Important Details to Consider when Adding an Associate Dentist

Gary Takacs: This is The Thriving Dentist Show with Gary Takacs, where we help you develop your ideal dental practice, one that provides personal, professional, and financial satisfaction.

Gary Takacs: Welcome to another episode of the Thriving Dentist Show. I’m Gary Takacs, your podcast founder and co-host. we have a great episode for you today. It’s titled, important Details to Consider When Adding an Associate Dentist. lots of good information here. If you are growing and considering adding an associate or perhaps another associate in your practice, I think you’re gonna get lots of actionable information from this podcast episode. Hey, before I get into that though, two quick announcements to make. The first announcement is if you’re a regular listener, that we regularly put on virtual events, and panel discussions, webinars, sometimes just conversations with experts. But, coming up, in June, in fact, this is June 30th. we have a digital event titled, when Digital Dentistry Increases Production and Profit. We’re gonna talk about 3D printing, same day restorations and cloud-based systems.

Gary Takacs: If any of those, technology topics interest you, then this event would be a great one for you to attend. it’s on June 30th, six to 7:00 PM Eastern Time. it’s a one hour event. you’ll get one hour of ce. There is no tuition to attend this event. Great value for you. the only thing you need to do is, so you need to register ahead of time. so go to thrivingdentist.com/events and grab your seat. if you’re interested in that technology, this will be a great way for you to get some awesome information, get an hour of ce, at no tuition. come join us. The second announcement I have is, we have my co-host, Naren Arulrajah, with our Thriving Dentist marketing tip. And this marketing tip, is titled, what Do I Need to Do To Know About Marketing in The Age of ai? That question was submitted by, one of our listeners, and we thought it’d be a great topic to, sort of unpack for you. No further ado. Here’s Naren on what do I need to know about marketing in the age of ai?

Naren Arulrajah: What do I need to know about marketing in the age of ai? This is my marketing tip for the day. I’m Naren the founder of Ekwa Marketing and the co-host of the Thriving Dentist Podcast. This is a really good question, and this is probably the number one question I get in 2026. How has AI impacted search, and what do I need to know so that I can respond correctly? Number one, AI is here to stay, so it’s no longer a nice to have. It’s a must have. We all know Google Search now comprises AI search built into Google itself. So you have regular search, Google Maps and AI search. AI search comes in two flavors. AI mode, which is for the deep, the people who want to ask more serious questions of Google versus AI overview, which is default. And Google will automatically, for certain queries, show an AI generated summary.

Naren Arulrajah: That’s called a IO View. Classic example is, what is the cost of veneers in a particular city? Now, Google knows you are looking for a researched answers. So you’ll go and study all the websites that are doing what Google is telling them to do, following all their rules, and maybe pick three of the best ones it likes and creates a summary from those three websites as to, this is the average cost, here are the different kinds of things that people are doing with veneers, and gives you a nice, comprehensive answer. And it’s, it’s really fast. And one of the things I’ve noticed is that Google’s AI search has, is now in the billions a day. It used to be like nowhere to be found, but over the last year, Google has really ramped up today, by far, when it comes to people using AI search, Google is 3, 4, 5 times bigger just on AI search alone.

Naren Arulrajah: Now, I wouldn’t just focus on Google, I also would focus on chat, GPT, perplexity and Gemini. We do that for all of our clients. And when we look at these other platforms, the reason we focus on them, even though they’re so tiny, is because you never know what the future might hold. So you don’t want to be in, caught in a back foot. You want to be proactive. So make sure you are showing up on all these platforms, and we track it every single quarter and make sure that our clients continue to do better. The next issue we are finding with AI searches, some of these platforms don’t update their information as frequently as Google does. So the problem with that is a lot of times there’s incorrect information about your practice that’s being spread. Perhaps they picked up some information from some other source, and that source didn’t have the right information.

Naren Arulrajah: And because they don’t have the breadth that Google has to get real time information on a daily basis from every single website out there, that will hurt your practice. So one of the other things we are doing is to make sure that these other platforms specifically, you know, charge GPT and Perplexity, we are, the information that people are seeing on those platforms are consistent with what is true. For example, your office hours, the services you offer, information about the doctors, anything you do, we have to make sure it’s accurate. Otherwise, people get the wrong information and they blame you when it’s the platform that gave them the wrong information. So these are some of the things I would strongly lean into. Now, when it comes to AI search, two things I wanna point out. One is CR ux, that is Chrome ux. Pay attention to it. I can do a full, detailed breakdown on how that’s helping you. And the second thing you need to pay attention to is EEAT and Human First Content. So are you following EEAT standards? Are you making sure all your content is written by humans? If it is, again, you will do well with ai. Don’t ignore it. Have acquire audit your AI search as well as your regular search book, a marketing strategy meeting, it’s ekwa.com/td.

Naren Arulrajah: Hello, everyone. Today I’m really excited about our episode. This is Nere, your co-host. Hope you enjoyed that marketing tip. What do I need to know about marketing in the age of ai? This is the number one question I get asked by everyone. hope you listen to it. And, I’m sure you have lots of questions about, Hey, when I google myself or look at myself at chat GPT or perplexity, this happened. So book a marketing strategy meeting. We’ll answer all your questions. We’ll do six hours of research, and, I share the link with you. It’s ekwa.com/td. Today’s topic is a really important topic because this is something I’m glad our clients go through and let me explain. when a practice is adding an associate, one thing is for sure, it means they’re growing, they are succeeding, they’re winning, they’re doing well, right?

Naren Arulrajah: But it’s one of those folk in the roads where if you don’t do it right, that winning could turn into a disaster. And, I’ve heard horror stories having done this for 19 years, and Gary and I have are now working together for more than seven years, and he has been doing this for 46 years, and he has seen his share of horror stories. In other words, the morale goes down, patients leave. the doctor ends up wasting a lot of money in this experiment, bringing on that new associate. So there’s a lot of nuances that unfortunately you don’t know till you have gone through it a few times. And it’s not something you can go through a few through it a few times. It’s like getting a dental degree, three times because, you miss something in the first one.

Naren Arulrajah: So what I’m hoping that you’ll get from Gary today is that expertise, that experience, because he has seen this dozens and dozens, maybe even a hundred times, the good, the bad, the ugly. And he has helped clients navigate this. and he has done helped them do it successfully. So, avoid the landmines. And, I guess, speaking of landmines, now I guess we all are familiar with mines in the strai of homo. So , it’s a phrase that we all familiar with, so avoiding those landmines. so Gary, the practice is going, growing beyond what the owner dentist can handle. I know one of the questions is, when do I bring people on? do I wait? Am I, is this the right time? And how do I do it? So, I know we are gonna dive into all of that, but having seen this go sideways more times than it should, in this episode, what I would like to, discuss with you is how to avoid the mistakes.

Naren Arulrajah: How to avoid the landmines. How, like, what are the common mistakes that people are making? I’m sure we all make 300 mistakes, but probably there are few that causes most of the grief, just like the 80 20 rule works for you, for us. when it comes to doing things, smartly, we also the 80 20 rule on the common mistake. So I’m really curious about this topic. so every one of our listeners, I think either has gone through this with some success or probably have failed, and definitely now or in the future will go through this, right? If they’re growing, this is given, like, you have to bring in other people, who are qualified as you are to support you continue with that growth. so you need to get this right as a practice owner. The last thing that you want as a practice owner is to have that revolving door. That’s another issue that we see associates come, associates go, associates come, associates go. And after a while, the team is just dejected and they just give up. I don’t care. they’re just checked into. So you have this very unhealthy situation for the patients, very unhealthy situation for the team. And of course, eventually the practice starts eroding. So, lots of things to unpack. before we get started, what’s your experience, Gary, just at a high level, having seen this? I just want to get your 360 view on this.

Gary Takacs: Yeah. You said it very clearly that the last thing in the world, if you’re a practice owner that you wanna happen is have a revolving door of associate erodes value, in your practice. But let’s remember, there’s another, a party to this. you’ve talked about the owner dentist, Naren, you’ve talked about the patient, but we also have, doc, many listeners are associate doctors. Yes. And they wanna make sure they’re in the right situation as well, so that it’s not a dead end, for them. because that feels like a big, a huge leap backwards in their career. so really there’s many parties involved in this. but let’s not forget the associate doctor that perhaps, has a desire, to have equity in a practice or has a desire to maybe become a practice owner themself. and maybe it’s a transition plan where a senior doctor would, set up an associate doctor to become their successor. So there’s a lot of different, playbooks on this, but it is, it’s one that has a lot of speed bumps, and we wanna help our listeners avoid those speed bumps, for sure.

Naren Arulrajah: Absolutely. Got it. Could done,

Gary Takacs: Right? It could be done, right? I have experience in my own practice with, adding, two, associate doctors who became partners in the practice with a great success story. And it can be done very well. and so hopefully the outcome for any of you is how to navigate those speed bumps and have them meet your goals and your vision, and really end up with a situation that, is, part of building your practice, not eroding it through making mistakes.

Naren Arulrajah: Absolutely. And I’m glad you pointed out that we may also want to look at it from the associates point of view. So maybe as we go along, I’ll ask questions and I’m sure you will chime in, not just from the patients and the owner on dentists, but also from the associate. Yeah. Let’s jump right in, Gary. So my question first is, talking to the practice owners who are our listeners, and that is why is hiring an associate dentist so different from any other hire a practice owner may have made up until that point?

Gary Takacs: It’s because of the DDS or DMD after their name.

Naren Arulrajah: Elaborate

Gary Takacs: It. It’s, let’s understand that the public doesn’t understand the language we use, that they don’t understand what an associate dentist is. the public doesn’t know what that is. they just see that person as a dentist, another dentist in the practice. And they assume the public assumes that if you are going to have someone in your practice, there’s a ver someone who’s also a dentist in your practice, that you have screened and vetted and approved them to add to your practice. They assume you’ve done that. Mm-hmm . because of the credentials that individual has by having either the DDS or DMD initials after their name. and so it’s a very important hire, because imagine how it looks to a patient therein. If you’ve hired a doctor, perhaps you have, hired out a desperation, that’s never a good situation to hire anybody on, whether it be a team member or an associate doctor who’s, looking for a pulse, and hiring them to fill a, fill a void.

Gary Takacs: and imagine that person, six weeks later isn’t there. any patients they have seen during that time will have questions. Hey, where’s so-and-so? and it really just erodes trust and confidence. I think trust and confidence is a quality that is very tangible. it can be me, it can be measured, and it can be felt. it’s also abstract, it’s, it’s not completely, measurable. but you want, you wanna always be building trust and confidence, not eroding it. and that applies to our team as well. team members that we hire, we wanna have long-term team members that develop a poor relationship with patients. and if that person all of a sudden isn’t there, that kinda erode trust and confidence as well. But it’s kind of on a different level.

Gary Takacs: If we’re talking a dentist, it really is an entirely, different level. That’s why it’s a different hire. I think any hire we make should certainly be vetted. And we should do our screening. We should determine values, we should do values matching. we should make sure the people that we’re bringing on the team, fit our vision and fit the type of practice we wanna have in terms of the behavioral side of the practice, and also the clinical side. If we’re hiring side, clinical team members like hygienists and assistants. But it comes at a higher level, when that individual is a, is a doctor. And, sadly, I’ve seen situations, where there has been a revolving door, of associates. and in some cases, you know, some of that couldn’t be entirely sorted in the beginning.

Gary Takacs: Sometimes, it was things outside of our control. But that also can result in a revolving door of patients saying, I’m gonna go somewhere where, I know the people that are taking care of me. And this applies much more so to the type of model that we advocate. Naren, if you’re a long time listener to the Prime Dentist show, you could complete this sentence for me, relationship driven. It’s a relationship driven practice. Yes. I guess if you have an HMO practice or a Medicaid practice, it doesn’t matter who sees you, sadly. but if you have a relationship driven practice, this becomes far more important. Any higher becomes far more important, and certainly any higher of a doctor, maintains, an even higher standard. and that’s what we really need to take into account here, because of course, I think our listeners are of the same, model, goal of having a relationship driven practice, which is really what makes dentistry, such a rewarding profession, is to have a relationship with our patients. When we have a relationship. We don’t want a stranger, in the practice, and we don’t want a, you know, a parade of strangers, dentists taking care of patients in the practice. ’cause that erodes that trust and confidence. Does that make sense? Yeah,

Naren Arulrajah: Yeah, it does make sense, Gary. But let me kind of, unpack this, and I’ve been thinking what you’re saying, this idea of associate also exists in law. I’ve heard, like associate lawyer, you bring in a new lawyer, but the difference there is always, who the big huncho is, and he’ll say, okay, I am going to assign this to so-and-so. Of course I’m overseeing it. I’m on top of it. Any issues, you can always come to me. at least that’s what I have experienced. Now, here, that’s not the case right here. Like, literally, you are their dentist, meaning the new associate is their dentist, and you are working inside their mouth. It’s not like, oh, you can go back and undo what you did. Like, it’s like

Gary Takacs: The public doesn’t use the word associate. They just use the word dentist. Dentist,

Naren Arulrajah: Exactly. Exactly.

Gary Takacs: Dentist, like the owner dentist, that’s a dentist. The other dentist is a dentist. Dentist.

Naren Arulrajah: So it’s like the same in the public’s eye.

Gary Takacs: In the public’s eye. Again, that can be different in a law firm or an accounting firm. they, that can be different. There’s even different pricing, in Yeah. Accounting firms, there are, in terms of what they bill per hour, we don’t bill per hour in dentistry, yes. Per service. and, in an accounting firm, a law firm, there might be, you know, a, junior associate accountant, there might be an associate accountant. and then there might be a partner. A partner,

Naren Arulrajah: Yeah.

Gary Takacs: That bill. And

Naren Arulrajah: They literally tell you, Hey, I’ll do it, but it’s gonna cost you $700 an hour. Or you can have my associate, I think he can manage this. He’ll cost you, whatever, 300 bucks an hour. So people are like, yeah, I’ll take the associate. But here,

Gary Takacs: , that doesn’t, that billing, variance doesn’t happen in dentistry. Yeah. That person is just a, not just that person is a dentist. Dentist in the eyes and mind of the public and the patient. So more important, because of that fact that they have that, you know, very high status in the eyes of the patient. they’ve got Aden, they’re, they are a dentist. so we really wanna do our vetting. And this, again, I’m gonna repeat that this applies to any higher you make, recently, Naren, if we go back to COVID, the hiring world is different today than it ever was. Right? would you agree with me on that?

Naren Arulrajah: Yeah. I think the psychology of people change. this idea of we work just because we have been doing it to why am I working? All these things that popping up in people’s head, and I’m not saying it’s right or wrong, the world is different

Gary Takacs: Prac, practical level. Yeah. there’s been more jobs looking for team members than there have been team members applying for jobs. Yes. Now it’s changing. It is changing, especially as we’re into, 2026. I’m seeing it closer to normal. but I wouldn’t call it normal, yet we’re, we’re still, there’s, there’s more positions that are open, whether that be for an office manager, an admin team member, an assistant, a hygienist, or a dentist. There’s more assistant, positions that are open than there are people applying for those, positions. So it’s resulted in kind of a hiring, what I would call dysfunction of just urgency and hiring out of desperation. And that is not good. it is not good. Higher ed desperation is not a good situation to be in. So you really wanna be very purposeful, wanna have a lot of intent, and you want to really match, make sure there is a match, so that we don’t have turnover, especially at the Dr. Lo.

Naren Arulrajah: Thank you, Gary. I think you have clearly articulated why this is a critical hire for the, definitely for the patient, and, also for the team member. can you kind of talk about from your experience, how can this backfire if it’s not done right from a culture, from a team perspective? I’m sure you have seen horror stories, Gary.

Gary Takacs: Yeah. we really need to screen for fit. there needs to be a clinical fit. in other words, is this, doctor that we’re bringing to the practice, going to be able to provide the care at the standard of that we insist on in the practice. It’s not gonna be a lower standard of care. It’s gonna be the same standard of care. And that might mean that some of the procedures, if it’s a younger doc, newer and earlier in their career, might be, more along the lines of everyday general dentistry, as opposed to some of the high value service. they can grow into that, right? But there needs to be a fit clinically, there needs to be a big fit in value system. In value system. Which, where are the values?

Gary Takacs: there has to be a fit in leadership style. because although an associate Dr. May not have, defined leadership components in the practice, but they’re going to be leading the team members they work with. And so we have to have, leadership, compatibility. We also have to have, the concept of a relationship driven mindset. do they have people skills, or are they willing to learn and advance their people skills? Well, all those things come into play. and all of those either determine that we’re a closer fit or we’re not. and you need to be very selective here.

Naren Arulrajah: And also the team has to respect and want this person to succeed, versus they’re like, ah, I don’t like this person. And they’re like, doing things to kind of make it hard, right? So it’s not only it’s on the person coming in, it’s also on the people receiving the person coming in.

Gary Takacs: I’ve certainly seen many situations with the associate doctors where the team members, incompatibility with the, associate doctor has resulted in, bad situations for the associate.

Naren Arulrajah: So they were not part of the process. They were not, they didn’t buy into it. Is that kind of what caused interest? And,

Gary Takacs: And maybe the doctor didn’t, the owner doctor didn’t provide the leadership. it should be the team member, the team members. A part of their role, should be to help onboard the associate doctor, not just give a thumbs up or thumbs down. . you know, that’s what happens. the team members think they have a voice in that , and they think, thumbs up, thumbs in. Now, part of their role should be to, roll the red carpet out and help the associate doctor, fit, into the practice and succeed, in the practice. we need, we need to think of that as, a really important process as well.

Naren Arulrajah: So what I’m hearing is it’s not just the screening, it’s also everything that happens in the first 90 days and that can make or break the

Gary Takacs: Solution. Can I’ll, I’ll, I’ll state the obvious here. Yeah. People don’t like change. Mm. Many times people don’t like change, right? And now all of a sudden there’s this new doctor who, doesn’t put the bib on the same way as the older dog . And they throw a fit over things that don’t matter. , as opposed to, really looking at the big picture of how this helps the practice succeed. And really, I’ve always said that, what we’re striving for is we’re doctor, and now I’m gonna use plural. Doctors and team members are all in the same boat, rowing in the same direction. We’re all in the same boat, rowing in the same direction. And that now becomes not just doctor and team, but now doctors, because we’re talking about adding a doctor. Yes. Doctors and team all in the same boat, rowing in the same direction. Yeah.

Naren Arulrajah: Thank you. Gary. Let me, now you really set the stage. You talked to us about why this goes wrong and on the cost of it, what are some things that an owner dentist should evaluate regarding whether a potential associate is a good fit or not?

Gary Takacs: Yeah, great question. And, there’s many things. One I mentioned earlier is clinical fit. we should be asking to see, perhaps, there’s a photo album of their work, that they’ve done. Even a dentists coming outta school. we teach that at Midwestern, where I’m a guest, instructor. we encourage our dental students to put together a portfolio of their work. We’re involving a lot of different procedures with full photo documentation, and those are dental students in school. So certainly if a doctor has been in practice for a while, we should look at a portfolio of their work. that’s fundamental. if it isn’t there, I’m gonna start to have questions, at that point. secondly, we need to do the due diligence, Erin, let’s check the state board and see if there’s any complaints, against the dentist.

Gary Takacs: Let’s also check to see if there’s been any legal action, against the dentist. and, those things have a way of, surfacing with stories and signals that go along with it. Right? and sometimes there’s been a complaint, but it’s been completely resolved. so the fact that there was a board complaint doesn’t necessarily disqualify an associate doctor. ’cause sometimes, it was brought up, from a malicious patient when there was no merit behind the complaint. so we, I’m not just saying look to see if there’s any work, look to see what the resolution of that was, because if it’s, if it’s resolved showing, that there was really no, lack of performance on the part of the doctor, then that’s something that, would be good to know. would you do these

Naren Arulrajah: Early in the process, Carrie, the screening, like the photos and, board complaints? Would you do that really at the start of the process?

Gary Takacs: yeah. I would, I would do it. It was certainly, we probably had some kind of content. We’ve had, perhaps interview or a phone discussion, with someone, and we’re feeling like this may be a fit. Then that’s where we started to get into a deeper d level of due diligence. Now, let me, let me take it in a different direction. Let’s assume, for a minute that everything’s going well. the doctor has a portfolio of his or her work. It looks, it looks to be absolutely our standard. Well, let’s also get a list of their postgraduate CE that they have experienced. There’s a telltale sign, Erin, right there. because if a doctor has taken the minimum number of ce, hours to keep their license in your state, I’m seeing a pattern there that may indicate not a fit.

Gary Takacs: especially if you’re an off office that, really, believes in, a massive amount of CE really believes that education doesn’t end when they have their dental license. It’s really the beginning to really master their craft. the panky ladder that Dr. Panky described, really sort of, makes perfect sense here. Naren, you might remember me talking about that, but some of our listeners haven’t heard about it yet. But Dr. Panke de defined a ladder that has four different rungs on it at the very top of the ladder. Dr. Panke said, these were master dentists. These were dentists that, delivered impeccable dentistry in a wide range of services. Any of us would be very happy to sit in their chair knowing anything that would be done in our mouth would be done impeccably. And he said, only 2% of dentists will ever achieve that mastery status.

Gary Takacs: They could do it, they can teach it, they can demonstrate it, they can write about it. and that was all what defined mastery status. And, generally, associate doctors will not have achieved that master status, but that’s the top run of the la the next rung run of the letter, ladder. He said, we’re highly competent. We’re highly competent, 8% of dentists. So add the two together, the two at the top at the master status, and the eight at highly competent represents the top 10%. And these are dentists that, again, any of us would sit in their chair knowing that, whatever was done in the mouth would be done extremely well. We’re very good diagnosticians. we’re very good at delivering a wide range of care to a, to a very high standard. and below that, he called them students. So the third rung on the ladder were students. And, that represented, 36% of the profession, students. And there weren’t students in the context of dental students. They were, con in the context of dentists, practicing dentists that were aspiring to move up the ladder and become highly competent and ultimately perhaps masters. And so there’s a, there’s a range within that students.

Naren Arulrajah: So you bring up a another good point.

Gary Takacs: Well, let’s go to the fourth. Let’s, before we do that, let’s go to the fourth rung, which, represents the largest group. If you add that up, we’re at 2%, 8% plus 36%. What does that leave Naren?

Naren Arulrajah: so that’s,

Gary Takacs: 54%.

Naren Arulrajah: 54%. Yeah.

Gary Takacs: So 54 4% are indifferent. And by the way, that’s the majority. And I would politely suggest that we don’t want an indifferent dentist as an associate.

Naren Arulrajah: So let me, let me,

Gary Takacs: Would you agree?

Naren Arulrajah: I don’t know, Gary. That’s what I wanna ask you. This is something you didn’t name, but I just wanna name it this clinical philosophy. What if, again, the 54% exists, and they also might be looking to hire an associate? What if I’m a hiring dentist and I’m in that 54%, I’m happy, I want to do good dentistry, but I’m not trying to be a master. Right? If I’m that, would I hire someone who wants to be a master? Because if I do, they’ll be looking for mentorship and that kind of always pushing the envelope. And I’m not, I don’t care about, I’m just, well, what’s the definition? Being devil’s advocate, getting,

Gary Takacs: What’s the definition of indifferent? They don’t care.

Naren Arulrajah: They don’t care. Yeah. Yeah. Let’s say the hiring dentist isn’t that 54%.

Gary Takacs: Well, I would, politely suggest if the owner dentist is in that indifferent position. Yeah. then they need to correct that. They need to make that change.

Naren Arulrajah: So you’re saying they’re not even ready to hire someone, are you saying that everyone who hires an associate must, you know, not be in that 54%?

Gary Takacs: Yes. I’m making that very bold statement. ’cause if they don’t care, then there is a lot more wrong with their practice than finding alignment with an associate dentist. Then if they’re looking for alignment, then there’ll be aligning with the dentist that doesn’t care. Mm-hmm . By the way, I don’t think we have any listeners right, that fall into that indifferent status, because they wouldn’t be listening to this on their own time. True. So, I think by default, they’re not gonna hear this message. But yeah, you asked a question, what, if we have an indifferent owner, well correct that. Right? I’m not suggesting that’s easy. And I understand that.

Naren Arulrajah: And that could take time, right? Like, you have to change the way you are, the way your team behaves. Yeah. Ma mindset, you have to start actually living it. Not just saying, I’m gonna do it, but live it, and then showcase to your team. So team also becomes focused on become ma becoming masters, the hygienist, and, so everyone is trying to always grow and improve.

Gary Takacs: Well, let me keep going down. The other things we look for. So once we’ve identified that there’s clinical, the potential for a good clinical fit, by the way, clinical fit could be a different, comment as well. It could be, we could be looking for someone that provides services that aren’t being provided in the practice,

Naren Arulrajah: Right?

Gary Takacs: So, for example, an owner dentist that doesn’t do end, make it up an example, than maybe we’re looking for someone that compliments. So, it could be clinical compliment as well. we don’t need to repeat, we don’t need, another doctor that necessarily does everything the same that we do, in terms of clinical services. In fact, that might be a reason for adding an associate doctor. Maybe, an owner doctor isn’t one that enjoys surgery, but we have an opportunity with, extractions simple and, more complicated extractions. Maybe someone that does, third molar, wisdom teeth extraction. And maybe if they do surgery, they’re also someone that’s interested in placing implants. So that could be a compliment. so in some ways, the match might be complimentary, not just, same as, so other things, again, keep, let’s talk about some things we should be looking for.

Naren Arulrajah: Just Gary, on the same topic. Gary, what about clinical philosophy? What if I’m the owner dentist, and I believe in minimally invasive dentistry? I’m just making this up. Oh, I believe in paying attention to the materials. You, we have a lot of listeners who are holistic, for example, right? Is it key that I hire someone who have that same kind of way of looking at dentistry?

Gary Takacs: If your practice, is branded that way? Okay. branded in terms of your marketing, in terms of what the culture of the practice is. For example, you talk about holistic dentistry or, there’s other names for that type of dentistry, then I think that fit becomes more important, right? If it’s a general dental practice, clinical philosophy, maybe you check things like, when do you generally recommend replacing, amalgam Phillips, that might be a broader way to look at fit. so we wanna have some fit there for sure, because there will be crossover procedures, things that,

Naren Arulrajah: So you don’t want to be on one page and your associate is on a different page. Yeah.

Gary Takacs: But now let’s go into a different direction. look for values match, in terms of their value system, how they, how they treat people, what their concept is. a good question would be, tell me your thoughts, a about a relationship driven practice. What does that mean to you? If they can’t answer that question? if the answer that you get a blank stereo, I don’t know what, I don’t know what you’re talking about. if you have a highly relationship driven practice, then that might be a strong indicator that, they’ve worked in environments where, you know, it’s, it’s drill fill and bill. and, it’s kind of hard to break that pattern depending on how long they’ve worked in that kind of environment. Mm-hmm . and, the longer they work in those kind of environment, the harder it is to transition.

Gary Takacs: And it’s perfectly okay for someone to say, the reality is, my past situations, I’ve been in, more basic transactional practices and I’m interested, I’m deeply interested. That model doesn’t fit me. Yeah. That would be an honest conversation for an associate doctor to have. I’ve been in transactional practices mm-hmm . And that model doesn’t fit my value system. Mm-hmm . If I was an owner dentist, hearing that, my ears would go at attention thinking we might have a good, now they may not arrive in your practice with all those skills, but the fact that they’re interested in it and they have an appetite toward it, would be a very good sign. So, and

Naren Arulrajah: Also values are unspoken. Right? I remember you or somebody sharing the story with me where they took this, associate to dinner and the way he or she treated the waiting staff told them, there’s no way I’m gonna hire this person. Like, they were not kind, they were rude, which

Gary Takacs: Brings up a good, a good, tactic here. Make sure that, the way you’re spending time together in the vetting is outside of just an interview setting. Mm-hmm. Have a, have dinner together, some watch and observe. I would also, encourage for our, let’s say our owner doctor is married, and let’s say our, associate candidate is also married. then in invite their partners, to those events, because that’s where we can really take a better assessment of who is this individual, who is this individual.

Naren Arulrajah: Exactly. Like, let’s say the practice is kind and people, help each other. And this person is like a doesn’t care about people, thinks he knows best. He won’t fit in with the team, he won’t fit in with the culture. Right. It’ll be like a total rejection. Yeah.

Gary Takacs: Yeah. So make sure that includes, that time together as well, other than just the formal interview, kind of setting. But really I’d be interviewing more, for values, than I would for, their, clinical skillset, you, their clinical quiver, in terms of what they do. That’s part of, part of it, for sure.

Naren Arulrajah: Let me, lemme throw a curve ball here. Like, if I say, we are relationship driven, do you believe in relationship driven? They’re gonna of course say yes. Right? So how do you really find out who they really are? Because tell me

Gary Takacs: What that means to you.

Naren Arulrajah: Okay. Okay.

Gary Takacs: Tell me what that means to you. What does relationship driven mean to you in a, in a context?

Naren Arulrajah: Right.

Gary Takacs: And then, you ask questions that do not have a yes or no answer,

Naren Arulrajah: Like, open-ended question, tell me how, what happened. Or, you do

Gary Takacs: Believe in relationship driven prayer, everyone’s gonna say yes, right? Everyone will say yes. Yes. So learn how to ask questions that do not have a yet. The, it’s a closed ended question. If the answer is yes or no,

Naren Arulrajah: Yes.

Gary Takacs: It’s open-ended when they, the question can’t be answered, yes or no.

Naren Arulrajah: Would you, would you encourage your team to kind of spend some time before hiring

Gary Takacs: At some point? Not in the very beginning.

Naren Arulrajah: Okay. Okay. And how would you set it up? Would it be like a working day or would it be like dinner? I’m just trying to kind of unpack

Gary Takacs: It. It would likely be more in the format of, a team meeting without an agenda. Okay. In other words, we wouldn’t be working through, an agenda. It’d be a team meeting, a chance to a meet and greet. more of a meet and greet, a friendly meet and greet, process with the team. Yeah.

Naren Arulrajah: Makes sense. This is all amazing stuff. And these are, might be the a hundred reasons why hiring an associate dentist goes wrong. Right? It’s just the nuances. The details. And what about,

Gary Takacs: And by the way, if you’re an associate doctor lot, you know, we talked about the other side. Yeah. I would highly suggest, don’t accept an associate position for, the 54% of dentists that are indifferent.

Naren Arulrajah: Hmm.

Gary Takacs: There, I would strongly suggest that, because that would be very frustrating if you, if you aspire to be exceptional and you work for an indifferent, dentists, that is not a fit on yours. So the fit swings both ways. Right.

Naren Arulrajah: What about motivation, Gary? Like some people might say, what, family is important, I wanna work part-time. Whereas if somebody says, I really want to lean in, I wanna become the best dentist. Somebody else might say, Hey, I want an ownership path. So how do you figure that piece out? Because there could be alignment in everything else, but if there’s not alignment in what the dentist wants and what the associate wants, I’m assuming that also could, not work out

Gary Takacs: A absolutely nothing wrong, with a part-time dentist. Mm-hmm . If that’s, if that desire desirable, and again, it has to fit your, maybe your, you don’t have the patient base to support a full-time dentist, but you could have a two or three day a week dentist by ba by virtue of your patient base. and that would be a, an example of fit. but absolutely nothing wrong with a doctor that, their goal is to land a two or three day a week associateship. Right. Especially if that doctor says that. And, this could be either gender, it could be a male or female, but they might say the way we’ve structured our life, I don’t only need to work three days a week and I’m, I don’t wanna work in one day in three different practices. I wanna commit myself to one practice three days a week. That would be a good sign. and again, that might match up with yours where you’re nervous about, the fact that you don’t have a big enough patient base to support ’em more than that. And that would indicate that there’s a good fit.

Naren Arulrajah: And you may also wanna get into the context, right? Because if they just say what they think you want them to say, then of course that’s not good. You really wanna find out is it, honest or genuine and stuff. let me go to the next question, Gary. When would you recommend, I’m gonna make it two parts, not hiring an associate dentist or flip side. I’m an associate dentist not accepting an offer.

Gary Takacs: The number one mistake far and away the dentists make when they hire an associate is the practice doesn’t have enough dentistry for the owner, doctor, and the associate doctor. Great. and if you’re a young doctor and you’re interviewing into a situation and you can say, tell me a little bit about what support I would be provided in terms of my schedule. If the owner doctor says, oh, that’s up to you. You gotta go get your own patients, I would run away. that is not the situation that you wanna be in. The number one mistake is there’s not enough of a patient base, not enough of, schedule to support both doc. And if you’re an owner doctor that is hungry and wanna make sure that his or her schedule is scheduled full, and what’s gonna happen to the owner doctor’s schedule, it’s going to be, a not good outcome. Yeah. Not a good outcome.

Naren Arulrajah: Yeah. No, I totally get it. Gary, thank you so much. how would you structure compensation for an associate dentist? And again, it does, it, does it depend on the kind of relationship, kind of long-term planning, or it doesn’t?

Gary Takacs: Well, there’s some guidelines. there is some industry standards that we can, look at. typically what we see of hire associate is they’re often provided a daily guarantee against a commission. So there’s a daily guarantee against a commission. And the commission is usually based on their adjusted production. Adjusted production. In some cases it might be based on the collections of their adjusted production. I like to base it on adjusted production. what does adjusted mean to you, Naren?

Naren Arulrajah: I guess I know I want you to define it because I don’t want to guess on this one. . So,

Gary Takacs: Adjusted production is what you can collect is what’s collected. Okay. so for example, if it’s a PPO office and the fee, for a crown is $1,600, but their contracted fee is 1100 adjusted production, they’d be paid on the $1,100. ’cause you can’t collect the difference. There’s other kinds of adjustments though. There’s, redos, warranty work that we have to redo. You don’t get paid for that. if we’re doing team dentistry, if we’re doing family me member dentistry, there’s other kinds of adjustments. So adjusted production is defined as the dentistry that we’ve done. That’s actually collectible. And the biggest category, what’s the biggest category gonna be? There by far,

Naren Arulrajah: PPPO write-offs.

Gary Takacs: PPO write-offs. So if a young desk doesn’t understand that, and they look at the fee schedule and say, wow, I’m, I’m gonna do really well. And then they realize, wait, when they get their first check, I’m, I’m seeing this happen more than a few times. No, I think there’s a mistake here. , it’s way less than I thought. And it’s because they didn’t understand the difference between, you know, your production and your adjusted production.

Naren Arulrajah: What about collection? What if a practice has a problem collecting that

Gary Takacs: That needs to be on the owner dentist

Naren Arulrajah: That needs, okay. Okay.

Gary Takacs: ’cause it’s, it’s the owner dentist. It’s the protocols, it’s your systems, it’s all of that needs to, that’s, that’s my strong opinion on

Naren Arulrajah: That. And so you’re saying if you’re an associate, you better make sure that’s the case. Like you are not penalized because the practice is not doing a good job collecting.

Gary Takacs: Right. And I would also say that this points to, the, our less insurance, if you’re less insurance dependent mm-hmm . Remember, less insurance dependent means you reduce your insurance for it doesn’t mean it’s eliminated. Yeah. But if you have a less insurance footprint, it puts you in a stronger position to hire associate docs because of the fact that they’re gonna be compensated better. Mm-hmm . based on the fact that, you have less, insurance write off and less adjustments. and if you have a fee for service practice, you’re really in the catbird seat in terms of hiring, associate docs. Because the number of associate pure, fee for service associateships are very few and far between, which really puts you in a strong position to attract and keep the best associate doctor. So you guys want help with that. If you want help with reducing your insurance dependence, or if you’re, feeling like you might have the practice that could go all the way to fee for service, and you’d like some help with that, reach out to me. go to thrivingdentist.com/csm. we’ll have a zoom meeting about that and talk about how we can strengthen your practice. That puts you in a really strong hiring position. You become like the employer that every dentist wants to work for, because of that status.

Naren Arulrajah: Yeah, absolutely. All you’re looking to hire an associate instead of, making a mess and then having Gary clean it up, talk to Gary, regardless of where you are. So, book that customer success, the CSM coaching strategy meeting, and, you will get a lot of value. Yeah. Gary, let me get to the next question. You have seen this probably like a thousand times from your experience, what would you say is the number one reasons why Associateships fail?

Gary Takacs: Well, it kind of goes back to ’cause it, that door swings both ways. It’s the practice isn’t strong enough to support the associate doc. So the doctor, he or she may have gotten, over her, his or her skis and thought they had enough, patients, but in fact it doesn’t match up. And, maybe they hire a full-time associate doc when in fact the data only supported two or three days. I see. So good analysis, really know your numbers, know your metrics, know your performance, and understand that, you know, look at that accordingly. Maybe we start with, someone at three days a week and their desire is to work four days a week and to grow into that. That might be okay,

Naren Arulrajah: You’re saying under promise and over deliver and make sure your numbers are solid. So that’s not enough volume. That’s number one. what is number two and three, just in case. So we can give a comprehensive view mis

Gary Takacs: Mismatch in values,

Naren Arulrajah: Mismatch in values,

Gary Takacs: Mismatching values, and then maybe false expectations would be number three, right? maybe this is a young doctor that, really aspires to, do a ton of aesthetic or cosmetic dentistry, and that’s a lane that the owner doctor, loves. And also, doesn’t have enough of that in that practice to let it go. Right? Or you can have two dentists in the practice that both love doing aesthetic dentistry. Right. But then we have to have a marketing plan in place to bring more patients that are interested in aesthetic dentist. All this can be solved with marketing. Yes. so, the fact that there’s similarity in clinical interest isn’t to disqualify,

Naren Arulrajah: Right.

Gary Takacs: But we have to look at the value. if, like, let’s say both doctors love doing, aligners and specifically Invisalign. if the support, if the case starts an Invisalign, doesn’t feed enough appetite for the owner dentist, then we’ve gotta build that up. If an, if an associate Doctor Al also likes to do Invisalign. So thank you. Kind of comes down to marketing there.

Naren Arulrajah: Yeah. If anybody needs marketing help, go to ekwa.com/td. We would love to help. we would see where you are and help you get to where you need to before you can bring that associate and become successful hiring an associate

Gary Takacs: Before we go back to that, Naren. Yeah. I wanna add one more thing to a previous question. Mm-hmm . And that question was, when should an associate doctor Absolutely. When should an known not hire an associate?

Naren Arulrajah: Yes.

Gary Takacs: it’s gonna be a quick answer. I’ve, I’ve asked a number of my clients over the years, so, your practice is really strong and you could benefit from an associate doctor. What are your thoughts about that? so the data shows that they could benefit from another doctor and on more than a handful of times, the owner doctor has said to me, either look me right in the eyes if I was face to face or look me right in the eyes in a Zoom meeting and said, I don’t play well with other dentists

Naren Arulrajah: Bad enough.

Gary Takacs: And when I get that it’s happened, yes. I compliment my client and say, well, you get an a plus for self-awareness . So if you are a dentist that doesn’t play well in the sandbox with other dentists, then don’t do it. So it isn’t for you .

Naren Arulrajah: Yeah, that’s an excellent point. It doesn’t mean that every single one has to have an associate dentist. Right.

Gary Takacs: We have in our, in our coaching, I love the idea of a three day doctor week mm-hmm . To clinical. and so if there’s a owner, doctor and associate doctor or owner doctor and a partner, doctor, they could easily, each doctor could work through maybe one doctor works Monday, Tuesday, Wednesday. The other doctor works Wednesday, Thursday, Friday. But I have a handful of clients that are thriving dentist coaching that work the three day schedule themself with by choice. ’cause they don’t play well in the sandbox with other dentist. That’s just what they want. It’s perfect. and there are limitations to that. There’s a limitation to, providing your patients enough access and hours, and these clients accept that. So these are our hours and yeah, this is when we work

Naren Arulrajah: E even team. Right? They can only work three days a week.

Gary Takacs: Well, that’s the second problem is yeah. That, it can limit your Audi, your audience of potential team members. Because if they’re working three eight hour days, that’s not a 24 hour week because of morning huddle and end of the day wrap. It’s probably more like 26 or 27 hours a week. Yes. And there’s plenty of team members that 26 or 27 hours a week don’t work for. They need more hours than that. But there’s also plenty of team members where the 26, 27 hour week would be perfect. Right. And there’s also some creative ways to solve that. If you have great people that need more hours, there’s some creative ways that we can solve that work for the patient, for the team member and the practice. Right. but that would be another disqualifier. If you don’t play well in the sandbox with other dentists, then don’t think about adding an

Naren Arulrajah: Don’t do it. Don’t do it. Last question, Gary. Hiring an associate dentist is not a one and done exercise. What do own a dentist need to do to make sure the associate dentist is a long term fit and success in the practice?

Gary Takacs: great question. And really, my answer is that, it involves, mentoring mm-hmm . Mentoring opportunity. Make sure we’re setting up mentoring time where we can meet together and talk about cases, talk, share radiographs and records and say, you know, here’s some things that I see here. What do ? here’s what I’m thinking of a treatment plan. How does that fit with what you would see as a treatment plan? and these don’t have to be, like long laborist sit down meetings. they can be, weekly check-in meetings. Mm-hmm. In fact, the check-in meeting can be just as valuable. imagine sitting down, at the end of the week and set a timer. literally set a egg timer, , where this is gonna be 15 minutes. and hey, I’m just checking in.

Gary Takacs: How was your experience this week? What, let’s talk about some things that went well, what went well this week? Where did, where did you feel like, we can all improve, this week? How can the team be more supportive? and think of regular check-in meetings is the way to do and set up the next check-in before you finish that one. and it doesn’t have to be weekly, but it can be a regular cadence, is what I’m talking about. A regular show that you’re investing in the success of your associate doctor show that you’re investing in that.

Naren Arulrajah: I had a, I had a follow up question on that, Gary. You said one of the reasons, partnerships or associateships fail is, mismatch in expectations. The doctor wants one thing, the owner doctor wants one thing and the associate wants one thing. How often, as part of these check-ins do you think they should talk about, Hey, life changes, right? Both for the owner as well as the associate. How often do they sh kind of look at the

Gary Takacs: What of the conversation? One of the questions to ask at the very beginning mm-hmm . And I would ask it this way. Mm-hmm

Naren Arulrajah: .

Gary Takacs: Do yourself becoming the owner of a practice? Mm. Ask that question. And if they say, I don’t wanna own one by myself, I’m not that fond of, the one doctor, owner, doctor practice model, but I would be interested in equity. Mm. If that is part of your plan, that you have a practice that would like to provide equity, then there’s a fit there. But it’s also okay for, a particular candidate to say, I’m really not interested in equity, and that’s not a disqualifier. That can be a perfect fit for an owner that doesn’t want to give up equity. That can be a very good fit, good, a very good fit, and there might be some good reasons why, an associate doctor, the ownership isn’t part of his or her career plans.

Gary Takacs: It’s perfectly fine. but we have to look for the match. Again, we’re looking for the match that Now, as we wrap up this episode, this has been a fun one. Lots of details here. Yeah. One you wanna go back to and re-listen. I like the idea of, at least the two doctor practice myself in terms of the model, especially if we can then structure the three day clinical work week, for each doctor. I like that model a lot, by the way, financially, that model can be, can really achieve incredible, performance. in that model. I also respect the model. If a, if a doctor simply wants to be a solo dentist by herself or herself, I respect that model as well. but, bigger isn’t always better.

Gary Takacs: Sometimes it’s bigger. and, someone might ask, well, why would I wanna own part of something when I used to own all of something? And the answer to that, is that a smaller slice of a bigger pie might be worth more than the entire pie down the road. I experienced that myself, as a practice servant. and that can absolutely be true. And also, it’s at some point the idea of having, another doctor that has ownership of your practice makes it easier to divide and conquer the other aspects of dentistry besides the clinical.

Naren Arulrajah: Good point. Good point.

Gary Takacs: Hr,

Naren Arulrajah: Like, you take care of marketing, I’ll take care of this, whatever.

Gary Takacs: And you can divide and conquer, and that way your time outside of share side can be much more manageable.

Naren Arulrajah: And also, you might enjoy certain things, but hate certain other things so that the other partner might enjoy , so.

Gary Takacs: Right. Absolutely. So, but I do favor the idea of, at least a two doctor practice. And it could be more, it could be a three doctor practice in the right environment with the right, you know, facility and everything else. and, if you’d like to explore that, I’ll invite you to go to thrivingdentist.com/csm and talk to me about what your vision is. Where do you wanna go? Yeah. How big is your, maybe your vision needs to be expanded and you can think bigger. And also, so much of this does revolve around marketing, making sure you have a big enough patient base. If that is, the missing link in this for you, then set up a marketing strategy meeting. Go to, share your URL for that, Naren.

Naren Arulrajah: It’s ekwa.com/td, thriving dentist.

Gary Takacs: Yeah. And that solve that proactively don’t, don’t try to solve the marketing problem after the fact. , solve . Yes. Then you’re in position to stroke, ab. Absolutely. Well, thank you. I wanna thank each and every one of you for your listenership. We appreciate thrivingness, we appreciate, each and every one of you. We treasure the fact that, you spend time, listening to the Thriving Dentist Show, and we appreciate that. well, on that note, Naren, let’s thank our listeners for the privilege of their time and let them know that, we look forward to the next Thriving Dentist show. And if you haven’t already registered for, the, event coming up, our digital dentistry event, that’s happening on, June 30th, go to thriving dentist.com/dance and register for that event. Thanks guys.