t’s no secret that only a small percentage of new grads opt for the challenge of chasing their dream and building a practice right out of school. In fact, as the leader for a company specializing in practice start-ups, I see it every day. The sad reality is that there are far more new doctors out there who are capable than those that actually attempt the endeavor. But for those that do buckle down and dig in, the end result can be very rewarding.
For that reason alone, I’m very outspoken about new graduates seizing the opportunity of launching their own practice. However, it’s my unfortunate observation that many new grads “default” to taking an Associate position due to some common fears, frustrations, and uncertainties. Some of those are justified, but many are certainly not. I use the term “default”, because, in a high percentage of the situations, it is simply not the preferred choice or original planned path.
It is clear to anyone in our profession (who actually pauses to assess it) that this common re-active approach results in many unhealthy and poorly orchestrated Associate D.C. employment scenarios. An otherwise excited, passionate and well-educated D.C. winds up in what we call “Associate Jail”. What’s that? It’s the endless cases you have probably heard of (or been in) when a doctor is captive to their circumstances … stuck in a place difficult to get out of. Not learning. Not earning. It can be very tough to endure and causes undue stress, loads of frustration, costly financial challenges, and perhaps worst of all, significant delays in your professional growth and achievements.
Even with all this said, I do suggest some consider an Associate position. Business ownership is not for all. For the sake of this article, let’s say you have considered your options, put aside the inaccurate fears instilled by supposed “experts”, and still ultimately chose to inquire into the idea of an Associate position. A thorough pursuit of establishing such a role that will be mutually beneficial for you (employee) and the owner doctor (employer) is a must.
Too many new grads jump on the first “job opportunity” that comes along. This proves detrimental in a high percent of cases, and seems to be the “norm” for Associate positions in our profession. In this article, I want to share some questions I suggest you ask as you explore the path of an Associate position.
Too many new grads jump on the first “job opportunity” that comes along.
First, why does the owner D.C. even want an Associate? Do they really “need” one to see a higher volume of patients, cover more hours, or deliver better care? Is there some other plan? Or do they just “want” someone who will handle some of the work they prefer not to do? There is no “wrong” answer, but it would sure be nice to know this from the start.
That question leads to the next point: get clarity about your potential role. Don’t assume that, because you are a doctor, you will do just “doctor things.” The term “associate” means different things in different offices. Will you be seeing patients, and if so, in what capacity? Will that include doing consults and exams? Or covering for the employer when he/she is out of office? Will you have your own patients and do everything? Or will you only be a marketing D.C. responsible for bringing in new patients? Maybe you will simply serve as a therapy assistant or “glorified C.A.” I’ve seen each of these scenarios, and as you might expect many of them leave the Associate very unhappy and frustrated.
I’d like to have you ask this: Was the employer ever an Associate? If so, what was their experience? This might give you an idea of their personality type, and establish whether or not they will be sensitive to your position in your working relationship.
Next, you may know what you want out of an Associate position, but ask them about their expected outcome. Where is this working relationship going? What does it look like after a year, or two years, or further down the road depending on your desires.
Establish your potential employer’s experience in the role you are counting on them to fulfill – mentor, trainer, etc. After all, you are probably banking on them teaching you a bunch, right? You want someone who will lead you and prove to be a great example. So, ask how many Associates they have had. Are you going to be an experiment? Do they have a training plan or agenda set, and can you see it? This will indicate “if” they really plan to make time for that teaching aspect.
Along with that, ask if the potential employer has an office manual. This will demonstrate if the office has systems in place. Is there an ongoing coaching plan? So often there is a barrage of half-organized training when the Associate arrives in order to hand-off what the employer doesn’t want to do. Then, the training stops before any leadership, management, marketing or other business sense is really taught.
The majority of the colleges are making a good attempt to deliver more and more business acumen to their students.
Find out how much they value growth. Ask them who their coach is. What sort of continuing education or training do they do for themselves? This can be a telling factor about their work ethic and desire to create something bigger and better with you there. What is their vision for the future of the practice? And, how does an Associate (you) fit into that?
Finally, make NO assumptions about how you will be compensated. As in so many relationships, money is often the “nail in the coffin” for a frustrated Associate D.C. Inquire about the total “compensation package.” Don’t just ask about the salary. What about bonus opportunities? How about malpractice insurance? Can you write a check for such a payment (sometimes quite large) before you ever see a patient? Who will handle that? Other things that may be discussed or negotiated include continuing education, practice building seminars and coaching, benefits, and retirement.
The list goes on and on, but you will never know for sure … unless you ASK! When you are bold enough to ask these questions up front, you will likely realize that many potential employers are simply not ready for that role … at least not up to your standards. If that’s the case, move on! Just say “next!”
As a result of being part of the business curriculum at a couple of chiropractic colleges and speaking at several others, I have made an encouraging observation. The majority of the colleges are making a good attempt to deliver more and more business acumen to their students. They realize more students need more business to succeed in practice. As this happens, we expect more and more new grads will choose to go into business on their own right from the start.
So, don’t be one to “assume” you have to take 2-3 years to fill an Associate position. It’s not all it’s cracked up to be. However, if you do feel that is best for you, ask questions like those above. Interview the potential employer as much as they interview you. After all, you have worked hard for that D.C. behind your name. Don’t settle for anything less than high potential, positivity and prosperity!Dr. Bart Anderson of HealthSource Launch U (HSLU), a specialized training & coaching program for D.C.s working to start, build, and succeed quickly in a practice they own. To date, HSLU has been involved in the launching and/or owning of over 100 combined practices. Dr. Bart speaks at numerous chiropractic colleges on a regular basis. To learn more about Launch U go to www.healthsourcelaunchu.com. Or call 888-550-3816 or e-mail him directly at