Preparing Your Practice for an Associate: 3 Essential Steps
Introduction:
Bringing an associate doctor into your practice is a significant step that can lead to growth, improved work-life balance, and fresh energy in your office. Determining the right timing for this transition—both personally and financially—is critical and warrants consultation with a practice transition advisor and your CPA.
Today, however, I want to focus on something often overlooked: how to prepare your practice to transition from a single-doctor to a multi-doctor setup in terms of the day-to-day act of practicing orthodontics. This discussion is also valuable for multi-doctor practices that feel some refinement is needed in their patient treatment systems.
As a former associate in two different practices, I learned firsthand what works—and what doesn’t—in a multi-doctor environment. These experiences shaped how I structured my own solo practice and prepared it to eventually bring on an associate. The key to success is systematizing everything. Here are three essential steps to ensure a smooth transition.
1. Clarify Communication Systems
When I was an associate, one of the biggest challenges I faced was navigating unclear communication. For instance, I would create a treatment plan during an initial exam and place braces, only to return months later and find a different plan being executed. Not only is this frustrating for the practitioner, but it also sends mixed messages to the patient and parents, eroding trust and confidence.
The breakdown often occurs due to insufficient documentation of what was communicated to the patient or parent. In a single-doctor practice, you may rely on personal memory or loosely documented notes. However, in a multi-doctor setup, consistent and detailed documentation is essential to ensure continuity of care.
To address this, start by customizing your practice management software (PMS). Many systems allow for pre-loaded “auto notes” tailored to repetitive procedures and treatment plans. For example, if a parent requests that braces be removed before an upcoming wedding, documenting this promise ensures the next doctor honors the commitment.
In our practice, we’ve added an additional layer of communication through Slack, a popular messaging platform used in many industries. Slack is HIPAA-compliant when configured correctly, offering a secure way to share patient-related information. Its “channel” functionality allows team members to collaborate on specific tasks or share critical patient updates. For instance, a #docs channel enables quick updates between doctors, ensuring alignment on treatment plans. Accessible on both desktops and mobile devices, Slack has become a critical tool for maintaining clear, compliant inter-office communication.
2. Simplify Treatment Mechanics
One of the hardest parts of being an associate is adapting to another doctor’s treatment style. If the mechanics are overly complex or inconsistent from patient to patient, it can feel like you’re constantly playing catch-up.
To prepare for an associate, I took the time to systematize and simplify my treatment planning and mechanics. I mapped out the most common malocclusion scenarios in my practice and linked each to a single, predictable treatment modality. For example, for Class 2 correction, I chose a single approach rather than juggling multiple appliances like Herbst, Twin Block, or Forsus. This “one solution” strategy ensures consistency and predictability across cases.
I also streamlined my day-to-day treatment mechanics. By reducing my wire sequence to six wires (not all patients require all six) and limiting elastics to four types, I simplified charting, inventory, and training. This structure follows a clear three-stage treatment process: each stage includes specific wires and goals that must be met before advancing. This roadmap creates a repeatable decision tree, making it easier for an associate to integrate seamlessly into the practice.
3. Align on Treatment Philosophies
As the owner doctor, you’ve built a successful practice—one that’s thriving to the point where adding an associate has become a necessity to manage growth. This success didn’t happen by chance; it’s a result of the systems and treatment philosophies you’ve developed. When bringing on an associate, it’s essential to own your philosophy unapologetically and set clear expectations from the start.
Your treatment philosophy is the foundation of your practice, and it’s not up for debate. When onboarding an associate, communicate this directly: “This is the system that works—it’s proven, and it’s the reason this position exists. Your role is to follow this successful path and ensure continuity for our patients.” While this approach might sound firm, it’s critical for maintaining consistency and upholding the reputation of your practice.
Make it clear that this isn’t a democracy. The associate’s primary role is to adopt and implement the systems and philosophies you’ve established. If they’re unwilling or unable to do so, it’s better for both parties to recognize that upfront.
That said, alignment doesn’t mean shutting the door on collaboration. Provide opportunities for the associate to learn your philosophy through hands-on case reviews, mentorship, and consistent dialogue. Over time, as they master your systems, you can welcome their input on refining processes. This balance ensures that while they operate within your framework, they also feel valued and empowered as part of the team.
By owning your treatment philosophy and setting clear expectations from day one, you’ll maintain the integrity of your practice and foster a successful partnership with your associate.
Conclusion:
Bringing an associate into your practice is about more than adding another set of hands—it’s about sustaining and scaling the systems and philosophies that have already made your practice successful. As the owner doctor, you’ve created a framework that works, and it’s this proven approach that ensures patient satisfaction, team efficiency, and continued growth.
By clarifying your communication systems, simplifying treatment mechanics, and owning your treatment philosophy, you establish a clear path for your associate to follow. Success in a multi-doctor practice hinges on consistency, and that consistency begins with your leadership and the systems you’ve built.
Preparing your practice now doesn’t just set your associate up for success—it ensures that your patients continue to receive the exceptional care that defines your practice. The more systematized and intentional you are in this transition, the smoother and more rewarding it will be for everyone involved.
Take the time to prepare, own what’s made your practice thrive, and you’ll position your team—and your associate—for long-term success.
