A question I find crops up fairly often on dental discussion boards, or in conversation with colleagues is ‘what makes a good
associate?’ From my perspective, I think this question really does depend on who’s asking.
The first thing we all need to recognise when asking this question, is that the NHS and private dentistry are different fields, and they place different requirements upon associates. In the NHS, especially these days, people have a relationship with a
practice. Patients have often gone to a certain practice and are used to seeing ‘someone’, as long as it means they are seen through the NHS. As such it’s fairly easy for a principal to pass a patient on to an associate.
Given the nature of the working environment, if you ask an NHS principal what makes a good associate, firstly they will want someone who looks after their patients and who’s ‘on brand’, but they will also one someone who works efficiently to complete their units of dental activity. Generally associates in an NHS setting tend to be younger and less experienced, so another key factor is their willingness to learn. This brings about a very different relationship to that in a private practice setting as often the principal and associate will develop a mentor-student relationship, where the principal is not only imparting clinical knowledge, but also brand values and how to work within a system where there are certain constraints that must be negotiated.
Within private practices however, the relationship is different, and this comes down to the way patients form closer bonds with the individual dentist. While this patient-dentist bond can of course be a very positive thing for all parties concerned, it does come with its own problems. For a start, this means it’s far more difficult for a principal to pass patients on. We have
also seen over the years how practice buyers must work incredibly hard with outgoing principals if they are to retain the goodwill of the patient base. With private practice such a ‘different beast’ to that of the NHS, a principal therefore has a number of different requirements of his or her associates. For a start, the role is far less focussed on learning, as a principal will want an associate charging private fees to be competent and good at what they do. They really need to be doing a job that’s at least as good as the principal. The difficulty here of course arises from the fact that when it comes to private practice, the associate doesn’t have as much attachment to the practice as a business – they don’t have any ‘money in the game’. This means a principal needs to be especially careful about whom they employ, and be sure that they are taking someone on who is ‘on message’ and can be relied upon to join in the practice’s marketing efforts. They also therefore need an associate who can attract new patients in their own right, and not just rely on the principal doing the bulk of the work to try and grow the practice.
Of course the other major area where the quality of associates is important is in specialist practice. From my own experience running my own endodontic practice I believe in these cases, it’s even more important that the associate is as competent, or if not more competent than the principal. I get a lot of people referred specifically to me from our referral practices, and as such I have to have a very good reason to pass them on to an associate. Thankfully I’m in that very fortunate position that I have an associate with skills that I do not possess. Daniel Flynn is an associate of mine who has such good endodontic
microsurgery skills that if a case comes along that fits his skill set better than mine I can explain that to the patient.
In a private referral practice working as a principal you really do have to put your ego to one side.
For me, a good associate is someone who puts their heart and soul into their work, who adds something to the practice, and is a valuable member of the team. If you’re an associate just starting out, I really do recommend you get as much experience as you can. Even if you don’t want to work in NHS forever, the lessons you learn in the NHS can give you valuable experience to add to your ‘toolbox’ as a clinician. I remember when I first started in the NHS in 1986 I used to complain non-stop about how my employer would keep pushing me. Though it was exceptionally hard work, now I reflect on those early days I can honestly say it was the greatest work experience I ever received as I learnt about efficiency and worked with a wide range of different patients. Even though I was working on the NHS, my mentor taught me more about private practice than anyone has ever taught me since, as he gave me valuable lessons about customer care, and how to really nurture patients. For me, these two points are perhaps the most important of all. Care and empathy are crucial to any dentist’s role. A good associate then will have these two traits in abundance, and will thus form a great relationship with their principal, perhaps even with an eye to succession at one point down the line.
Whether you’re a principal or an associate, we all need to remember that dentistry is about forming relationships. Whether it’s with your patients or with your employer/employee, only by working together towards a common goal can we all learn and grow together. Our patients, and our practices, will only benefit as a result.