Unhappy with dental associate position

[Mauricio45]

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Hi all. I am currently working as an associate in a private office for many months now right after dental school. I am not happy with the position. I've been noticing many times (not all the time) that when I see and diagnose emergency patients or hygiene recall patients, the treatment ends up going to the principal. Even though I was the one who actually diagnosed and discussed the treatment plan with the patient. This only happens with his patients or the previous associate's patients. Any new patient to the clinic I am 100% responsible for all the treatment plan and it doesn't go to the principle.

It just saddens me because I miss out on big treatment. For instance, I treatment planned 3 PFM crowns on a patient the other day during a recall, and after I discussed with the patient about the treatment plan, I found out later the front desk scheduled this patient with the principal and I miss out on 3 crowns. I think that is unfair because I think the person who diagnoses and discusses treatment plan with the patient should be the one who does the treatment. I remember the office manager stating that it is up to the patient to decide which doctor they want to see, and that they don't compel the patient to see the doctor that diagnosed them. But how do I know that the office is not screwing me over by not giving me the patients that I diagnose but instead to the principal? However, I do understand that if a patient has been seeing the other dentist for +15 years, they're going to want to see him and not some new grad.

Is this a common thing amongst dental associate positions, and should I suck it up because it is his practice after all? I am considering giving my notice and finding another practice to work in.

 

[786783]

Dang, I hope seasoned dentists can chime in and say that this is an exception to the rule.
Things are uglier in real life dentistry than I imagined.

 

[bing12]

are you busy at your practice? Are you on a daily minimum? What is your avg daily production? If this bothers you, say something to the owner.

 

[beannaithe]

if your boss is reasonable, try talking to him about it. there are certain situations where a patient may request to see the owner (schedule/timing/seen them for 20+ years) or the front desk might be feeding the patients to him to keep his schedule full (also happened to me). if it's a patient of his (like seen multiple times and then you see them once), i would not be surprised if the treatment goes to the owner. if it's someone you've seen a few times, then it's not fair. it takes some time for people to get used to you being there and begin to trust you.

also, is the front desk offering an appointment with you? or are they sending right to the owner? listen to how they phrase scheduling, "do you want to take a chance and see new doc? or would you rather stick with the known: dr. owner?" when my office would say that, every single one would shcedule with the owner. when they changed it to, "dr. owner is sooooooo booked up. newdoc has an opening in 2 day? how about that?" most people scheduled with me.

i do a lot of same day treatment. patient broke a tooth and needs a fill/crown. i look at the schedule and say, "i've got some time to do it now. we've been pretty busy lately, so it might be a little while before we can get you back in. do you want to take care of it today?"

unforuatenly, it is normal to have your schedule picked either by accident (front desk wants to make the owner happy because he pays her) or by the owner directly telling her to fill his schedule. both have happened to me and it sucks. the best thing to do is talk to your boss. how he handles it will tell you which one it is. but if he says, 'i took care of it' and it keeps happening. find another office.

overall though, how is your schedule?

 

[comatose]

Hi all. I am currently working as an associate in a private office for many months now right after dental school. I am not happy with the position. I've been noticing many times (not all the time) that when I see and diagnose emergency patients or hygiene recall patients, the treatment ends up going to the principal. Even though I was the one who actually diagnosed and discussed the treatment plan with the patient. This only happens with his patients or the previous associate's patients. Any new patient to the clinic I am 100% responsible for all the treatment plan and it doesn't go to the principle.

It just saddens me because I miss out on big treatment. For instance, I treatment planned 3 PFM crowns on a patient the other day during a recall, and after I discussed with the patient about the treatment plan, I found out later the front desk scheduled this patient with the principal and I miss out on 3 crowns. I think that is unfair because I think the person who diagnoses and discusses treatment plan with the patient should be the one who does the treatment. I remember the office manager stating that it is up to the patient to decide which doctor they want to see, and that they don't compel the patient to see the doctor that diagnosed them. But how do I know that the office is not screwing me over by not giving me the patients that I diagnose but instead to the principal? However, I do understand that if a patient has been seeing the other dentist for +15 years, they're going to want to see him and not some new grad.

Is this a common thing amongst dental associate positions, and should I suck it up because it is his practice after all? I am considering giving my notice and finding another practice to work in.

Okay this scenario isn't actually all that uncommon. I'm sure you've heard that 99 percent of associatesships fail, and this is one of the reasons. I would quit and find something else, unless you're getting a guarantee daily salary.

 

[Marmalade]

"So can I see you for that crown next Tuesday at 10am or 2pm?"
Wait.
"Great. See you then"

PD.

 

[Mauricio45]

My schedule has not been productive within the last 2 months at all. There is a lot of white gaps in my schedule. However, some days it can get crazy busy. But a lot of times it's been very slow. For instance, 2 or 3 hour gaps between patients which is ridiculous. It wasn't like this at the beginning of my associateship but slowly, the schedule started to gradually change. I'm frustrated that front desk isn't giving me a full schedule.

I've also noticed the principle's schedule. He is booked at least a month in advance! Whereas, my schedule is often booked at the last minute, and I don't really have a set schedule to be honest. A lot of times patients would get booked with me at last minute and it would be procedures that are low yield (re-cementing a crown, post-op checks, denture adjustment, etc).

I'm planning on giving my notice early next week and looking elsewhere to work.

 

[beannaithe]

sounds like they're starving you out (getting you to quick). time to jump for something more productive. i'm sorry. it's happened to all of us at least once.

 

[CanaDMD]

My schedule has not been productive within the last 2 months at all. There is a lot of white gaps in my schedule. However, some days it can get crazy busy. But a lot of times it's been very slow. For instance, 2 or 3 hour gaps between patients which is ridiculous. It wasn't like this at the beginning of my associateship but slowly, the schedule started to gradually change. I'm frustrated that front desk isn't giving me a full schedule.

I've also noticed the principle's schedule. He is booked at least a month in advance! Whereas, my schedule is often booked at the last minute, and I don't really have a set schedule to be honest. A lot of times patients would get booked with me at last minute and it would be procedures that are low yield (re-cementing a crown, post-op checks, denture adjustment, etc).

I'm planning on giving my notice early next week and looking elsewhere to work.

or just cut your days in this office to 2-3 days of fully booked days a week, compress your schedule and join another office part time. It's not easy to have a full 5 day schedule in one clinic as an associate.

 

[tinman831]

What does the contract say?

 

[Mauricio45]

I gave my 90 day notice a couple of days ago. I feel relieved. The principle understood, and I think he knew I was going to quit. He stated he would put in a good reference for me. I've had a couple of interviews at other offices so far this week.

or just cut your days in this office to 2-3 days of fully booked days a week, compress your schedule and join another office part time. It's not easy to have a full 5 day schedule in one clinic as an associate.

Yeah, I see why many associates do 2 part-time jobs because my schedule was literally never full within the last 2.5 months and it was frustrating. I think next time, I will do 2 part-time jobs instead of one full-time job. But I don't want to stay in this office anymore as I don't trust them. I am happy to leave. I feel like I got stuck with "leftovers" all the time while the principal got all the "good stuff".

What does the contract say?

There is one part that states "The Associate further understands that the Principal is in no way guaranteeing any number of available patients or levels of income to the Associate during the term." But I think this is pretty much standard in most contracts? I didn't have any guarantee daily salary or daily minimums which are not common here where I'm from (BC, Canada).

 

[fancymylotus]

Dang, I hope seasoned dentists can chime in and say that this is an exception to the rule.
Things are uglier in real life dentistry than I imagined.

I dont take procedures that the other docs tx plan unless they have no space or time in their sched to do them and we have time or schedule or procedure constraints.

I have heard of things like what the OP is talking about being rampant in private practice.

Its just not the way we choose to treat our associates, run our business, or practice dentistry

 

[comatose]

I gave my 90 day notice a couple of days ago. I feel relieved. The principle understood, and I think he knew I was going to quit. He stated he would put in a good reference for me. I've had a couple of interviews at other offices so far this week.



Yeah, I see why many associates do 2 part-time jobs because my schedule was literally never full within the last 2.5 months and it was frustrating. I think next time, I will do 2 part-time jobs instead of one full-time job. But I don't want to stay in this office anymore as I don't trust them. I am happy to leave. I feel like I got stuck with "leftovers" all the time while the principal got all the "good stuff".



There is one part that states "The Associate further understands that the Principal is in no way guaranteeing any number of available patients or levels of income to the Associate during the term." But I think this is pretty much standard in most contracts? I didn't have any guarantee daily salary or daily minimums which are not common here where I'm from (BC, Canada).

90 days? That's a lot of notice. I would just quit or not show up to work. Just say your sick. He's basically taking advantage of you by you diagnosing and then him taking all the work from you. I would just start cancelling days, so you can get out of there faster.

 

[Mauricio45]

90 days? That's a lot of notice. I would just quit or not show up to work. Just say your sick. He's basically taking advantage of you by you diagnosing and then him taking all the work from you. I would just start cancelling days, so you can get out of there faster.

The contract stated 90 days notice. He said I could leave earlier if I want to. I'm looking (and have interviewed) for other associate positions at the moment, so I'm keeping this job for now as I need income. It's better than having no job. Once I get another associate position, I'm definitely leaving.

The thing is I don't want to just not show up to work because I may need his reference when I apply for the other jobs. He told me he would give a good reference.

 

[Lane138]

Unfortunately this is common. If you're on DentalTown, I even read one poor associate saying that the front desk makes sure the owner's two column schedule is nearly full before giving him any restorative.

Something like that happened at one of my clinics because I was there part time, so when patient schedules an appointment, FD asks which day they want to come in, chances are it's not on a day I'm working so I don't get to see patient again.

I complained a little and then started being proactive: while pt was still in the chair I'd pull my schedule up and confirm a time and tell patient to go front to make it for that time

 

[Jason49]

I've heard of this happening to classmates of mine. I would quit and find somewhere else to work. He is completely taking advantage of you.

 

[I_Love_Huskies]

Similar thing happened to me when I first started out as an associate right after school. The owner and front desk would screw me over by making me do exams and then owner doing the treatment. Plus, I had a rude dental assistant who was disrespectful. I remember she would jump in and start recommending treatment (crowns, bridges) to the patient when that is my job. I'm sure patient didn't like that. Also, I remember one time I was in the middle of a molar endo procedure and the assistant said to me right in front of patient that we should end the procedure and let the owner take over to finish the molar endo procedure. But I finished the procedure and did not end up referring to the owner. I'm sure patient felt nervous in the chair when assistant said that. It's definitely a horrible feeling when both owner and staff are working against you and treating you badly and only a fool would stick around at a place like that. I hope you have found a better place to work now.

Most associateships suck. The front desk do not care about the associate at all because they're getting their paychecks from owner, so they want to make the owner happy. Even the janitor who cleans the building gets treated better than the associate. I suggest buying as soon as possible.

 

[2TH MVR]

A bit of reality. Owners hire associates to do the crap work while they enjoy the good procedures. This is just common sense. Unless the owner and the associate have a concrete contract for a future partnership scenario ... the associate is just a hired worker. This is pretty common in all types of employment.

The goal of any associate should be ownership. Use your time as an associate to learn the business side to dentistry and to work on your speed.

 

[321931]

A bit of reality. Owners hire associates to do the crap work while they enjoy the good procedures. This is just common sense. Unless the owner and the associate have a concrete contract for a future partnership scenario ... the associate is just a hired worker. This is pretty common in all types of employment.

The goal of any associate should be ownership. Use your time as an associate to learn the business side to dentistry and to work on your speed.

Yep. This is true. Been in both positions. Now as an owner, I will put the 2 MOD, 15 DB on the associate schedule while I do the 4/12 premolar crowns.

 

[Munks]

Yep. This is true. Been in both positions. Now as an owner, I will put the 2 MOD, 15 DB on the associate schedule while I do the 4/12 premolar crowns.

Nothin' like continuing the cycle 😉

 

[DentinBond]

My schedule has not been productive within the last 2 months at all. There is a lot of white gaps in my schedule. However, some days it can get crazy busy. But a lot of times it's been very slow. For instance, 2 or 3 hour gaps between patients which is ridiculous. It wasn't like this at the beginning of my associateship but slowly, the schedule started to gradually change. I'm frustrated that front desk isn't giving me a full schedule.

I've also noticed the principle's schedule. He is booked at least a month in advance! Whereas, my schedule is often booked at the last minute, and I don't really have a set schedule to be honest. A lot of times patients would get booked with me at last minute and it would be procedures that are low yield (re-cementing a crown, post-op checks, denture adjustment, etc).

I'm planning on giving my notice early next week and looking elsewhere to work.

It is illogical (on the owners part) to schedule in this selfish way.

Both of you *could* be busy simultaneously. That is most productive. If the owning doctor and/or staff are robbing from your schedule to pad his, it is foolish as well as mean-spirited. They are making the philosophical assumption that the "pie" is of a fixed size and cannot be grown larger, and are taking the largest slice of that finite "pie" that they can.

Smart doctors recognize that it is possible to grow the pie. It's not a zero sum game. And there's more than enough pie for everyone.

When I was first an associate my future partner understood this. One example: he despised endo. So if endo was indicated and we didn't refer, I did the endo. Then some patients saw him for the crown (when indicated) since they knew him so well; yet some saw me since they felt comfortable after the endo. Our goal was TWO filled schedules, not grabbing production. As long as that was the result, we didn't worry about who an individual patient scheduled with.

All these years later, I remain grateful.

Now that he's retired & I hired an associate, I pay it forward. I've often said things to her like, "You take that multiple implant case from the periodontist, Suzanne." And she's a genius at dentures, so I go all avuncular with denture patients & tell them they should see her not me, haha. Honesty! And she's got a great surgical mind so I'm helping her develop the surgical implant placement part of our practice. We will always refer many implant surgeries, but the ones we can do, *she* should do, not me. As practice owner, I have enough other stuff on my plate.

This all makes sense, with room for individual variations and preferences, doesn't it? In my view, any other way of proceeding on the part of the practice owner--any selfish way of grabbing a big slice of pie for themself--is foolishness. Foolishness because it's so much smarter to grow the pie instead.

Plus, all these short-sighted dolts miss the big point:

Generous businesses are more interesting than selfish businesses.

 

[321931]

Nothin' like continuing the cycle 😉

Haha you know that dentists will eat their own. You and I both know that.

I feel for the newer and newer grads... They are going to have a very tough time in this changing field. Oh well not my problem.

 

[yappy]

It is illogical (on the owners part) to schedule in this selfish way.

Both of you *could* be busy simultaneously. That is most productive. If the owning doctor and/or staff are robbing from your schedule to pad his, it is foolish as well as mean-spirited. They are making the philosophical assumption that the "pie" is of a fixed size and cannot be grown larger, and are taking the largest slice of that finite "pie" that they can.

Smart doctors recognize that it is possible to grow the pie. It's not a zero sum game. And there's more than enough pie for everyone.

When I was first an associate my future partner understood this. One example: he despised endo. So if endo was indicated and we didn't refer, I did the endo. Then some patients saw him for the crown since they knew him so well; yet some saw me since they felt comfortable after the endo. Our goal was TWO filled schedules, not grabbing production. As long as that was the result, we didn't worry about who an individual patient scheduled with.

All these years later, I remain grateful.

Now that he's retired & I hired an associate, I pay it forward. I've often said things to her like, "You take that multiple implant case from the periodontist, Suzanne." And she's a genius at dentures, so I go all avuncular with denture patients & tell them they should see her not me, haha. Honesty! And she's got a great surgical mind so I'm helping her develop the surgical implant placement part of our practice. We will always refer many implant surgeries, but the ones we can do, *she* should do, not me. As practice owner, I have enough other stuff on my plate.

This all makes sense, with room for individual variations and preferences, doesn't it? In my view, any other way of proceeding--any selfish way of grabbing a big slice of pie--is foolishness. Foolishness because it's so much smarter to grow the pie instead.

Plus, all these short-sighted dolts miss the big point:

Generous businesses are more interesting than selfish businesses.

Great post. If my time in dental has taught me anything it is that there is no shortage of "mean-spirited" or "foolish" dentists. Unfortunately there seems to be a streak of immaturity in the field.

 

[321931]

Great post. If my time in dental has taught me anything it is that there is no shortage of "mean-spirited" or "foolish" dentists. Unfortunately there seems to be a streak of immaturity in the field.

It goes both ways. Most associates leave after X months for the own practices or a different (yet crappy-ier) job, and then you are left fixing all the associate's crappy work. Honestly, for most associateship models, they are simply expendable. There's more and more graduates coming in that will work for scraps so one comes...another one comes... the boss salary stays the same though so meh. That's how corporate sees it to. Practice ownership is the way to go, but finding a good practice to purchase and run it well is hard.