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How to prevent associates from leaving your dental practice

Sept. 24, 2018
It costs a dental office hundreds of thousands of dollars to replace an associate dentist when the person decides to leave. But there are several things a practice can do to prevent these departures and make a new dentist happy.
During my early years in private practice, it often felt like my office was a revolving door for associate dentists. Every time we lost an associate, we had to find a replacement, the team had to build a relationship with another new person, we had to train a new associate, and patients had to reset and rebuild trust with a new provider.

Many dental practice owners have experienced these frustrations and know how critical the right team is to the success of the practice. Some studies estimate that it costs up to $320,000 to replace a $150,000 dentist.(1) This includes the cost of hiring, training, and lost productivity.

A recent Gallop report estimated that millennials make up 38% of the workforce and are expected to make up as much as 75% by 2025.The report also showed that the key to retaining millennial employees is to keep them actively engaged.(2) New dentists entering the workforce are not just looking for a paycheck. They’re looking for mentorship and a place where they can be in charge of their own success.

There are four steps dentists can take to keep their associates engaged. These include creating an action plan, hiring the right person, setting expectations, and scheduling for success and mentoring.

Creating an action plan

One of the mistakes dentists often make is to bring on a new associate dentist without consulting the office manager or team members. This lack of communication and planning with the team can often result in a conflict between the new associate and team. When it is time to bring a new associate dentist on board, it’s important to involve team members in the interview process where appropriate, and to sit down with the entire team to develop an action plan. The plan should include measurable imperatives such as daily production goals, number of patients per day, as well as a deadline to achieve these goals. This simple step will create a clear and concise plan for the new associate and team so that everyone knows their roles in achieving these goals.

Hiring the right person

Once a game plan for onboarding has been established, it’s time to find the right associate. Take the time to find someone who is a good fit for the office, someone who will be well-aligned with the culture of the practice. Finding a good fit starts in the interview process. It’s important that the new associate share the same vision when it comes to treating patients. Dentists should always be clear about their expectations for the new associate during the interview, but they should also find out what the potential associate expects from them and the practice to make sure they can deliver. This can range from mentorship to working hours to production and compensation.

Setting expectations and scheduling for success

The first month of work can be a nerve-wracking experience for a new dentist. It is important to set up the person for success from day one. First, set written expectations of what is expected from the new associate and what he or she can expect from the practice. Next, schedule no more than six or seven patients per day for an associate during the first month. This gives the person enough time to connect with new patients and become familiar with how the practice operates. In a patient-centric practice, this helps the new associate focus on the quality of care and on building relationships with patients. In turn, the associate will feel valued that the dentist takes the time to set up him or her for long-term success with the practice rather than placing an emphasis on production during the first month.

Mentoring the associate

The first three months of onboarding are the most critical for determining if a new associate will stay on for more than one year. The associate is evaluating the dentist and practice just as much as the doctor and team are evaluating the associate. During this period, set aside time for mentoring and chart reviews. Depending on a new associate’s level of experience, a mentoring program may vary greatly.

The dentist can set aside shadow days where the associate follows him or her around to observe interactions with patients, including diagnosis and treatment planning in a variety of cases. The dentist should also set aside days to assist the new associate chairside. This provides an opportunity to observe the new associate at work and ensure that he or she has the same values and ethics when it comes to treating patients. The dentist should praise good work publicly and give constructive feedback privately.

Many of us have tried to hire an experienced associate and just hope for the best rather than investing time in the planning and onboarding process of the new person. Unfortunately, this typically results in the associate leaving as soon as he or she finds a new opportunity. As practice owners, we need to start investing in our associates so that they remain actively engaged and see the value in us and our practices. What’s more gratifying then seeing an associate grow and flourish under our guidance? By taking these four steps, we can be intentional in setting up our new associates for success, and as a result, maximizing their retention. While some associates may still leave for other opportunities, the ones who stay will help us achieve long-term practice growth.

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Quyen Pham, DDS, is a graduate of New York University College of Dentistry and is an owner-dentist supported by Pacific Dental Services in Las Vegas, Nevada. He currently serves as a faculty member of the PDS University–Institute of Dentistry.


1. Boushey H, Glynn SJ. There are significant business costs to replacing employees. Center for American Progress website. Published November 16, 2012. Accessed August 31, 2018.

2. Rigoni B, Nelson B. Many millennials are job hoppers–but not all. Gallop website. Published August 9, 2016. Accessed August 31, 2018.