Looking for the Right Balance between Dentist as Manager and Dentist as Care Provider

In the quest to understand the implications of separating management and treatment, we must first examine the forces driving management decisions. By defining ownership and equity interest, we are able to isolate a critical factor in the decision-making process. Evaluating the spectrum of the different models of dentistry gives us insight into potential advantages as well as disadvantages that can arise. In private practice, an owner typically wants to see the business grow over a lifetime, while, on the other end of the spectrum, corporate dental companies may be prioritizing dividends, investment returns through speedy packaged sales, or other means of reporting progress to investors. Interestingly, each model of dentistry has shown strength and growth, but there is no clear path to what is deemed ideal.

Group Practices and Partnerships: A traditional model that Fits Many Situations

The traditional group practice model can take many forms, including general practitioners, specialists, and combinations, as well as solo practitioners sharing space and staff, partnerships, and other legal entities. These practices may share some or all staff functions, including contracting for some functions. The essential characteristic is that those treating patients also have full control over and often direct management of the business aspects of the practice. The most important requirements for success in this model may be a common philosophy of patient care and mutual trust regarding business matters.

Sharing the burden

Expense sharing arrangements are extremely beneficial to dentists and not just in a financial sense. They can be easy to organise and administer, but must be based on a proper written legal agreement.

The keys to successful associateships

When a practice is running at a high volume and stress is increasing, dentists often feel that it might be time to add an associate. This can be a good decision if the practice has the right data-driven systems in place. Conversely, if the scheduling system is inefficient and not managed properly, adding an associate will only increase the practice stress levels. Once the right systems are in place, hiring an associate still requires excellent communication and training skills on the part of the dentist.

Partnership is a three-step process

BACKGROUND

Many dentists would like to bring in a future partner but are reluctant to do so for various reasons. The author outlines a three-step process toward achieving a successful partnership: the employment phase, in which an associate is introduced to and integrated into the practice; the at-risk associateship phase, in which the new doctor begins to assume financial responsibility for his or her portion of the practice; and the partnership phase, in which the partners achieve their full function as a team.

CONCLUSIONS AND PRACTICE IMPLICATIONS

There will be challenges in any partnership. Regular meetings, division of responsibility and open, nonjudgmental communication will diffuse the problems encountered in day-to-day practice and will ensure that the partners enjoy a rewarding relationship for many years to come.

When is the best time to hire an associate?

Hiring an associate is a natural step in the growth of a dental practice. However, it is a choice not to be made lightly or based on vague perceptions and expectations. A dentist wishing to bring another dentist into the practice needs to consider concerns such as the business of the operative schedule, personal and professional wishes in regard to sharing the workload, and how future practice growth or retirement will impact the choice of an assistant.

A study of the career development of male and female dental practitioners

AIM

The aim of the study was to determine differences between male and female dental practitioners in the positions they occupy within their employment, and to analyse the correlates of such differences.

METHOD

Postal questionnaire survey of a 1 in 10 sample of individuals taken from the General Dental Council register.

RESULTS

Female dental practitioners occupy lower positions in the employment hierarchies of the Community Dental Service and the Hospital Dental Service. Women general dental practitioners are significantly less likely to be sole proprietor of, or a partner in, a general practice. Ownership of a general practice is related to: sex, age, number of years qualified, number of children, and hours worked. Consultants in the Hospital Dental Service are more likely to be male, older, to have been qualified longer and (obviously) to hold more additional qualifications than their non-consultant colleagues. Senior Dental Officers and Directors of the Community Dental Service are more likely to be male, work longer hours and (again obviously) to hold more additional qualifications than Community Dental Officers.

CONCLUSIONS

Differences exist between male and female dental practitioners in the positions they occupy within employment hierarchies. Age, length of time since qualification and the acquisition of additional qualifications are consistently found to differentiate dental practitioners' status.

Successful associateship agreements

When evaluating potential associateship agreements, dentists need to recognize and understand how status, noncompete clauses, scheduling and compensation affect the strength of an associateship agreement. Dentists should not enter an associateship agreement without fully understanding the agreement and its obligations or without the help of an accountant and an attorney.