Associateship contracts

Some dentists think you should always always always have a contract before starting to work for someone.  Sure, in an ideal world.  After meeting over 20 dentists in the past year, I've only seen two contracts.  Maybe most dentists don't even think about them, or maybe they don't care... but most of them never mentioned anything of a contract.  One even said, "Why do we need a contract?  Everything I say goes."  But be careful, and tread lightly if you decide to go into a job without a contract.

If you don't have a contract, just make sure you have the following spelled out for you and agreed upon before you even start a working interview:

1)  Compensation -- Ask if you'll be paid per diem (i.e. base rate per day), or by percentage of collection OR production.  Often they'll promise a percentage of production, with a minimum base, so that at least you can be sure you'll be making at least a certain amount each day you work.

If paid strictly on a per diem basis, ask if there's a possibility in the future for an increase.  You don't want to be stuck at base pay forever.  For an 8-hour day in the SF Bay Area, I'd say $500 is pretty average for an associate starting out.

Being paid per collection is a pain because it's dependent on when and how money is collected, which is a lot of times hard to predict in a PPO office.  Being paid on production is better because the day you do a procedure, a percentage of that procedure goes in your pocket the next times you get paid.  It's not dependent on whether the front office collects the money or not.  You did the procedure, you get paid.  Be careful with percentages of production or collection, especially when you're in a group practice with multiple doctors.  The front office can easily mistake who did what procedure, and then keeping track can get loosey-goosey.  Average percentage I've seen for an associate starting out is 25%.

Also, when and how are you going to be paid?  Have you filled out a tax form?  By the way... most employers will count you as an "employee," subtract all your taxes, but they won't give you any benefits.  I have yet to find a dentist who will provide benefits.  They'll add you to their payroll and pay you twice a month.  Sometimes you'll get compensated as an "independent contractor" and get a straight up check without anything subtracted from it.  Keep in mind how much you collect as an independent contractor in a year, because if you don't report your taxes quarterly to Uncle Sam, you may get penalized with interest during tax season!

Also do you pay for labs?  Or any materials?  Or assistant salary?  You'd be surprised, some offices will take these portions out from your paycheck!  Don't worry though, most won't... just ask to be sure!

2)  Schedule -- What days and hours do they expect?
3)  Duration of the position -- Are they expecting long term?  Or just temporary help?  If you decide to leave, or if the doctor wants to fire you, what kind of notice are we looking at?  Two weeks?

(Obviously, there are more things you should know, but I'll go into that in another post... these just seemed the most basic.)

If given a contract, make sure you read it really well.  There was one office that told me that he wanted me to sign a contract binding myself to him for 3 years.  He also wanted to include in the contract to move closer to  the office.  I live in the East Bay, and was commuting to San Jose during the working interview process.  I never actually saw the contract, because he never showed it to me, but there were a couple red flags:  1) CA is an at-will employment, so there's no way an employer can enforce a 3-year term (unless your working for a corporation like WesternDental and will suffer a huge financial penalty for not finishing your promised term); 2) forcing me to move is extraneous to being able to do the dental work.

The one office I did sign a contract with, it was completely legit.  Click here to view a blank copy.

Here's a more official look at what an associate contract should spell out according to Barry Josselson, a Professional Law Corporation.  Click here to view.

This is another view on the importance of contracts, and also explains employee vs. independent contractor pickle that most dentists face when working for an employer.  Click here to view.

Something else to consider, which may be written in the contract, is the ownership of patient records.  Most dentists will write in the contract that if you leave for any reason, you cannot take their patients with you.  You may not take any of their information with you and potentially "steal" them from the doctor.  Granted, if patients find out that you are gone, some may want to seek you out.  There's nothing you can really do about that.  But to go back and solicit to the patients with the sole intention of taking them with you when you leave... obviously it's illegal if you sign in your contract that you wouldn't do that.

Here is an ADA section on Associateships, published in 2009, with lots of good tips as well.