What are Associates looking for in a position? Where can I find the best candidates?

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LauRiley

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I am a general dentist who has been practicing for almost 30 years. I own 3 practices, and I'm looking for a new associate for the busiest, and most lucrative one. I have two associates currently, who are older like myself and work limited schedules, so I am looking for an associate to work a more full-time schedule. I had hired a colleague's son who worked as an associate with us for almost 3 years, but only wanted to work 3 days a week - as a new grad! Once he gave his notice I hired another new grad who seemed like he genuinely understood the hard work and patience it takes to be successful in this field, and he signed a 3 year contract with me. I was even discussing potential ownership possibilities with him, and was fairly confident I'd found someone to pass the torch to, (because I truly do not want to sell to a DSO when I retire). WELL - This past Tuesday, this associate gave his notice AFTER 6 MONTHS because he was offered a Fellowship in AZ where he recently took an Implant course. I was surprised, incredulous even, that he seemed to not think anything of breaking a contract and cares even less of the implications it has for others whom he's affecting with his decision. Actually, it seemed to shock him that my business manager and I were not excited for him and this new opportunity. He tried to say that he had a few slow weeks, and realized that he's just not making the money he thought he'd be making... and in my head I thought, "It's been 6 months.. you get the majority of exams, if patients aren't receptive, maybe look at your approach" - and he has done better in his first 6 months in private practice than any associate I've hired in the past.

So my question is - what are Associates and new grads looking for in a position? Because my manager and I went back and forth with this person 3 or 4 times in the hiring stage and pretty much acquiesced to any and all of his requests. How do find someone who will follow through on a commitment they make and someone who understands that dentistry is all what you make of it? If you are willing to make the sacrifices and work hard, you can build an incredibly successful career. I want to feel confident in the person I eventually sell my practice(s) to, and I don't know that there many of those people in this coming generation of dentists.

How do I find someone who is not going to break a contract when the next (seemingly) best option presents itself?

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Why would you expect someone to stay with your practice when there are better opportunities elsewhere?

If you want an associate to stay, a better compensation package and an partnership track baked into the contract will probably do it. I don’t know the specifics of your situation, but many of the owners I’ve encountered with similar complaints tend to pay pennies then complain that their associates aren’t willing to sacrifice their time and energy into a practice that they have no vested interest in.
 
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Young dental grads are looking for a Position not a JOB.
You are clearly offering a job.

I would advise looking for a dentist that has worked in the real world at some time in the past.
 
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Why would you expect someone to stay with your practice when there are better opportunities elsewhere?

If you want an associate to stay, a better compensation package and an partnership track baked into the contract will probably do it. I don’t know the specifics of your situation, but many of the owners I’ve encountered with similar complaints tend to pay pennies then complain that their associates aren’t willing to sacrifice their time and energy into a practice that they have no vested interest in.
Why would I expect them to stay? Because they made a commitment. Do contracts and commitments mean nothing anymore? Then why have them? And the potential for ownership was absolutely discussed with this associate and it was made clear to him that he would have the option to buy in, and gradually take over as the practice owner. And compared to many other practices, our compensation package was much better than most. Like I said, in the negotiating stage we gave him what he was asking for, even things we did not want to because we felt that he was the right candidate to work with and eventually transfer ownership to. I personally invested my time and energy into mentoring him and helping him develop his skills as a professional.
Young dental grads are looking for a Position not a JOB.
You are clearly offering a job.

I would advise looking for a dentist that has worked in the real world at some time in the past.
Can you be a little more specific about what you mean by "Position" vs. "Job"? I'm not trying to be rude, I just need to understand what the difference is to you. In my opinion the difference in job vs. position is that jobs lead no where and positions lead to future opportunity... if that's what you mean, then I am offering a position.
 
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He tried to say that he had a few slow weeks, and realized that he's just not making the money he thought he'd be making... and in my head I thought, "It's been 6 months.. you get the majority of exams, if patients aren't receptive, maybe look at your approach" - and he has done better in his first 6 months in private practice than any associate I've hired in the past.
May I ask what is the income that your associate was expecting to make? Do you offer a guarantee salary so he does not have to worry too much even when he has slow weeks? Finally, what is your general location (e.g. metro vs rural)?
 
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Why would I expect them to stay? Because they made a commitment. Do contracts and commitments mean nothing anymore? Then why have them? And the potential for ownership was absolutely discussed with this associate and it was made clear to him that he would have the option to buy in, and gradually take over as the practice owner. And compared to many other practices, our compensation package was much better than most. Like I said, in the negotiating stage we gave him what he was asking for, even things we did not want to because we felt that he was the right candidate to work with and eventually transfer ownership to. I personally invested my time and energy into mentoring him and helping him develop his skills as a professional.

Can you be a little more specific about what you mean by "Position" vs. "Job"? I'm not trying to be rude, I just need to understand what the difference is to you. In my opinion the difference in job vs. position is that jobs lead no where and positions lead to future opportunity... if that's what you mean, then I am offering a position.


I'm not a business owner, but as a future associate I appreciate the perspective that is given in the podcast above.
 
New grads have 500k of student loans. You need to pay $$$ to keep them around. They keep hearing about the land of milk and honey where they can make 200k a year....but alot of new grads are stuck making 500$ a day base pay- lower than a hygienist...and once they realize that they can't break base pay they go off to greener pastures looking for that elusive 200k 4 day work week associateship (hint it doesn't exist) but they keep trying. Eventually they give up and go buy a practice. but on the flipside- they don't understand why the greedy owner can't pay more (hint it because owners also have loans, and are limited by PPO fees- and hint they keep getting less year over year)

Been there done that. Associateships last 6 months or less on average.
 
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May I ask what is the income that your associate was expecting to make? Do you offer a guarantee salary so he does not have to worry too much even when he has slow weeks? Finally, what is your general location (e.g. metro vs rural)?
I'm not sure what number he had in his head as an expectation - but I can say that he has/had the potential to make close to $200k - and personally, in my opinion, his first year out of dental school, that doesn't suck lol. And we are located in suburban Massachusetts, about 25 minutes north of Boston.



I'm not a business owner, but as a future associate I appreciate the perspective that is given in the podcast above.

I appreciate this input! I'm listening now.
 
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New grads have 500k of student loans. You need to pay $$$ to keep them around. They keep hearing about the land of milk and honey where they can make 200k a year....but alot of new grads are stuck making 500$ a day base pay- lower than a hygienist...and once they realize that they can't break base pay they go off to greener pastures looking for that elusive 200k 4 day work week associateship (hint it doesn't exist) but they keep trying. Eventually they give up and go buy a practice. but on the flipside- they don't understand why the greedy owner can't pay more (hint it because owners also have loans, and are limited by PPO fees- and hint they keep getting less year over year)

Been there done that. Associateships last 6 months or less on average.
Right! But our associate had the potential to make that kind of money in his first year. I just did the calculation, he started August 1st, 2022 - he has made $112,747 so far. We have been receptive to everything he's wanted to do, like placing implants despite us having two periodontists who come in. We are all about allowing our dentists autonomy and investing in them as much as we can. And yeah, the reimbursements from insurance keep going down while our costs keep going up. It's just discouraging because I'd like to retire in 4-5 years, and I am trying to position myself to sell to an associate rather than a DSO.
 
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First of all, thank you for caring about future of dentistry and not just selling it to DSO.

Have you had frank conversations with your previous associates about why they are not staying?

Its not just about compensation. It can be about autonomy, office dynamics, feeling valued and fulfilled at work, is there any pressure from the management side? etc.
 
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Why would I expect them to stay? Because they made a commitment. Do contracts and commitments mean nothing anymore? Then why have them? And the potential for ownership was absolutely discussed with this associate and it was made clear to him that he would have the option to buy in, and gradually take over as the practice owner. And compared to many other practices, our compensation package was much better than most. Like I said, in the negotiating stage we gave him what he was asking for, even things we did not want to because we felt that he was the right candidate to work with and eventually transfer ownership to. I personally invested my time and energy into mentoring him and helping him develop his skills as a professional.

Can you be a little more specific about what you mean by "Position" vs. "Job"? I'm not trying to be rude, I just need to understand what the difference is to you. In my opinion the difference in job vs. position is that jobs lead no where and positions lead to future opportunity... if that's what you mean, then I am offering a position.
Again, I don’t know anything about your specific situation so it’s not meant as a personal attack but the reason why job hopping is becoming increasingly more common across industries is because traditional expectations of reward in exchange for loyalty have proven to be unfounded— too many people I know have been burned as associates by throwing their lot in with an owner who has promised them the world and delivered little. Partnership track needs to be explicitly written in contracts to mean anything.

As others have mentioned, student loans are another factor. If a better paying opportunity is available, it makes no financial sense to stay. You’re essentially paying money to stay by not paying down more of your principle. This can be pretty significant for those with 500k+ in loans
 
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So, I have seen every aspect of this.

I have been an associate, or have friends who have been associates, where the owner expected me (or them) to work for peanuts, meaning that those owners would do well financially. It was understood. That was a long time ago.

I was actually happy to work hard, and the financial parts are not why I did not stay in those positions. And I never broke a contract.

I have been an owner and have had an associate who was given every financial advantage by me, but they still were not satisfied.

Every generation is different. Everyone pursues their separate interests.

As a dentist, there is only so much work you can do, so there are only way two ways that you can make the big bucks:
1. Be a solo practitioner and own everything; then you have total control over your income.
2. Have someone else do the work, and you keep some of their proceeds. This is how the DSOs make their money.

As a surgeon who believes that the best interest of the patient is the only interest to be considered, I would avoid DSOs like the plague.

The current generation has a mountain of student loan debt. I blame the schools and the administrators at those schools who are raking in the bucks from the exorbitant tuition. This is endemic in all of higher education, so I will never give money to any of the schools that I attended.

And in the words of my father, noted OMS, "Son, there are no solutions. There are tradeoffs."

I would look at your situation and think, even if you have to close the doors at the end of your career, you have given a great service to your patients and your community.
 
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Again, I don’t know anything about your specific situation so it’s not meant as a personal attack but the reason why job hopping is becoming increasingly more common across industries is because traditional expectations of reward in exchange for loyalty have proven to be unfounded— too many people I know have been burned as associates by throwing their lot in with an owner who has promised them the world and delivered little. Partnership track needs to be explicitly written in contracts to mean anything.

As others have mentioned, student loans are another factor. If a better paying opportunity is available, it makes no financial sense to stay. You’re essentially paying money to stay by not paying down more of your principle. This can be pretty significant for those with 500k+ in loans
From what I can tell from these posts OP is a well meaning person and likely a good boss and mentor.

I think the frank truth is that despite anything OP or any owner may do, associates will come and go. This is definitely the mentality of millenials in general, and dentists are no exception.

200k in your first year may sound great, but he may be drowning in 500k+ in loans and looking for the greener pastures. Totally not your fault
 
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I am looking for an associate opportunity like you offered to your associate. If you know someone like you looking to hire an associate, please let me know. Please feel free to message me. Thank you.
 
I think you need to look for an associate that has ties to the area that you practice in. A national search is going to get you an associate that may or may not like the area.
 
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As a surgeon who believes that the best interest of the patient is the only interest to be considered, ...
I appreciate your firm stance in doing what is best for the patient. Often, the financial bottom line trumps what is truly the best interest. For an example, yesterday I had a 14 y/o patient scheduled for Consult & RCT #31 from another dentist. Tooth has no sxs and tested vital. Occlusal caries was close to the pulp. I ended up doing a one surface filling leaving slight internal caries and sealing it with bioceramic pulpal protectant (liner). Prior to the procedure, I had informed the pt and mother all the details and what to look out for in case sxs arise. If I worked for somebody, most likely I would get fired because I lost so much production.
 
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I want to thank you all for your insightful input. It's encouraging to see there are many dentists who have found themselves in the same position at one time or another. I'm trying to stay positive and hold out hope that I will find an associate who is going to stay committed and sees the value in practice ownership. Does anyone have any recommendations on where I can go about finding a new associate? I've dealt with recruiters in the past and lately all I've seen is their postings on job boards that have been sitting there for a month or longer... I'd rather do some in-person networking but I'm not sure where to start. I appreciate any responses! I'm located in MA and have one office in Southern NH if that helps.
 
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I want to thank you all for your insightful input. It's encouraging to see there are many dentists who have found themselves in the same position at one time or another. I'm trying to stay positive and hold out hope that I will find an associate who is going to stay committed and sees the value in practice ownership. Does anyone have any recommendations on where I can go about finding a new associate? I've dealt with recruiters in the past and lately all I've seen is their postings on job boards that have been sitting there for a month or longer... I'd rather do some in-person networking but I'm not sure where to start. I appreciate any responses! I'm located in MA and have one office in Southern NH if that helps.
You can try Military dentists separating or retiring. Maybe the recruiting team may have some connections or insights on how to approach them. I was USAF and many of them won't have burdening student loans to think about jumping ship (as in from the Navy?).
 
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I appreciate your firm stance in doing what is best for the patient. Often, the financial bottom line trumps what is truly the best interest. For an example, yesterday I had a 14 y/o patient scheduled for Consult & RCT #31 from another dentist. Tooth has no sxs and tested vital. Occlusal caries was close to the pulp. I ended up doing a one surface filling leaving slight internal caries and sealing it with bioceramic pulpal protectant (liner). Prior to the procedure, I had informed the pt and mother all the details and what to look out for in case sxs arise. If I worked for somebody, most likely I would get fired because I lost so much production.
I work for Endo1. For those unfamiliar, it’s a specialty DSO run by Endodontists. But we do this all the time. They give us 100% autonomy for hours, time off, and care delivered. Coming out of residency I was pretty against “DSOs” because of what you hear about them. But I can say, from what I have seen from the specialty side, it’s an amazing deal. 40-45% collections, they let you run the office the way you want, 401K, health insurance. If you don’t want to run the office, you can delegate decisions to the manager. I’m of course skeptical that 5 years down the road something could change.
 
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Speaking as a former associate... equity is really the only way to keep someone invested. Otherwise why WOULDN'T they just take a better gig when it rolls around?

Loyalty? Psssh.... that's not really something millennial (and soon Gen Z) associates believe in because it has not been demonstrated to be true for most of our professional lives.
 
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I want to thank you all for your insightful input. It's encouraging to see there are many dentists who have found themselves in the same position at one time or another. I'm trying to stay positive and hold out hope that I will find an associate who is going to stay committed and sees the value in practice ownership. Does anyone have any recommendations on where I can go about finding a new associate? I've dealt with recruiters in the past and lately all I've seen is their postings on job boards that have been sitting there for a month or longer... I'd rather do some in-person networking but I'm not sure where to start. I appreciate any responses! I'm located in MA and have one office in Southern NH if that helps.

Is there an AEGD or GPR where you could cover clinic and network with residents? If so I would start there.
 
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I want to thank you all for your insightful input. It's encouraging to see there are many dentists who have found themselves in the same position at one time or another. I'm trying to stay positive and hold out hope that I will find an associate who is going to stay committed and sees the value in practice ownership. Does anyone have any recommendations on where I can go about finding a new associate? I've dealt with recruiters in the past and lately all I've seen is their postings on job boards that have been sitting there for a month or longer... I'd rather do some in-person networking but I'm not sure where to start. I appreciate any responses! I'm located in MA and have one office in Southern NH if that helps.
UConn grads. The ones interested in being GPs largely do AEGDs and GPRs. If you can establish a relationship with one who is about to graduate, you can try to get them to sign on so you have a concrete start date for them once they complete the AEGD/GPR.

A ton of people from New England would be thrilled to live/practice there. Unless the office is in Lawrence 😂
 
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so
UConn grads. The ones interested in being GPs largely do AEGDs and GPRs. If you can establish a relationship with one who is about to graduate, you can try to get them to sign on so you have a concrete start date for them once they complete the AEGD/GPR.

A ton of people from New England would be thrilled to live/practice there. Unless the office is in Lawrence 😂
or Lowell.

Or Roxbury/Dorchester :rofl:
 
I feel like we need two tiers for "Associates" in dental practices. Candidates would have to apply for one or the other. but they cannot apply for both.

The first tier are dentists who only want to work 3 days a week, or less, and who only want to ply the trade (it is not a profession for them) while they are physically in the building. They want to make a ton of money. They don't want to be there after 3:30 p.m. They think the practice will run itself.

The second are dentists who understand that it is up to them to bring in the patients, it is up to them to treat the patient well (or maybe the patients won't come back), it is up to them to manage and pay the staff, it is up to them to pay the overhead, it is up to them to worry about making the pension plan payment on time, etc. They can take time off, but who will be there for their patients when they are gone?

I once interviewed someone for an associateship (with a path to ownership), and their main question was: "OMSDoc, how much will I make as an owner/partner?" My response was, "You know, that is up to you. Moreover, you are the last person to get paid."

Uffda.
 
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As far as garnering an associate who "fits" with your practice, the possibilities are endless, and you have to make your own bed.

It is best to show them that you mean business at the get-go. For me, again, that means that, "The best interest of the patient is the only interest to be considered."

In my own case, I have been committed to serving as a mentor to young people who have an interest in the dental or medical professions. Starting with my own practice in 1998, and now with my partners, we hire young people (mostly college students...we are in a college town) as laboratory and anesthesia assistants.

These young people learn universal precautions...from a Type A surgeon. They learn decorum. They learn how to treat themselves and others with respect. They learn how to wash and sterilize instruments, how to set up a sterile trays, how to chart, how to assist in supporting patients' airways during outpatient oral surgery anesthesia, and how to assist in surgery (in a proper, sterile fashion).

Since 1998, 31 of these students have been accepted to dental school, 8 have been accepted to medical school, 3 to nursing school, one to podiatry, and one to physical therapy. I am so, so proud of them.

Of the 31 students accepted to dental school, to date, only two have gone on to oral and maxillofacial surgery. One of them now practices with me. Actually, it is more accurate to say that I practice with him. I am so, so proud of him.

I think that there may be more of the OMS interest in the current dental group, but time will tell.

And, some people figure out that this was not for them, which is good to figure out early.
 
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I am a general dentist who has been practicing for almost 30 years. I own 3 practices, and I'm looking for a new associate for the busiest, and most lucrative one. I have two associates currently, who are older like myself and work limited schedules, so I am looking for an associate to work a more full-time schedule. I had hired a colleague's son who worked as an associate with us for almost 3 years, but only wanted to work 3 days a week - as a new grad! Once he gave his notice I hired another new grad who seemed like he genuinely understood the hard work and patience it takes to be successful in this field, and he signed a 3 year contract with me. I was even discussing potential ownership possibilities with him, and was fairly confident I'd found someone to pass the torch to, (because I truly do not want to sell to a DSO when I retire). WELL - This past Tuesday, this associate gave his notice AFTER 6 MONTHS because he was offered a Fellowship in AZ where he recently took an Implant course. I was surprised, incredulous even, that he seemed to not think anything of breaking a contract and cares even less of the implications it has for others whom he's affecting with his decision. Actually, it seemed to shock him that my business manager and I were not excited for him and this new opportunity. He tried to say that he had a few slow weeks, and realized that he's just not making the money he thought he'd be making... and in my head I thought, "It's been 6 months.. you get the majority of exams, if patients aren't receptive, maybe look at your approach" - and he has done better in his first 6 months in private practice than any associate I've hired in the past.

So my question is - what are Associates and new grads looking for in a position? Because my manager and I went back and forth with this person 3 or 4 times in the hiring stage and pretty much acquiesced to any and all of his requests. How do find someone who will follow through on a commitment they make and someone who understands that dentistry is all what you make of it? If you are willing to make the sacrifices and work hard, you can build an incredibly successful career. I want to feel confident in the person I eventually sell my practice(s) to, and I don't know that there many of those people in this coming generation of dentists.

How do I find someone who is not going to break a contract when the next (seemingly) best option presents itself?

I don't find anything wrong with your associate terminating the contract early and do not understand your outrage. Surely there were terms that allowed him to do so with a 30, 60, or 90-day notice. If so, then he was completely within his rights to have done so.
 
Finding an associate is very hard. Finding a good associate is extremely difficult. Finding a great associate is almost impossible.

The best associates all leave because they’re constantly trying to level up their lives. Most associates are moving on to something new in 24 months.

That’s also one of the benefits to being an associate - you can do what you want, live where you want, etc.

Loyalty is overrated and has never existed in our profession as far as I can tell.
 
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I don't find anything wrong with your associate terminating the contract early and do not understand your outrage. Surely there were terms that allowed him to do so with a 30, 60, or 90-day notice. If so, then he was completely within his rights to have done so.

I agree. As long as the associate followed the dictates of the contract and gave proper notice, it is okay for them to leave. It sounds like they wanted more training.
 
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I feel like we need two tiers for "Associates" in dental practices. Candidates would have to apply for one or the other. but they cannot apply for both.

The first tier are dentists who only want to work 3 days a week, or less, and who only want to ply the trade (it is not a profession for them) while they are physically in the building. They want to make a ton of money. They don't want to be there after 3:30 p.m. They think the practice will run itself.

The second are dentists who understand that it is up to them to bring in the patients, it is up to them to treat the patient well (or maybe the patients won't come back), it is up to them to manage and pay the staff, it is up to them to pay the overhead, it is up to them to worry about making the pension plan payment on time, etc. They can take time off, but who will be there for their patients when they are gone?

I once interviewed someone for an associateship (with a path to ownership), and their main question was: "OMSDoc, how much will I make as an owner/partner?" My response was, "You know, that is up to you. Moreover, you are the last person to get paid."

Uffda.
I mean, you just described associate versus owner mentality... lol

That second tier of associates will leave if you don't eventually give them equity
 
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I mean, you just described associate versus owner mentality... lol

That second tier of associates will leave if you don't eventually give them equity
Ya...life and business are full of trade-offs.

Equity is such a loaded term in this day and age. I avoid using it now because of its Marxist connotations of equal outcomes. But if I have to use it, I only use it in a business/financial format. I am guessing you mean an equal partnership/shareholder position.

No one is "given" financial equity in a dental practice, mostly.

They have to earn it and/or buy it. If they expect to be an owner/equal shareholder, they have to step up, show leadership, and do what needs to be done. After that, if there is no offer of equal ownership, the associate can go elsewhere.

There is always a risk in business, both with the owners and the associates.

The owners/shareholders of a dental practice have enough on their plates without having to ask the associate to do every little thing noted in my previous post.

The original poster was surprised that his associate wanted to leave after only six months. But that is life, and as long as the associate followed the contract, there is nothing wrong with that. To give notice is not "breaking" a contact.
 
Ya...life and business are full of trade-offs.

Equity is such a loaded term in this day and age. I avoid using it now because of its Marxist connotations of equal outcomes. But if I have to use it, I only use it in a business/financial format. I am guessing you mean an equal partnership/shareholder position.

No one is "given" financial equity in a dental practice, mostly.

They have to earn it and/or buy it. If they expect to be an owner/equal shareholder, they have to step up, show leadership, and do what needs to be done. After that, if there is no offer of equal ownership, the associate can go elsewhere.

There is always a risk in business, both with the owners and the associates.

The owners/shareholders of a dental practice have enough on their plates without having to ask the associate to do every little thing noted in my previous post.

The original poster was surprised that his associate wanted to leave after only six months. But that is life, and as long as the associate followed the contract, there is nothing wrong with that. To give notice is not "breaking" a contact.

For those interested in partnership from the get-go, a buyout, if terms are explicitly enumerated in the contract, is fair. Signing a contract with some hand-wavy nebulous "you need to earn it" type language is a recipe for disaster. A contract lawyer is non-negotiable.

Generally speaking, as an associate you should advocate for yourself first and foremost. Good owners will understand a self-preservation instinct.
 
Absolutely…the devil is always in the contract details.

Everyone should pursue their separate interests.
 
Ya...life and business are full of trade-offs.

Equity is such a loaded term in this day and age. I avoid using it now because of its Marxist connotations of equal outcomes. But if I have to use it, I only use it in a business/financial format. I am guessing you mean an equal partnership/shareholder position.

No one is "given" financial equity in a dental practice, mostly.

They have to earn it and/or buy it. If they expect to be an owner/equal shareholder, they have to step up, show leadership, and do what needs to be done. After that, if there is no offer of equal ownership, the associate can go elsewhere.

There is always a risk in business, both with the owners and the associates.

The owners/shareholders of a dental practice have enough on their plates without having to ask the associate to do every little thing noted in my previous post.

The original poster was surprised that his associate wanted to leave after only six months. But that is life, and as long as the associate followed the contract, there is nothing wrong with that. To give notice is not "breaking" a contact.

The trade off is what I'm getting at.
The kinds of associates that take initiative, show leadership, will eventually want to advance to being an actual leader. They will not want to stay associates forever. The ones that stay life-time associates want to come in, do the work, and go home. Just two different lifestyles that people choose.

The only incongruous part is if you expect an associate who takes their own initiatives to be satisfied as an associate forever.
 
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