Does this sound accurate? Hierarchy of single doctor private offices.

[Mauricio45]

From top to bottom:

Owner dentist
Office manager
Front desk staff
Hygienist
Assistant
Janitor
The dog
Dirt
Crud
Gum on the back of the shoe
Cigarette butt on pavement in the parking lot
The grime in the sink
Mold in ceiling
Turd in the toilet bowl
Associate dentist

And after a few years, the associate can work his/her way up above "Dirt" . "Dog" will always be favoured over associate.

---

Members don't see this ad.

 

[allDAT]

pretty much

 

[monkeykey]

Why wouldn’t the associate dentist be right below office manager? Doesn’t make sense to me

 

[Mauricio45]

Why wouldn’t the associate dentist be right below office manager? Doesn’t make sense to me

Because everybody knows associate don't stick around long enough anyway. Why should staff respect someone that is not signing their paycheques and who is likely going to leave soon? They don't care if associate has a doctorate degree. Often times, the staff books the high prodn cases to the owner (i.e. the one signing their cheques) and the associate is often stuck with the "leftovers" or "breadcrumbs". That is pretty much the hallmark of every associateship at private offices. Read all the horror stories on DentalTown about bad associateships.


The only reason for owner to hire an associate is for owner to take more time off (i.e. associate works the undesirable late evening and weekend shifts, or the days owner is not in office thus allowing owner to have vacation time).


The owner will always favor his staff more than associate because he knows deep down that associates leave. It's crucial for owner to have a well-functional front desk, assistants, hygienists because a good staff is hard to find. Associates are dime a dozen.


The associate is considered to be a joke. The laughingstock. They're considered the "dunce" of the practice. They are also a convenient scapegoat for all the practice problems. I.e. "monthly revenue production is down? Let's blame the associate." "Somebody left the toilet seat up? Must be that associate.", etc. The toilet seat part I'm really not joking about. I've had that said to me from a long-term assistant when I was an associate. It's a crummy feeling when you have no control of staff issues as an associate.

 

[I_Love_Huskies]

"Dog" should be above "Janitor". Just saying....

 

[2TH MVR]

OP is pretty much correct. Been there. Done that. Luckily for only 6 months right out of residency. That's the nature of the beast. An associate is brought in to make the owner dentist money. Staff will always be fiercely loyal to the owner dentist (read: pays their paychecks). An Associate is new to the practice. Staff basically has to work harder now to accommodate you. They have to explain your role to the new patients. which is a PIA. The staff spent many years "training" the owner-dentist, now they have to deal with a newbie.

Not that I like DSOs, but this is another advantage to working for one as an EMPLOYEE. You, the Dr. and everyone else (staff) works for an invisible owner. Yes. You have to deal with DSO bs. But the minute you arrive at the DSO ... you are the DOCTOR in charge. Period. Do your job and nobody bugs you. Yes. Of course .... there will be those mid level people wanting you to produce, but that is in any office (Private or DSO).

After selling my ortho practices .... I wanted a nice, easy part time job (3-4 days per week). No way was I going to work as an associate. I already knew how that was going to be. Also ... being a seasoned ortho ..... my ego would probably get in the way of working for another ortho, pedo or GP. I've worked at this DSO for over three years now. I've spoken to my direct boss TWICE in that time. Seriously. I'm pretty much left alone to do my job.

 

[Mauricio45]

Not that I like DSOs, but this is another advantage to working for one as an EMPLOYEE. You, the Dr. and everyone else (staff) works for an invisible owner. Yes. You have to deal with DSO bs. But the minute you arrive at the DSO ... you are the DOCTOR in charge. Period. Do your job and nobody bugs you. Yes. Of course .... there will be those mid level people wanting you to produce, but that is in any office (Private or DSO).

I 100% agree with you on DSOs. I know a lot of people look down on DSOs (I was one of them). However, my lackluster experience working as an associate at a prior private office made me go the DSO route. Generally, I think DSOs are way better experience than private offices. Of course, there are some exceptions.

I agree with you on the comment on "invisible owner". You show up to work. You are the doctor. The staff listens to you and respects you. More autonomy than an associateship at a private office. Except in my case, the owner comes to the practice 1x or 2x a month to do IV sedation cases. But that's it.

The corp I work for, I work with 1 other associate but he works the days I'm not there. Neither the other associate nor myself own the office, so staff doesn't feel loyal towards one side. So we both get treated equally. This is a HUGE advantage for DSOs.

I currently work two part time associateships (one for corp and other at a small private office). The private office I work for I do all the endos that owner doesn't do. So, it gives me good practice to hone my molar endo skills. That's a good reason to keep an associate if you can do a procedure that owner doesn't do or want to do. The politics has to favor the associate in order for it to work.

Most private offices cannot offer full-time work for two dentists hence why so many of them fail.

Yes, DSOs do have drawbacks but generally, they are better than private office associateships (in my experience).

 

[yappy]

Have any you associates tried yelling or speaking aggressively at people? It raises you pretty high on the hierarchy.

I make my priorities the owner's priorities; quality ethical care while being profitable/productive. I have not ran into an issues with owners and have been able to steam roll unruly staff.

 

[schmoob]

Have any you associates tried yelling or speaking aggressively at people? It raises you pretty high on the hierarchy.

I make my priorities the owner's priorities; quality ethical care while being profitable/productive. I have not ran into an issues with owners and have been able to steam roll unruly staff.

I’ve tried that and it did not work out well for me. The lead assistant who has worked for the owner for 20+ years got loud and mouthy with me in front of the rest of the staff, so I responded to her very sternly and made it clear that I will not be talked to in that manner. I don’t speak to any of the staff like that. Anyway she went to the owner doc and I got chewed out as if I did something wrong.
in these situations the doc will side with the staff because they will feel the need to “protect them.” The assistant was on a power trip and it caught her off guard that it wasn’t going to fly with me.

 

[yappy]

I’ve tried that and it did not work out well for me. The lead assistant who has worked for the owner for 20+ years got loud and mouthy with me in front of the rest of the staff, so I responded to her very sternly and made it clear that I will not be talked to in that manner. I don’t speak to any of the staff like that. Anyway she went to the owner doc and I got chewed out as if I did something wrong.
in these situations the doc will side with the staff because they will feel the need to “protect them.” The assistant was on a power trip and it caught her off guard that it wasn’t going to fly with me.

I suppose if the owner is owned by his/her staff that can happen. I'm lucky to have worked for principled people.

However, if you made out okay it was likely worth it. The key to changing that type of behavior is to make them incur a cost every time (assuming you cannot fire them).

 

[Mauricio45]

Have any you associates tried yelling or speaking aggressively at people? It raises you pretty high on the hierarchy.

I make my priorities the owner's priorities; quality ethical care while being profitable/productive. I have not ran into an issues with owners and have been able to steam roll unruly staff.

The only problem with that is if you raise voice or yell at staff, the staff will complain to owner about how "mean" and "unprofessional " you are to them. Guess which side the owner will take? As an associate, you are replaceable.

If I was the owner, I would place more weight on my long-term valued assistant, front-desk staff, and hygienist than some associate. Just the nature of the beast.

 

[I_Love_Huskies]

Here's the thing. It's extremely rewarding for staff to put down the associate. It's rewarding for them to put down someone who is more educated than they are with a doctorate and someone who is not their boss. They know the boss will always have their back. It's a way for them to overcompensate due to their lack of education knowing they will never be as successful as a dentist. Perhaps they had a prior bad experience with a previous boss and they're taking it out on associate as a way "to get back".

I've only been a dentist for 4 years and if it's the one thing I've learned in this field is that there is rampant insecurity and a streak of immaturity amongst the dental community (other dentists, staff). Alot of people throw each other under the bus to make themselves look good. It's sad. Never trust anyone in this screwed-up profession.

 

[charlestweed]

At my own office,

Owner doctor (me).
Office manager = Receptionist = Chairside assistants = non-chairside assistants.

No one, but me, has the authority to give orders. I am the only person who can give orders, who assigns tasks for each of the employees to perform.

Everybody wants to be treated with respect. No one wants to be belittled in front of other staff members and in front of the patients. Treat others as how you want others to treat you and everything should be fine. When everybody gets along well, the clinic flow becomes smoother, more things get done quickly, less wait time for the patients, and everybody gets to go home to see his/her kids ontime....team work is very important.

 

[aggie-master]

At my first job as a dentist the owner was such a jerk that he produced some organizational chart not that different than the OP’s. He had himself at the top, then his wife, then the office manager, then the lead assistant, the his number two assistant, then me.

I laughed it off and kept doing things the way I felt like since it was my license. I ended up quitting before my first year was done for a better job but I’m sure if I had stayed long enough I would have been fired for not bending the knee.

 

[schmoob]

I suppose if the owner is owned by his/her staff that can happen. I'm lucky to have worked for principled people.

However, if you made out okay it was likely worth it. The key to changing that type of behavior is to make them incur a cost every time (assuming you cannot fire them).

That’s the thing though, he isn’t owned by his staff at all. He’s mean to them and they are all female. Not 1 or 2, but about 12. He enjoys the illusion of superiority.
You are fortunate to have worked for principled people. And you’re right, I did make it out okay. I quit

 

[Mauricio45]

He had himself at the top, then his wife, then the office manager, then the lead assistant, the his number two assistant, then me.

That's already a major red flag when the owner's WIFE or spouse works in the office especially as the office manager. That never goes well. Major morale killer and it would be a dealbreaker for me. Other staff would not like it either.

 

[Molar Whisperer]

"Dog" should be above "Janitor". Just saying....

"Woof, woof," does that count for a promotion? In my 23 years of observations, it's the actions that speak loudest regardless of DSO, DMO, private assoc, public health, etc. A newbie that looks very young will not get taken seriously in the beginning. A more mature associate dentist may get initial respect until he or she fails to produce or routinely runs everybody behind (which is usually the case very quickly). Staff do not like to run late into lunch or after close. If the "loser" assoc starts producing, treats patients well, and runs very efficient, the owner/mgt would be a fool not to make him or her happy. If they are fools or if there are not enough cases, then find greener pastures. The owner of the DMO that fired me liked me because I could do a lot of specialty procedures like molar endo while treating patients well. Since DMOs deal with capitation and not production, mgt did not want me because I was too expensive. After my firing, the owner felt bad and gave me about $60k in severance. That made the bitter experience sweeter since I was triple dipping with unemployment and working at another place. Too bad those bean counters didn't know what they're doing and a lot of good dentists had left as well.

 

[schmoob]

That made the bitter experience sweeter since I was triple dipping with unemployment and working at another place. Too bad those bean counters didn't know what they're doing and a lot of good dentists had left as well.

So when you would file for UE you wrote that you didn’t work that week, despite the fact you were working?

 

[Molar Whisperer]

So when you would file for UE you wrote that you didn’t work that week, despite the fact you were working?

I didn't start the other job until the 4th week. My state pays UE after the first week and I failed to mention that I triple dipped for only a week. It sounded nice though. My endodontic mentor triple dipped with military retirement and SS before he fully retired.

 

[I_Love_Huskies]

...