent results and growth year in and year out.
  6. Never work for someone that has all new staff members or can’t seem to keep long-term team members. You will just be the next failure in a long line of cultural failures. Attitude and expectations with team and doctor input is an absolute “must have”, check the box, can’t succeed without job requirement.
  7. Culture, team members, and strong leadership have the greatest controllable influence on the results in a practice.
  8. While ideal, remember that owner mentorship and strong leadership as well as competent knowledge of transitions will usually be lacking in most practices. Truly, the owner hiring the doctor, as well as the new hire usually fall short of the knowledge of what it will take to succeed. Be patient with each other but expect that it will take an extraordinary effort for each of you to stay engaged in the process.
  9. The hiring spectrum needs to limit your choices and push you to only hiring a certain category of doctor: Above average clinical skills, incredible people skills, self-motivated, adequate experience, a mindset of striving to be continually learning, and a strong communicator. You will find a spectrum from terrible, poor, to just ok or average being an area that you should never consider as a hire. The trick will always be in figuring out a way to interview that culls these individuals. The sad news is that most of the candidates will fall here. I would only consider the good to great candidates. If someone pops up that seems perfect, I would also flee that choice too. If someone appears too good, then you are missing something. Remember that as the owner and leader of your practice you are the main reason it does well and the main reason it struggles. Any time you make a poor choice, you are at least 50% to blame. Choose wisely and take on the attitude of “whatever it takes” to make this work. I caution both the job hunter as well as the practice owner to become self-aware of your own preference, limiting beliefs, as well as what you do well and where you struggle. We have spoken of this before but take the time to look this up: The OODA Loop. An air force mantra designed to help fighter pilots win during dog fight engagements. Observe, Orient, Decide, and Act. The skill is in not skipping a step and having the whole Loop take seconds to minutes. Time pressures seem to handicap most practices. This will adversely affect your expectations, candidate pool, where you look, competitive wages and benefits, situational awareness, short cuts that don’t work, and hiring mistakes. Both parties need to be educated hirers and job seekers, both agree on the good to great hiring bracket, and both are flexible.

In the quest for a successful job or hire, you must be able to answer this question: What does success mean to you? In this definition you must describe your potential future, profits, and ultimate goal in taking on a transition or a new job. While the job market and economy can change and you have little influence on them, there are things that you can influence.

You can’t influence the personality, people skills, confidence, or competence of a candidate no more than a young doctor can influence a practices’ culture and historical numbers. You need to find the right office and candidate because it is unlikely that you can change them. This doctor must fit a profit formula for your practice as well as the practice must have the arena for the young doctor to succeed and meet their own take home needs.

Here are a few things I run into when I look at potential associate/partner hires or what I see when I look at practices to buy or suggest to the young doctor to consider or walk away from.


  1. Only appears successful because there is no other choice of jobs or candidate. (Like at 2 AM, the bar is closing, and everyone is starting to look like a 9 or 10.)
  2. Some practices have a great location: no competition, good access, wonderful signage on busy road, growth of demographics, large draw area, etc. You must ask yourself: Are the facts changing or can we depend on these great circumstances to carry the office through the next ten years?
  3. Lowered expectation for the hire or the practice because either or both parties are willing to settle for just OK, just average.
  4. Great self-image for no apparent reason. I see this on both sides of the isle. A kind of “legend in their own minds”. These doctors always got a participation ribbon but never really tested themselves or strived for winning. Someone raised with everything given to them. Great grades but no real-life experience. Some feel like success is owed to them (entitlement). Generational handicaps: work less with more pay, deserve the very best without tying that to performance, they justify this because they are “a doctor”, etc. They feel like success is owed to them.

I have spoken to doctors that previously produced well but failed to understand that the production was the result of unlimited patients supplied by the owner doctor and not through the efforts of the employee or their business skill. In fact, many times no one ever came in because of the employee doctor. They never really inspired those they worked on to refer or created referrals by what they did. They never really figured this out because they change offices every year.

Some made good grades in school, but don’t realize that this is an artificial environment that does not translate into success in the real world. For over 50 years, I see most honor graduates from dental school end up working for the C+ students. See, there really is hope for the masses. Real competence comes from learning, that is then tested in the fires of a small consumer driven business where the patients vote with their feet and their pocketbooks. Hierarchy of learning: from unconsciously unskilled to unconsciously skilled. There is a vast range of doctors out there that fail to ever progress too unconsciously skilled. True competence comes from having already been mentored in real world excellence and success. They have experience with lots of different types and ages of patients, and they are familiar with a wide range of services.

There is a huge chasm when we look at practices as well as employee doctors with absolutely no business sense or business skills. Why should there be, when we look at the curriculums of todays “for profit” dental schools. There is no, or even worse poor, training in situational awareness and how to run a successful business when the doctors leave dental school. Far too many offices are relying on someone else to do or perform areas in which they are not skilled or knowledgeable without first studying the challenge to become competent so that they know if the outsourced job is being done at a level of excellence. The thing that perpetuates this poor performance in dental businesses is that they seldom take the time to self-diagnose or even compare their results to a worthy office performing at a much higher level of competence.

Here is my short list for foundational Success in the new dental economy we find ourselves in. Without these in both the senior dentist and the new hire, the transition will not be successful.

Good schools that continue to improve their professors and curriculums. Candidates who have worked in lots of different jobs in their life.

Candidates that have parents who owned businesses and have lived through and been influenced by consumerism and the impact of strong and poor economies.

Candidates that have strived and succeeded through various challenges.

Candidates that have team player experiences in undergrad and in jobs they have held.

Doctors who have a lifetime student attitude, not an “I know it all” attitude.

Candidates that have great people skills and communication skills.

Candidates that have a Chameleon type of personality awareness. Can you stay centered depending on the person you are speaking with? (Driver, Amiable, Analytical, Expressive)

Candidates that have a curiosity for business and dentistry. They will always strive for a better result.

Candidates that are problem solvers in everything they do, have great situational awareness, and never settle for just OK.

Candidates that have persistence always get back up when they encounter a challenge. In fact, no one ever fails if they get back up when their challenges knock them down. In life you only fail when you don’t get back up.

Great doctors are future focused. They have become the type of person who sets a goal, creates a timeline to do it, and follows through to completion.

Great candidates are nearly always leaders as a student or at other jobs they have had.

For me, a great candidate has a servant mentality. The patient and others come first. I rarely find this type of candidate that does not also have integrity and a great work ethic.

Great candidates have lots of friends because they have people skills, and they use them.

Great candidates are trustworthy. I know that when I am not there, my partner or associate will represent the culture we have created over several decades. I trust them with my business because I treat every employee like a partner in “our business”, not just my business.

Great candidates have great morals. The way they live is the way they work. They have a great family and treat them the way they treat their patients and fellow employees. If you are looking for a job, then each of these last comments apply equally to an employer or practice.