So, who’s managing the dentists?

One of the many ironies about the way dental practices are run is that the managers rarely feel they have the skills or the mandate to manage the very people that can make the biggest contribution to the success or otherwise of the practice; that is, the dentists!

In most practices I visit, the practice manager manages the support team and the principal manages the clinical team, or not… (don’t get me started on who manages the principal — often the hardest task in the whole place!).

So the salaried staff are kept in line and on-brand by the practice manager who has to accept that the dentists can behave like complete mavericks, come and go as they please, run late, go home early, do the work or not do the work. We know why, of course. It’s all about their self employed status and the much lauded clinical freedom that goes with being self employed (as some kind of right). That’s the freedom to be a bad dentist as well as the freedom to be a good one…

Many hygienists are self employed as well and they often behave like hired guns; they arrive and treat some patients, keep themselves to themselves at lunchtime and then go home at 5pm. They often work in several practices during the week and probably won’t come to your Christmas Party. They’re not really part of any team and it must be quite a lonely existence… However, they’re usually consistent and reliable (and at the risk of filling my inbox with emails from irate hygienists) they have less impact on the practice success.

Unless you’re going to own one of those sad one-man-band practices, you need associate dentists and hygienists to achieve business scale. And you can either cross your fingers and hope that you’ve managed to hire some good, responsible, self-motivated associate dentists, or you’re going to have to manage them! Although many associate dentists move around during the week from practice to practice, most have committed to one or two practices and you need their commitment to your practice so that they can build quality relationships with patients and with your support team.

If you don’t manage your associates then these situations can arise (here’s a selection from Breathe client practices over the last few months):

  • They won’t refer to your hygienists, preferring to keep the fee themselves
  • They refuse to keep a day book, review their production or accept that they need to gross a minimum amount
  • They won’t attend practice meetings
  • They want to start work after dropping the kids off at school and leave in order to pick them up on the way home
  • They won’t refer to the in-house specialists
  • Or use the recommended labs
  • They wont contemplate working Saturdays or evenings
  • They won’t give sufficient notice (six months) of their holidays and they take more time off than is in their contract
  • They won’t sign a contract
  • They won’t agree to run a zoned diary

So what’s the best way to manage your associate dentists so they best contribute to your business success as well as their personal success? The secret is in my last sentence; in order to have their attention you have to help them achieve their success as well as yours. It’s as if you have to see them through two lenses:

Lens 1 — how do I get what I need from them in order to have a successful practice?

Lens 2 — how can I help them develop themselves and their career/earn more money (if that’s what they need)?

In order to do this you are going to need a clear understanding of your associate’s:

  • Personal and professional goals
  • Income requirements
  • Preferences, communication style and motivators

You can’t get this information by talking to your associates between patients, at lunchtime or just before they go home. It’s better to find these things out before you hire them! But once you do understand their aspirations you can see how best you can accommodate and fulfill their requirements within your business plan (and if you can’t help fulfill their aspirations, they’re not going to stay anyway, so don’t hire them!). Many, many associates’ number one complaint about their practice is the poor quality of the communication!

Some of the corporates manage their associates by telling them how it’s going to be at XXX Corporate and that they can (essentially) take it or leave it. In the more sensitive world of owner-driver practices I suggest that you treat your associates like highly tuned race horses and take great care of them and their aspirations.

Here are my top 10 tactics for keeping your associates onside:

  • Before they start work in your practice, spend at least half a day with them, one to one; introduce them to your team, tell them how the practice is managed and how you want them to behave towards your patients. Also how they can achieve the average daily gross that you have forecast for them.
  • Explain to them the practice expectations for: punctuality, communication and follow through on tasks, clinical standards, holidays, emergency cover etc.
  • Ask the patients, either formally or informally, how they like your new associate.
  • Meet with them (at least) once a week to iron out any housekeeping problems and once a month to review their production and their clinical development.
  • Host a formal appraisal at least every 12 months (and preferably every 6-8 months). Part of this appraisal will be to help them create and implement their personal and professional development plan.
  • Involve them in the big picture of your business; invite them to the annual vision meeting/day and ask them to contribute.
  • Play to their strengths — don’t work on and accept their weaknesses.
  • Accommodate their personal and professional requirements if you can, and in return expect them to accommodate yours.
  • Give praise for a job well done, a situation well handled, an extra mile travelled…
  • Communicate more than you think you need to, support them, mentor and coach them if appropriate and, in this uncertain world, offer them stability.

If you would like some help with hiring, inducting or managing your associates, contact me for a chat:


m. 07770 430576

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