Dr. Christopher Richardson, DMD, MS, answers questions about how he found an associate position and began his periodontal practice after completing his postdoctoral training...

What to Do After Graduation Day
STARTING AS AN ASSOCIATE

Below is an interview with Dr. Christopher Richardson.
Christopher Richardson, DMD, MS, is a private practitioner in Richmond VA, and has been a member of the AAP for 6 years. He is a member of the Committee on the New Practitioner and a committee liaison for the Committee on Clinical Practice. He received both his periodontal certificate and masters of science degree from University of Texas-San Antonio in 1998.

What was your ideal plan after graduation?

If I could draw up the perfect plan, it would read as follows: I would associate into an established and well known practice. This practice would preferably be located in the Southern United States and have enjoyed growth over its lifetime from both a new patient and gross collection standpoint. It would have one or two practitioners willing to assist me in developing into a periodontist who was well versed in both the business and clinical aspects of periodontics. Finally, it would be important to receive a compensation package that provided for my family, not extravagantly, but comfortably.

What appealed to you about starting as an associate?

A number of factors appealed to me to start as an associate. First of all, you do not have the burden of starting your own practice from scratch. The business plans, architectural plans, marketing plans, hiring a staff, negotiating leasing vs. buying, setting a fee schedule, looking for patients, and most importantly developing an initial inroad with a referral doctor or doctors are time consuming, stressful, and just don't fit into my personality. Being an associate bypasses these events. All of the previously listed factors were already in place and I just had to join in the fun. In addition, an associateship allows you to get your feet wet, where the only person who is counting on you is you. Finally, I had always envisioned myself as having a partner. An associate position allowed me to evaluate if in fact this is what I truly wanted vs. the possibility of being a solo practitioner.

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

A number of routes now exist for a periodontal resident to find out who is looking to hire. I searched the AAP Web site, spoke with contacts in different states, looked at the positions available posted outside the office of my graduate director, and finally, let my graduate director know what my plans entailed. Graduate directors have contacts throughout the country and can be very useful in the placement of their students.

What variables influenced your decision on location?

The number one influence for me was to be flexible on location. This is another perk for an associate in that you don't necessarily have to have your lifelong practice where you associate. Also, there are a number of great opportunities around the country. I just needed to be able to pick up and move to the one that fit my needs the best.

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

My initial niche was dental implants. My employer had made the decision that he was no longer going to place implants. Therefore, I immediately had a designated hook on which to hang my hat. It also allowed my employer to push the implant patients my way, since he was no longer doing implants. In developing referral relationships, this gave me a quick contact which would allow these referring doctors to view my work, develop trust, and subsequently refer patients for other periodontal needs.

What were you looking for in a practice?

I was looking for a practice which had a comfortable daily patient load, an established hygiene practice, demonstration of growth over the previous ten years, adequate space in the office for me to work, and someone who had previous experience as an associate or working with associates. This may sound strange, but it makes sense for your employer to have a historical foundation along these lines. That way, you both are not trying to figure how this is going to work.

What realities did you encounter?

I found that several practices at which I interviewed did not fit into my criteria. Either the practice was too small logistically, or the owning practitioner was trying to decide if he was ready or not to hire an associate. Again, I was looking for someone who was ready to have a new graduate associate into their practice with the intention of selling. My hope was to find someone who wanted to be a partner.

What did you do and why?

I found an associateship position through the advice of my graduate program director. The practice was located in the South, had a strong positive reputation within the community it served, and had an owner who was significantly involved in organized dentistry. He was able to meet my needs financially, had experience with previous associates, had a strong and stable practice, and had room for me to work providing two operatories and a private office. I knew it would take time to integrate into the office, and I was willing to give it the time it needed to allow for my own growth to occur.

What is your situation now?

Today I am 50% partner of the practice in which I began as an associate. I was an associate for 18 months, and have been a 50% owner for 2.5 years. I obviously decided that I enjoy having a partner.

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

A number of factors influence your decision about where to go, whether or not you enjoy it when you get there and whether or not you are going to stay. As I mentioned, I was open to location anywhere in the continental U.S., with preference to the Southern states. This made the initial decision easy. The hard part comes after you are there. For example: Fortunately, these have worked out well and my decision to stay has been relatively uncomplicated.

What risks were involved?

When you are an associate, you basically have no risks. First of all, you are an employee and it is as if you worked for Wal-Mart. You certainly want to make new contacts, keep the customers happy, and work hard, but you have no vested interest in the corporation. If you don't like where you live, don't fit well in the community or are not getting along well with the boss; MOVE, and find a new position. Your risks may be that you have to sell a home or find a new school for the kids, but these are certainly minor. Probably the biggest risk you are taking is finding out whether or not you are going to like private practice periodontics. If you have chosen the wrong career, you are in trouble.

How did you assess and mange those risks?

The theme here is low risk, potential high return.

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

The people who were most helpful were practitioners in my area who had been in practice between 5 and 10 years, especially other specialists. They gave me some insight as to how my dental community worked and what “dues” or time I would have to put in before I began to see steady results. I was also instrumental in starting two study clubs. Both clubs (each having its own focus) are made up of younger people in the dental community and we were/are able to bounce concerns/experiences off of each other and discuss how we handled them. Fortunately, I have also had several friends go through this transition from associate to partner and found them to be invaluable resources.

Given what you know now, what might you do differently?

I would still associate. The negotiation game of contracts, compensation and buy-in/buy-out was stressful, but that will always be the case. For me, the positive aspects of association far outweigh the complexity of hanging your own shingle. Even if you want to “start from scratch,” an associate position can provide excellent information on how to run a business, develop an office design, establish communication with patients and referrals, and priceless information on how to manage your staff and your schedule.

What suggestions do you have for individuals transitioning into practice?

Try to be flexible. I truly believe there are a large number of excellent opportunities available to new graduates. You just need to be open to their location. Second, make sure the practice has an established hygiene program. Meeting and treating these patients can provide immediate and good visibility for your skills to their general dentists. Finally, make sure the established practitioner you are associating with is truly ready to have an associate.

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

When I found the right office to associate into, I then obtained local information on the cost of living. I developed a monthly budget and then presented this to my future employer relaying that this compensation would be what I would need to pay mortgage, electricity, water, food, student loans, auto loans, etc. He agreed and put together a compensation package which was very fair. Specifically, I was given a guaranteed salary with a bonus option attainable on a quarterly basis. The bonus was paid as follows: 40% of all collections over $50,000 per quarter. I was also given an annual continuing education expense account of $3,000 as well as coverage of a portion of my health care insurance. All of my malpractice insurance, assistant salary and normal social security and employment taxes applicable to any employer were also paid.

Find Out More

Student/Educator Links

What's New