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728: How to Fail Hiring an Associate - Bob spiel

Most associateships — 75% of them — are doomed to fail. If you want to be part of the 25%, don't miss this episode! Kirk Behrendt brings back Bob Spiel, founder of Dentist Partner Pros, to share his expertise in building successful associate relationships, no matter what stage of your dental career. Are you ready to commit? To learn how not to fail when hiring an associate, listen to Episode 728 of The Best Practices Show!

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Episode Resources:

Main Takeaways:

  • Understand why the majority of associateships fail.
  • Before anything, be ready to commit to an associateship.
  • Be clear about what you and your team want in an associate.
  • Clearly communicate onboarding, mentoring, and salary expectations.
  • Set aside formal time to give and receive feedback from your associates.
  • Synergy is your goal. Don't view your associates as a threat or competition.

Quotes:

“When a practice gets really busy, that doctor has to make a decision about what to do next. Often, that decision is, ‘I need to replicate myself. I need to find another doctor who can come in here and take the lower lying stuff that's closer to the ground. I'll do the bigger stuff and we'll make sweet music together.’ Instead, what I found is, so often, those relationships are entered into really poorly to start with. Then they fall apart, and the hiring doctor, who is usually the practice owner, is back holding the bag and this time in a worse situation because the associate did get busy, and they did continue to grow. And now, it's right back at square one, and they're looking at themselves like, ‘Why did I do this? What can I do next time that's going to make it different?’” (4:56—5:48)

“What do we see over and over again with why the 75% number has been out there for decades? This is what I find, is there are two groups of dentists that are looking in this market space. You've either got those that are in their late fifties, they've succeeded, they know that they need to make a transition, and they don't just want to sell. They want to bring somebody and mentor them. Or the other person who is probably about 20 years younger, has succeeded really well in his or her practice, also a booming practice, and they've reached this point of saturation where they have very little time for themselves, and they feel like they're on the treadmill all the time. Both of these doctor groups have a distinct need, and that is, ‘How do I find somebody else to be able to help shoulder this load who is going to be a fit, who is going to make money, and who is going to stay long term?’ But sadly, what they typically do is the exact opposite of what they should do. I've heard the phrase that dentists spend more time planning their vacation than they do actually figuring out how to hire their next associate. I think a lot of that is true." (7:01—8:18)

“The older [dentist] may end up hiring a firm because there are lots of people in the space that do this. They hire a firm, but there's not a lot of vetting. They're just getting the job ad out there. They find a few candidates. They find one they really like. They like their resume. They've talked to them over the phone. They go to dinner. The dinner goes well. There's a loose contract. Then, he announces to his team the next day, ‘Oh, Dr. so-and-so is going to be joining us in a month.’ Then, between the two of them, they're fighting for the schedule back and forth. And within seven months, the associate leaves because he or she hasn't hit their numbers. They don't see a lot coming their way. There hasn't been any mentoring, and things have been really loosey-goosey. The other thing that happens is there is no contract, or they didn't even hire a firm to help them. They are just using their own resources to go find people that are out there. They may network. They may use social media to do it. They've got really unclear mentoring and communication — a lot of expectations that are unmet on both sides. And again, boom, the relationship ends. The irony is that this happens often. Not just once, not just twice, but for many of the clients we have, they'll say, ‘Yeah, this is my fourth associate.’ ‘What happened to the other three?’ ‘Well, they didn't work out.’” (8:21—9:47)

“Are you ready to make this commitment and make this happen? Do you have the levels of busyness that are required to be able to move this person in? The phrase I use is, is this doctor so busy that on some days they practically want to throw up? Is that level of busyness to a point where you realize, ‘You know what? I am not effective in my role,’ and it starts to impact your life, it starts to impact your marriage, your kids — everything — because you're running and running and running? So, once you know that you're at this point of saying, ‘Yes, I want to make some changes. I've got to do something about this,’ and knowing that the old way never really worked, what's the new way to do it? Determine if you have a need. Once you say yes, then the next thing you've got to do is be really intentional about who is going to fit this need.” (11:30—12:33)

“There are times that we will turn around and tell somebody after we do this initial analysis for them, ‘We don't think this is a fit. There are other solutions that you've got to look at.’ You've got the combination of, are you personally the type that will work well with somebody else in your sandbox? Do you have the space in your practice to be able to bring them on board? Is your busyness at the level where you know that there's enough that you can start to share with somebody else as you dial them up?” (13:55—14:28)

“Where you go next is clarity. And what we found is it doesn't take a lot of time . . . You brought up the word vision earlier. What we're doing is envisioning who this person should be. I joke with the teams that we work with because we will go and interview the teams. Solicit their feedback. Who do you think this person should be? What should they be like? I joke and say this is kind of like match.com for dentistry. But instead of tall, dark, and handsome, we've got another set of criteria we're looking for. What are they like? How long have they been in dentistry? How do they fit, personality wise, with the practice? There's a whole list that we've come up with.” (15:38—16:25)

“Here's the thing that I found in interviewing and selecting and hiring. Too often, we use all our gut and very little of our brain. We've got to reverse that whole thing. So, if we're intentional about their characteristics — and we go as far as to break them down into what we call givens and wants. The givens are the absolutes. They have to nail these characteristics or they're not a good candidate. And what are the wants? You can rank them based upon how important they are to each other but be really intentional of who is going to fit here. And solicit your team's input into this because that's one of the biggest mistakes doctors make, is this idea that, ‘Well, I don't need to include my team. I don't want to let my team know.’ Okay. But who's going to help this doctor succeed the most? It's the team. So, bring them in early. And it's not that they have the final say, but you want their opinions. You really want them to help create what we call this avatar of the ideal person because that is what you use to be able to interview against, survey against, do reference checks against. So, it's using your brain, and then you allow your gut in the end to confirm if this is the right person or not, instead of using your gut and then your brain in the end tries to figure out, ‘How do we make this work?’” (16:28—17:56)

“What's fascinating is, for some reason, in love, opposites attract. But in business, opposites repel in the end. You've got to be close enough, but not the same person to be able to actually have a good fit. But if you're exact opposites of each other, typically, the relationship will fail just because by showing up you both bug each other.” (18:36—19:03)

“I'm a huge believer that if you want this associate to buy in and work that you've got to have that opportunity down the road, but it's really clear in the contract what that time frame looks like, how the practice is going to be valued when that does happen. By the way, we recommend that you value it at the time they join and the time they buy in, and you split the difference. But you also make it really clear, in order to reach that golden carrot, ‘This is what you need to be able to perform in terms of production, but also in terms of the type of dentistry you do,’ but also how you help with the management. Again, clarity. If there's a word behind this, why we fail, it’s because it's unclear. Why do we succeed? When do we succeed? It's because it's clear. It's clear to everybody. So, that's the first piece about equity. Make it clear. Make the pathway very understandable. And then, provide feedback to this dentist to know how he or she is doing towards that.” (20:32—21:44)

“It's about creating synergy and not being afraid that, ‘Oh, man. I've got this other doctor who's coming in, and they're going to start to compete against me.’ That's not the goal. You want them to be at your skill level because you can actually then grow your skill level even more, clinically. So, there can't be this thought that, ‘I'm just going to feed them the junk, feed them the lower line stuff,’ because nobody is going to want to stick around to do that. And if they do, it's the wrong person.” (22:05—22:36)

“Be really clear about mentoring. Have a very clear path of how you on-board, how you mentor, how you provide feedback back and forth between both. And share in CE. Love to have a 50/50 agreement up to $5,000 a year to invest in this new associate’s CE. They kick a dollar in, you kick a dollar in, for instance.” (23:04—23:26)

“Onboarding means, number one — and it actually starts before they're even there inside the practice — you arrive at a contract that is a win-win between both of you. Once again, clarity. Make sure this contract is well-written. It doesn't have to be more than eight pages long. It's got everything you need, but it's clear and it works for both parties. After that, to on-board, you actually have to begin the process even before they show up. Have a really well-written bio. Have a great way to alert your patients that you're excited about this brand-new associate dentist. One of the greatest things I learned from Linda Miles years ago was, never use the phrase “associate dentist”. They're called a “hand-picked clinical partner”. Isn't that sexy? Because you know what happens? ‘Well, we've got this new associate.’ Boom! You've got a pecking order already in place.” (26:19—27:22)

“The day that [the associate arrives, have] a clear plan of how you're going to have them shadow. Some clients of mine have actually had them assist the senior doctor for a month, which I thought was fascinating. Others have them shadow for a week. But again, clarity. Be really clear what it is you want them to do, first and foremost. Then, you have a plan to get them busy. And the busyness will come from limited exams, select new patients, select patients out of hygiene, and production that's being referred by the senior doctor to the new doctor. That's how you start. That's not how you end, but that's how you start. That's priming the pump. And have one of your most senior assistants work with them. You may not be able to have that senior assistant there all the time. But, by golly, you want the senior assistant there part of the time. Why? Because who is going to be the best judge of their clinical skills? It's going to be that senior assistant. And who is also going to help them learn more if they haven't been in the industry very long? That senior assistant can really mentor them.” (27:33—28:46)

“In the contract, there should be a time where there's a minimum guarantee. That allows the associate dentist to be able to relax and breathe while things are dialing up. For the owner dentist, that also lets them set a budget number that they know that they've got to be able to hit . . . We recommend that minimum last three to six months. In some markets, 12. But honestly, if you've hired the right person, within about two or three months, they've already stepped outside of the minimum guarantee and they're outperforming that. The normal amount that you find in private practice today is about 30% of either adjusted production or collections.”  (29:57—30:44)

“Thinking about the whole equity side of things, we also love to recommend that after about a 12-month period of time that if this is geared towards having this new doctor buy in, you've got another five percent “escrow agreement” or escrow account where they have added collections that are going into that pool which will go towards their buy-in. Now, if the new doctor leaves, that goes right back to the senior doctor. If the new doctor stays, it still goes to the senior doctor, but this time as cash. It's a mental hook, for one thing, and an emotional hook. But it also helps establish the balance between the two of them in terms of where they're going and why.” (30:57—31:48)

“Don't force patients to see Dr. New. You say, ‘Dr. Wonderful’s next opening is in six weeks, but his new clinical partner has an opening next week. Which would you like?’ And if the front desk believes in this doctor, they can do that authentically. But in addition to that, we found it's also really important to have time for feedback. Not just informal, because there are going to be these discussions all day long about this patient, that patient. Actually have a time to sit down and talk about, ‘How are things going? What's working well for you? What's working well for me? What's not working well for you? What's not working well for me?’ And that gets scary. Most dentists do not like to have those types of conversations. We found that it's really helpful sometimes to have a third party involved in that. We would call them marriage counselor calls, but that last piece is really important to keep things moving forward.” (32:12—33:18)

“Often, when you're busy, clarity is tough to find. What we found is it actually takes — if you're going to do this right — about 100 hours of time to pull it off by the time you've interviewed, looked at resumes, come up with a list, and all those different things.” (34:33—34:48)

Snippets:

0:00 Introduction.

2:59 Why this is a problem in dentistry.

5:49 Why 75% of associateships fail.

10:18 Are you ready for an associate?

15:20 Clarify your givens/wants and get your team’s input.

19:04 Be clear to get buy-in.

21:47 Create synergy, not competition.

22:40 Be clear about mentoring expectations.

23:30 Great associates are out there.

25:56 Onboarding, explained.

28:48 Be clear about compensation expectations.

31:52 Set aside time for feedback.

33:37 Final thoughts and how to get in touch with Bob.

Bob Spiel Bio:

Bob Spiel’s passion is building high-performance teams who deliver exceptional service while doing more, in less time, with less stress. His firms, Spiel Consulting and Dentist Partner Pros, transform general and specialty dental practices by building leaders at all levels, with a special focus on building leaders among owners and associate dentists.

Bob had over 25 years of business experience before getting into dentistry, including being a hospital and surgical center CEO, as well as an operations director for two mid-cap firms. This taught Bob to see each need in a dental practice with a “systems orientation”. Using this approach over the past 10 years, his firms have achieved a remarkable 90% success rate in searching for, hiring, and retaining associate dentists compared to the dismal 75% failure rate the dental industry has as a track record. He sees this as the number-one threat to the continuation of private practice dentistry and aims to change that.

Bob is a faculty member for Dr. Gordon Christensen, where he teaches a breakthrough course on leadership each fall called Igniting the Leader in You. He is also the author of Flip Your Focus: Igniting People, Profits and Performance through Upside-down Leadership.

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