Recently, I wrote an article about a strategy for integrating a new associate into the practice. It produced some passionate responses in the comments from young dentists – responses that raised interesting questions that I think are worth exploring further.

In that article I talked about the strategy of having a new associate integrate into the practice by performing hygiene on reactivated patients. It's a way to rebuild the patient base while ensuring that the new dentist is productive and getting to know the practice in those crucial first few weeks.

The objection from a couple of younger dentists in the comments section – and it is a valid one in many respects – is that they did not invest heavily (in time and money) to earn a dental degree only to become a glorified hygienist. One dentist shared a horror story of being exploited by an owner-dentist. "The only way I could find pleasure in my profession," this commenter writes, "was to buy my own practice."

I agree. I do not, under any circumstances, believe that anyone who devotes themselves to the practice of dentistry should be satisfied with only performing hygiene duties or being a lifetime employee. Every dentist should be given the opportunity to grow and realize their full possibilities, and that includes ownership.

What does any dentist need to start a career? They need a facility to practice in, a team to support them, and a patient base to work on. Doing hygiene is not (or should not be) about doing low-level work for little reward. By doing hygiene appointments – even if it's just one time to launch the relationship – you are providing a valuable service, getting to know the patient, and getting an opportunity to do some early diagnosis and treatment planning. That's how you earn trust and earn the right to treat their family and friends. That's how you build a loyal clientele. And when you think about it, that's how every dentist who starts a new practice from the ground up has to do it, too.

So I stand by my assertion that a well-executed transition is an excellent way for a new dentist to grow into the role as owner. Think of these introductory hygiene exams as a new patient exam – after all, many of those reactivated patients are going to be coming in with clinical needs as well and this gives you time to get to know them, and their mouths. Eventually, as the patient's are reintroduced to the practice and the associates schedule fills, the need for them to do hygiene appointments passes. When it's done right, this kind of strategy is remarkably effective in launching a new associate's career. I know because I have seen it work many times.

But that is the key, isn't it? It has to be done right. There has to be respect on both sides. The new dentist must respect what the owner-dentist has at stake and what they have put into the practice to get it to this point. And the owner-dentist must respect the new dentist's need to be fulfilled clinically and to be compensated fairly so they can deal with the economic realities of becoming a dentist today. There has to be a plan. The expectations and the timelines have to be clearly defined on both sides.

The fact is, it is easy to find successes and failures no matter which approach you take. Yes, some associateships fail. So do some start-ups. So do some staff hires for that matter. That doesn't mean that transitions can't work, or entrepreneurship is wrong, or that you'll never get good team members. What it means is that to succeed everyone involved has to have clarity.

This is obviously a complex issue. If you are a new dentist there are a lot of possible routes to take. Whether you associate for a while at a couple of places before buying your own practice, or buy into an existing practice, or build one from the ground up, or work as an associate on a transition path to partnership or sole ownership, there are a lot if moving parts. For a more comprehensive look at what is involved, I invite you to look at my series of lessons on our Digital Suite. There you will find a full explanation of what it takes to create a transition process that is a winning proposition for everyone.


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