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The Associate Interview

September 29, 2021 954

Interview Preparation

Preparing for the interview is just as important as the interview itself. Your level of interest and commitment to the practice in which you are applying to work will show based on how much you prepare for the interview. Keep in mind, the owner-dentist may be looking for an associate who wants to eventually transition to practice ownership; therefore, your research and knowledge of the practice is paramount to demonstrating that you are the ideal candidate.

  • Submit and track each CV and cover letter submitted. Utilize an Excel spreadsheet to track and record dates and details.
  • Follow up with prospective employers. Set a follow-up date for each stage of the application process.
  • Update your voicemail message and email to ensure they are professional. Prior to an in-person (or virtual) interview, research the practice via its website and internet search
  • Demonstrate your skills and strengths. Assemble a professional portfolio that includes a copy of your CV, cover letter submitted for the position and pictures of cases you are proud to show and discuss in the interview. Be sure to deidentify any photos or other patient information to ensure patient confidentiality and HIPAA compliance. Share only information that is not prohibited by an employment policy or agreement by a current or previous employer.
  • Bring a list of references and/or letters of recommendation to either include in the portfolio or have available upon request.

Find a friend or get in front of the mirror and role play the questions you might be asked or that you wish to ask about the practice and the owner. You may know what you want to say, but if you don’t practice out loud, it may be difficult to convey your message effectively. Work on your body language and expressions. Make sure to smile, sit up straight, make eye contact, keep arms uncrossed and face the interviewer squarely. Open body language demonstrates confidence and respect.

For more interview tips, read How to Prepare for Your Interview

 

The Interview

The following are questions the practice owner may ask of you followed by questions you might ask the owner. Being prepared to answer and ask these questions will help both parties determine if the working relationship is a good fit.

Questions the Owner Might Ask

To Assess Experience/Skill Level

  • How has your education prepared you for this position?
  • What challenges did you face in dental school and how did you overcome them?
  • Tell me about your range of clinical/experience and what did you enjoy most/least?

To Assess Patient/Time/Team Management

  • Tell me how you would handle a patient who arrives 20 minutes late for an appointment.
  • What would you do if you were the one who was 20 minutes behind schedule?
  • How would you handle a patient who doesn’t agree with your treatment plan?
  • What would you do with a patient who comes in for an emergency appointment?
  • Describe a time when you had a conflict with a colleague and how you dealt with the situation.

To Assess Motivation/Goals/Desire To Learn

  • What do you want out of your career in the short term? Long term?
  • How do you set and measure your success?
  • What makes you the ideal candidate for this position?
  • What do you enjoy most/least about dentistry?
  • What are your strengths/weaknesses clinically? What do you want to learn?
  • How would you improve this practice?

To Assess Leadership/Interpersonal Skills/Communication

  • Two staff members are having an argument in front of a patient. What do you do?
  • Our new-patient volume decreases. What do you do?
  • You see a better way to manage the schedule. What do you do?
  • Which of your previous employers/instructors did you like best and why?

Questions for the Associate To Ask

Most of these questions are appropriate to ask in an interview, yet some may simply be questions to ask yourself as part of your evaluation of the practice. During the associate interview, you may not have time to ask all of these questions. Consider narrowing the list to those issues most important to you. Some of these questions address confidential topics or information. The practice owner may ask you to sign a nondisclosure agreement before providing such information to you during the interview process.

Practice Production/Collections/Patient Flow

  • What is the practice’s annual, average monthly and daily production?
  • How many new patients does the practice see monthly?
    • Approximately 20 new patients a month per provider is a common benchmark to indicate healthy growth. If the practice sees less than 20 new patients a month, consider asking how the owner plans to market the practice to generate more new-patient volume to support an associate.
  • When a new associate is brought on, what are the work days and hours?
  • Will the practice owner be in the office on the same days as the associate?
    • This question is important so you can understand the expectations of the practice owner. Some practice owners hire associates to reduce hours while other owners want to be present to coach. Many associates are looking for mentorship from the practice owner; however, practice owners often hire associates to give themselves more days out of the office. If you are seeking mentorship, you may not want an associateship where you are the only provider in the practice when you are scheduled.
  • How many patients do you anticipate the associate to see each day?
  • How will patient assignments be made between the owner and associate?
    • This is important if you are paid on production or collections — you will want to know how new patients are delegated to ensure the potential production will provide you with fair compensation.
  • What is the daily production range (or average) you anticipate the associate to produce based on the practice’s patient volume?
    • Ask to see three sample days of the schedule — a slow day, a moderate day and a busy day over the past six months. The practice owner should deidentify any charts before sharing them with an associate candidate to ensure patient confidentiality and HIPAA compliance.
  • What percentage of the production is restorative versus hygiene?
    • Most practices operate at a 75% restorative-25% hygiene ratio for one doctor and one hygienist. If the restorative number is low, this may indicate that the practice is underdiagnosing or has low case acceptance.
  • If the schedule is slow or there are a lot of cancellations, will I be asked to not come in? If we are both working the same day and our schedule is slow, will I be asked to take the day off or will we each be responsible for our own patients?
  • What is the office policy on cancellations or no shows? Does the practice charge the patient for a last-minute cancellation?
  • What is the policy on late patients? After how many minutes of tardiness do you reschedule the patient or cancel the appointment?
  • How are accounts receivable managed? What percentage of the practice’s accounts receivable is:
    • 30 days or less?
    • 60 days or less?
    • 90 days or less?
    • 120 days or less?
    • Over 120 days?
    • This is important especially if your compensation is based on a percentage of collections. You will want to know how quickly you can expect payment to be received.
  • What is the practice’s overall collection to adjusted production percentage?
    • The industry benchmark is a 98% collection to adjusted production rate. This is important to monitor if being paid on a percentage of collections.
  • Can I review a copy of the practice’s fee schedule? How often are the practice fees analyzed? (Specific fee schedules should only be shared once a nondisclosure agreement is signed by both parties.)
    • Fees are typically reviewed on an annual basis. It is important that fees are evaluated and increased as necessary to remain competitive for the area.

Procedure Mix and Dental Benefit Plan Makeup

  • What is the insurance makeup of the practice? Percentage of PPOs, capitation, fee-for-service patients? If capitation, how does the practice post payments for capitation?
    • This is especially important if your compensation is based on collections. Billing to insurance takes longer to receive payment than direct billing to patients. If the associate compensation is based on collections, understand the timeline in which collections will be received, and thus, payment to the associate will be processed. If the practice participates in a high volume of insurance plans, you may want to consider asking to be paid based on adjusted production rather than collections.
    • It is important to understand the relationship the associate will have with the plans in which the practice owner is contracted. For more information: Considerations When Billing for an Associate
  • In case of nonpayment from the insurance or patient, who is responsible? Will there be a deduction in the associate’s pay?
  • Who will cover emergencies? Will I be on call on weekends? Will I be expected to come to the office for an emergency patient?

Staff

  • What is the current staff structure? What changes, if any, will be made to the structure once the associate joins the practice?
  • How is the team managed and how is performance evaluated and measured?
    • Performance evaluations should be completed on an annual basis, at the least. The process for evaluations should be documented, preferably as part of the practice’s employee manual.
  • What staff management responsibilities, if any, will the associate have?
    • Prior to beginning any associate position, it is important to know the managerial responsibilities that are expected, if any. If the associate will be working when the practice owner is not, ask who manages the staff. Is there an office manager or are you as the associate responsible for staff management in the place of the practice owner?

Hygiene Management

  • How are hygiene exams coordinated? Are they discussed and coordinated in a morning huddle each day?
  • How will hygiene exams be distributed? Will I be responsible for only checking my patients? Will I be responsible for checking your patients? Tell me how you conduct your hygiene exams and coordinate treatment plan recommendations with the hygienists.
  • How is the production for hygiene recalls tracked (if compensated on production)? What part of the hygiene appointment will be tracked as the doctor’s production (i.e., exam, radiographs)?
  • How many patients are seen in hygiene a day? A month?
  • What percentage of the restorative production is generated from hygiene recall? (In other words, not generated from new patients.)
    • A common percentage of restorative care that derives from hygiene recall patients (not new patients) is 40% to 45%. If this number is low, it may indicate that the practice is not reinforcing necessary treatment for patients who are seen for hygiene care.
  • What is the hygiene recall percentage? What is the percent of patients pre-appointed for their next recall?
    • Nearly 98% of patients should be pre-appointed for their next hygiene appointment. This number will reveal how successful the practice is at retaining patients.

Mentorship/Leadership

  • What is your treatment and practice management philosophy?
  • What is your vision for the future of the practice?
  • What is your motivation in bringing an associate into the practice? (Do you want to decrease your hours, increase the practice’s production or develop a transition plan?)
  • Are you open to mentoring me in areas that I would like to develop or be exposed to? What about in terms of utilizing supplies, materials and equipment that may be different from those I had in dental school (or the last practice I was in)?

Marketing

  • What is the marketing plan to introduce the associate to your patients and the community?
  • As far as the associate generating new patients, what are the marketing expectations for the associate? Which party is responsible financially for the associate’s marketing?
  • What type of marketing does the practice currently do? What percentage of patients come from each marketing source? What percentage of patients come from patient referrals (internal marketing)?
    • It is important to make sure that marketing is monitored and tracked by collecting referral data from patients and tracking referral sources.

Facility/Practice Location(s)

  • Are there multiple locations? If yes, where will the associate be practicing? In all locations or just one? Is there different staff in each location or do staff go between all locations?
  • Does the current location/facility have growth potential? Is the facility equipped for another provider?
  • What are the patient demographics? Is the community growing, leveling out or declining in population?

Associate Agreement/Buy-In/Partnership/Compensation

  • What is the compensation structure for the position? If on production/collections: What percentage? What production does that include (i.e., hygiene exams)? Will there be a daily base pay or an initial draw? Who is responsible for lab costs?
  • Will the associate be classified as an employee or independent contractor?
    • It is wise to seek legal advice to ensure you are properly classified. This classification will make a significant difference for the associate in terms of total compensation and employment taxes. Be sure to speak to a tax advisor before committing to either type of classification.
  • If classified as an employee, are there employer-paid benefits such as health care, retirement plans, continuing education, liability insurance coverage and association membership dues?
  • If classified as an independent contractor, would the associate need to cover overhead expenses such as a percentage of staff costs, supplies, equipment or rent?
    • If an independent contractor, how will the facility be shared? What parts of the facility will the associate be able to access? Are there any areas that would not be accessible or any times/days when the facility cannot be accessed?
  • At what point in the interview process will an associate agreement be available to review and consider?
    • It is highly recommended that a written agreement be prepared. This should be reviewed by an attorney and available for both parties to review and sign before the associateship begins.
  • What are the terms and length of time for the associate agreement?
  • What is your transition plan (if ownership potential exists)? How long do you envision the transition to take?
    • If a transition plan is decided, have a set date in writing when the transition is complete and the selling doctor will no longer work in the office.
  • If ownership is an option, what objectives need to be met in order for the buy-in to progress?
  • Is there a current practice valuation that I could review? (A nondisclosure agreement should be signed before this information is shared.)
    • If ownership is in the associate’s future, the practice valuation and all legal documents pertaining to the practice purchase should be prepared before the associate joins the practice.

Large Group Practice or Dental Service Organization Interviews

There are a number of advantages and differences in large group practices (LGPs) and dental service organizations (DSOs) of which the associate candidate should be aware.

Advantages

  • Strong employment and management protocols
  • Advanced marketing strategies
  • Fast-paced environment
  • Wide variety of patients and exposure to a variety of treatment plans
  • Known hours
  • More abundant employment opportunities
  • Learn from others’ experience

Potential Disadvantages

  • High volume of patients with lower fee schedule
  • Management may not match your treatment philosophy
  • Production pressure
  • Lack of autonomy

Differences Among LGPs

  • What are the advantages of working for an LGP as opposed to a solo practice?
  • What is the average number of new patients seen by a dentist each month
    • Many LGPs see a high volume of new patients due to the number of dental benefits plans in which the practice is contracted. This may or may not appeal to you — either way, it’s wise to know the numbers before accepting the position.
  • What is the average dental benefit plan fee for the most commonly performed procedures (i.e., crowns)?
    • Because LGPs tend to contract with a number of dental benefit plans, the average fees for certain procedures may be lower than the fees you might see in a solo practice.
  • What is the average hourly/daily net production (after dental insurance write-offs) for your associates?
  • What ownership potential exists? After how long?
  • What are the production expectations for associates? Does this increase year to year? Is there a base salary or initial compensation until I increase my speed?
  • What is the process of the practice’s new-patient appointment? How is treatment presented? Who discusses finances with the patient? When is the patient seen for hygiene?
    • Many LGPs have strong patient and financial systems in place and often have a large number of staff responsible for these procedures.
  • How is the practice managed? By whom?
  • How is the staff managed? By whom?
  • How are the associate doctors managed? Are there opportunities to be mentored by more senior doctors?
  • How is the practice marketed? Who is responsible for marketing and generating new patients?
  • What are the terms of the associate agreement? (Are there any restrictions or length of term requirements to be aware of?)

Working Interview

Working interviews may be beneficial in the decision-making process and are very common. They allow candidates to practice in the clinical setting and provide the opportunity to observe how the practice owner conducts the office. It’s also the best way for practice owners to observe your technique and see how you interact with patients and staff.

Before the working interview

  • Contact a professional liability carrier and request a binder for a working interview. Do not go to any interview without coverage. See the “Associate Insurance Needs” section of this toolkit for more information.
  • Clarify with the practice owner whether you’ll perform treatment on patients or spend the day observing.
  • You are to expect compensation and the amount is typically based on a per-hour rate. Clarify if payment will be given at the end of the business day or mailed to you within 48 hours (required in California). Delay in compensation by the employer is a violation of California labor law.
  • Ensure all mutually agreed upon arrangements are in writing and determined before the day of the working interview. Keep a copy for your own records.
  • Ask the practice owner or office manager about the attire. If treating patients, be sure to ask if personal protective equipment (PPE) will be provided. It’s better to ask these questions before the working interview than to come unprepared.

During the working interview

  • Request to review some of the patient records. Look for a pattern of practice issues and signs of supervised neglect in patient charts. This will help determine whether you will be comfortable joining the practice. Be aware that joining a practice whose services are below the standard of care places you at risk of professional malpractice, as you may be held liable for the negligence of others with whom you associate.
  • Ask for proof that the practice owner has professional liability insurance. If they practice without coverage, seriously consider passing up the position.
  • Ensure that you and the potential employer have similar approaches to treatment, philosophies and patient communication skills. Effective resolution of future patient and business issues may rely upon your like values.
  • Observe the practice owner’s case presentation techniques and how they interact and coordinate treatment plans with the hygienists in the practice.
  • Watch how the dental team interacts and communicates — does the day run smoothly and does communication flow easily between staff members? Does the doctor seem stressed and the staff frazzled?
  • Are staff acting within the scope of their licenses? Are infection control standards being followed? Does the team meet for a morning huddle to discuss the day’s schedule? Are there communication breakdowns between the front and back office? If yes, how are these errors managed and resolved?
  • Interact with the dental team. Make sure your interactions are professional, but respectful and kind. Do not become too much of a confidant to the staff. Remember, if you become an associate in the practice, you will serve in a leadership capacity, whether directly managing staff or not, and should demonstrate this role throughout the interview process. Ask staff questions about their roles in the practice. This will not only show you how the practice is managed, but also give you a sense of the team dynamics.

After the interview

  • Send the practice owner, or whoever conducted the interview, a thank you note. Always check for spelling and grammatical errors when sending written correspondence. Simply thank the interviewer for the opportunity and point out a few aspects you appreciated about the interview, the associateship opportunity and/or the practice.