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Specifics you want to address in an associate contract:

These are important questions to ask before you start working…HOWEVER…if you came into my office, and I was offering you a job, I would be a little taken aback with the assumption that I wouldn’t treat you fairly. It’s quite a balancing act! You don’t want to be too demanding, but you also don’t want to sign a contract without thinking about all the scenarios that happen in a dental office.

If you have a few offers you are comparing, then ask every single one of these questions. If you have one job that you are looking at, decide what is important to you and get those answers in your contract (Pro Tip: if it is not IN WRITING – it was never said and can not be relied upon). I’ve been an employer for 25 years and have had a few associates. I used very simple written agreements – we paid our associates on production, and they paid nothing towards any lab bills. We offered no benefits but paid very well (29-33%of production in a FFS office). We never had any issues, and everyone left on very good terms.

We then watched our daughter go through a couple of offices as an associate where she was treated unfairly and not paid according to what was the “understanding”- (and this is with both her parents in the dental field and looking at the contract), so get as much in writing that you possibly can!

Define EXACTLY what will be included in the calculation of your production/collection percentages. After you think you understand, create a few example scenarios that you can then calculate your compensation from – and make sure the other party agrees with your math. What if the front desk does not collect what they are supposed to? What do you do? Are financing charges taken out of your pay (care credit)?

Who determines what is “written off”? Do you have the option of refunding money to the patient if something goes wrong? I assure you things will occasionally go wrong.

Make sure you know the difference between actual production, adjusted production, and collections. Ideally (even from an owners perspective) you’ll be paid on production. You have very little control over collections, so if the front desk or office manager doesn’t like you- you are screwed. I would take a lower percentage of production over a higher percentage of collections every time.

Print out reports of production and collections every day and keep them in a safe place (not at the office). Calculate your own pay before you get your paycheck and make sure they match. If they don’t, find out why. This isn’t something you can just assume will happen correctly. Be proactive. Don’t wait until 3 months later and then try to figure out what went wrong. Start looking as soon as you get your first paycheck.

Who calculates your pay? Do you have access to the same reports so you can check to see what your pay is based upon? For instance – the owner does a crown that insurance denies, and then the patient comes in for a checkup and gets an exam by you. Insurance pays for your exam- does that go to you or to the old balance for the crown?

Will you be paid for hygiene exams? Will you be paid for x-rays taken by your assistant or your hygienist? What about promotional offers? Are you paid standard rate or discounted according to the offer?

Will you be compensated if you do treatment on team members? At a discounted rate? At full rate? For free?

Can you do treatment for free on your immediate family? Can they come in during regular hours? Does it have to be on your day off? If you can’t treat them for free, can they get a discount? If your family member has dental insurance, can they just collect what insurance pays, or will you have to pay out of pocket for the treatment you actually do.

What is your role with the team members? Can you tell them they are doing something wrong? If you are the only dentist in the office on any given day, can you ask team members to stay late, or send them home when there are no patients? Are you their supervisor or is it the office manager or owner dentist?

Can you set policies for your patients? For instance- I do two exams on new patients – I see them after charting and probing, and again after prophy. Can you implement this type of system? Or do you have to do everything the way it’s always been done?

If the office is adding a day, will they be increasing marketing to increase patient flow into the practice? If not, how will they provide patients to fill up the day? This is a big deal if you are paid on a percentage, if you have a guaranteed salary this is not as important.

Who is in charge of your schedule? Will you be paid a minimum amount if you have very few patients and are mostly there to check hygiene? This is important when you start the job and when you are leaving it. If there are no patients, do you still have to be in the office?

How much notice needs to be given for requesting time off? Six months is ideal and achievable. You’ll get used to planning your life in 6 month increments. Is there another doctor to cover for you? Will patients have to be canceled because you need time off? The further out that you can plan, the better for the office.

Will you be asked to do hygiene? I don’t think this is bad, but something to know going in.

How much notice needs to be given if you want to quit?

If you give notice and they start taking patients away from you (this is normal during a transition) – negotiate for a daily minimum at the end of your contract in addition to the beginning. If they hire another dentist to replace you, will you be let go sooner than you expected? Unfortunately, you need to plan for what to do if the associateship does not work out. It is much better to do this at the beginning rather than when things are going downhill.

How are labs chosen? Do you have to use certain labs? Do you have to pay a percentage of lab bills?

How are redo’s handled? You’ll usually be responsible for your own redo’s but what if you are replacing something on a previous dentist’s patient? If the patient would normally not be paying to have a new crown done (say recurrent decay because of open margin on a crown less than a year old) – how will you be compensated? What about recementing crowns? Will you be paid for redoing another dentist’s restorations? Who decides if it needs to be redone?

Who is responsible for after hours calls (weekends and evenings)? Will patients be given your cell phone number? This is not a big deal, but better to know ahead of time if you’ll be the only one on call. Emergency dental visits where you actually have to open the office after hours are VERY rare, but people do call occasionally.

How are team members assigned? If your assistant can’t come in, will you be provided with a sub? If the owner doc’s assistant doesn’t show up, will they take your assistant?

How are patients assigned? Is there a rotating system where everyone is given new patients? Are new patients that come in for checkups assigned differently than new patients that come in for emergency exams? Ask for reports of new patient numbers in the last year or so. Divide this by 12 and see how many new people are coming to the office monthly. Divide that by how many docs there are. Is that enough new patient volume to keep you busy?

Will a dentist be looking over your treatment plans (you might want this, you might not)? What if there is a disagreement about a treatment plan? Start getting nervous if they tell you every 2 or 3 surface filling has to be treatment planned as a crown.

Will you be paid for staff meetings, promotional events, mandatory CE (that you didn’t choose), coming in on days off to train new people?

What is their training system for new employees? Is it written down? Does everyone know the same information?

What systems are in place for collecting money from patients (if you are paid on collections)?

How long is the contract term? Is it automatically renewable if everyone is happy? What kind of notice do they have to give you if they don’t want you to continue (it should be the same that you have to give them).

Who will be your supervisor? Is it the office manager? Is it the owner? Is it another associate dentist?

Can you pick supplies? Do you have a supply budget? Are basics provided but you can get a few things that you like and have worked with before?

Can you have time off for CE? Are you entitled to vacation time (paid or non paid)? Is there any CE allowance?

Do you have to sign insurance contracts to be in network? If you do, KEEP COPY OF EVERY SINGLE ONE. Know what you are signing up for, it can affect the rest of your career. Do you know the “rules” of what can be charged based on the insurance the patient has? If you do a crown and B/U on a patient and the B/U is denied because the insurance says it can’t be done on the same day as the crown, is anyone going to let you know so you can do it differently the next time? If you are paid on collections, this stuff matters.

Take a look at the mix of patients. Are the majority of the patients Fee For Service, PPO, Medicaid, DMO, cash? These all require different business models.

Do you have a say in hiring team members? Can you interview candidates? Have final say on who is hired? Can you advocate for a raise in pay for the team if you think that is why you cannot retain people?

If you are paid on collections, if you leave, how long will they continue collecting on your behalf? Will you receive a monthly check for 30 days, 60 days, forever?

If you do Invisalign or implants – how are these cases charged out? As a new associate, will you be responsible for taking over someone else’s Invisalign case mid treatment? How will you be compensated? How are implant components paid for? Are they part of supplies that the office pays for? Or are they considered part of the lab bill that you might have to pay?

Non solicitation: It is normal for a clause in your contract to prevent you from contacting current patients and telling them you are moving to a new practice or starting your own. It’s also frowned upon to contact former team members you have worked with and ask them to work for you (unless they no longer work for the practice you are leaving). If a patient happens to seek you out at another practice – that really can’t be prevented.

Non-compete: Make sure it only applies to the office you work in usually (if someone sends you to another office to temp for a dentist – make sure that’s not included). The time can be 6 months to forever – make sure you know you won’t be able to practice in the same area for that amount of time (and can live with that). The distance can be a city block or up to 50 miles depending on where you practice. Non-competes are all valid until a judge says something different. In the meantime, you will be out $$$ for lawyers and court costs. Don’t believe “they aren’t enforceable”, because they absolutely can be. Only sign something you can abide by!

We offer an associate contract review service. Click here for more information. We have reviewed countless contracts for associates, going clause by clause to provide an in-depth analysis of the employment agreement and any potential red flags. We’ve got your back!

Look at all contracts from both sides. It should be a win win for everyone. Just because you are presented with a contract does not mean it cannot be changed. Don’t sign ANYTHING until you understand everything in the contract and know how/when you’ll be paid and what that pay is based upon.

With a detailed understanding of who you are as a dentist and what you’re looking for in an associateship, you can ensure that the contract you sign is the right one for you. We wish you the best of luck! To find a private practice office that’s hiring near you, make sure to become a member today!