Dr. Sally Jo Cram answers questions about her experiences joining a group practice as an associate and later starting her own practice in Washington, DC...

2005 Student Event: Scaling to New Heights in Periodontal Practice
STARTING AS AN ASSOCIATE

Below is an interview with Dr. Sally Jo Cram.
PhotoSally Jo Cram, D.D.S., is in practice in Washington, DC. She completed her periodontal residency at University of Texas, San Antonio in 1988.

What is the most rewarding part of what you do everyday?

The long-term relationships that I have made with my patients are the most rewarding part of what I do everyday.

What was your ideal plan after graduation?

It was my plan to become an associate in a perio practice with eventual partnership/buy-in. I also planned to teach one day per week.

What appealed to you about starting as an associate?

Walking into an established office and having a mentor to bounce ideas off of. I thought that they would give me some patients to get me started until I could begin to get my own referral sources.

How did you go about searching for an associate’s position?

I was teaching at Georgetown Dental School in Washington, DC and talked to other faculty. I also put an ad in the DC Dental Society Newsletter.

Was location an issue for you?

No, not really.

Did you have a niche to assist in marketing yourself (i.e., cosmetic surgery, dental implants, etc.)?

The biggest niche was being female. There was only one other female periodontist in DC at the time and she was only practicing part-time.

What were you looking for in a practice?

I was seeking an organized office, quality practitioners with good referral base, modern office and partners who would share clinical and business expertise.

What realities did you encounter?

The office was very poorly organized (no office business or staff policies were in place) and the partners did not want to provide me with any patients. They expected me to get my own referrals and patients. My philosophy of clinical practice was not the same as the partners.

How did you obtain new patients?

I made lunch dates and cold calls to general dentists in the area and I joined study clubs.

What is your situation now?

Now I am a solo practitioner in a private practice.

What factors affected your plans and decisions about your career and future?

I decided that I needed to be in more control of my office and staff. I also decided that I couldn’t continue to practice with periodontists who did not share my practice philosophy.

What risks were involved?

It was a risk to take out a big loan and not know if I could generate enough referrals to pay the bills and staff.

How did you assess and manage those risks?

I consulted with an attorney who was versed in opening small businesses. Also consulted with an accountant who understood how dental offices are run.

What resources (i.e. people, publications, web sites, group) did you find the most helpful?

I went to numerous ADA/AAP sponsored Practice Management course and networked with other general dentists/specialists who had started their own practices. I found out what they did right and what they did wrong.

What suggestions do you have for individuals transitioning as an associate into practice?

Get to know as much as you can about your potential employer/business partner (i.e. their practice and business philosophies). Maybe do a 30- or 60-day trial associateship to see if you are compatible.

What did you learn from this process?

It was important when I decided to leave the associateship and start my own practice that everyone’s obligations were spelled out.

Please explain your financial compensation arrangement, using real or fictitious figures.

I was paid 50% of my production.

What was your biggest mistake as a new practitioner?

My biggest mistake was being naïve and not standing up for my own principles in a group practice (associateship).

How many employees were in the office at which you were an associate?

Six.

What is the most important thing you have learned about managing people?

If you are going to practice in an associateship or partnership, you really need to make sure you’re compatible with all parties involved.

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