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Professional Courtesy: Improvement on Two Front by Dr. Thomas Giacobbi

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Categories: Practice Management, HR and Accounting;
Professional Courtesy: Improvement on Two Front


by Thomas Giacobbi, DDS, FAGD, editorial director

There are many discussions online about current threats to the happy life we know as private practice. New grads are choosing to start their careers in DSO Land, team members are difficult to find and patients are getting meaner.

If our profession is truly declining, is it from the outside or the inside?

This month, I would like to discuss three issues we can control on the inside to improve our chances against some of the outside forces that threaten our great profession.


Find a better way to pay associates
Paying your associate a percentage of collections is the most widespread— and poorly conceived— approach to compensation. The first day you meet your associate, you might as well say, “You can’t trust me, and when you leave, I won’t pay you for your final month of work.” Is that the foundation for a relationship of mutual trust and respect? I think not. The scheme is simple: Collections always trail production, so when the associate leaves and collections continue to happen, the dentist usually keeps the money.

Many associate contracts plainly state that the associate won’t be paid after they leave. Furthermore, during their tenure, they don’t have the time, access or resources to continuously audit the practice ledger; they will never know when an innocent mistake has been made or have the ability to detect an ongoing effort to trim their wages. The burden of collections rests entirely with the owners of the practice, and penalizing the income of the associate is simply unfair.

If you’re worried about collecting for procedures performed by your associate, your office’s financial policies and procedures need your attention ASAP.

The fair and proper method of associate compensation is to pay them a percentage of adjusted production. Production is easily seen by both the associate and owner, and any discrepancies are easily remedied promptly. Adjustments to production would include contracted PPO fees, refunds and warranty work (procedures redone for a patient at no charge by another provider in the practice). Lab fees are paid out of the percentage retained by the owner. If there is a concern for excess lab fees, simply have the associate use the same labs as the owner.

If you are charging lab fees, do you also ask associates to pay for a percentage of the composite they use, the minutes they spend with the dental assistant or the rent? Of course not. What would your dental assistant, front office or hygienist say if you told them they were all getting paid on a percentage of collections? I’m guessing they would say goodbye.

If you want a loyal associate, then treat them like a great employee. If you want them to be compensated like you are, then make them an owner.


Adjust after-hours availability
Taking care of patients after hours is the other issue that plagues our great profession. Some dentists choose to be completely unavailable after hours. Unfortunately, if that’s the case, patients who are in desperate need of assistance will end up calling one of your local colleagues, not you, for help.

I’m not suggesting you have to drop everything the second any patient calls or run to the office to smooth a chipped tooth. What I am saying is that your voicemail should have a method to send you a message after hours, and you can choose the best way to respond.

Making yourself available is a also great way to truly own your work.
  • If I see a handful of patients calling with their temp crowns in hand, it’s time to discuss it with the team.
  • If I have patients calling after their numbness wears off, complaining that their filling is too high, I know how to avoid that interruption in the future.
Every dentist needs some time out of the office periodically, but the responsibility of ownership doesn’t leave town then too. Share a call with a colleague when you need to be away from the office.


Collaborate for better patient care
Let’s work together to ensure our practices operate with integrity and continue to be a differentiated experience for both patients and associates.

I fully expect these topics will generate some debate and discussion! Please share your feedback below. Or, if you prefer to email me directly, tom@dentaltown.com will get the job done.
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