Increasing business pressures mean it is ever more likely that the dental principal/associate relationship is placed under strain, so dental practices need to avoid sleepwalking into a scenario where clinicians tolerate poor interpersonal relationships as it forms a mistaken mandate for team members to follow suit.
The damaging ramifications of this are well understood by both principals and associates: a toxic working environment with a standoff between staff and management.
This creates a workplace where no one performs at their best.
What's in it for you?
As an associate, if you disengage with your practice, you may unwittingly decimate your own career advancement.
Without doubt, there is much principals can do, but the question for you as an associate, is whether to 'associate' or 'dissociate', with the challenges ahead.
The answer lies in the fundamental nature of associate employment; you are self-employed, meaning you are incentivised with a percentage split in return for creating value for the practice, with resources available to both parties.
You are not salaried, meaning you are not compensated with a regular income for concentrating specifically on clinical skills, with professional support provided only by the practice.
This concept is so simple that many associates and principals have difficulty in understanding how powerful it is.
This vital role distinction is typically lost in a cloud of contracts, clauses, rates, percentages and hours.
However, the most successful dental associates have identified the need to 'associate' by an empirically-observed intuitive insight: "My principal is permanently overwhelmed by business pressures, therefore, to create the dental work environment I need to succeed, I must develop non-clinical skills."
Take the test: how engaged are you? And how successful…?
I have clarified the term 'non-dental skills' by the defining the top ten dimensions in a table you may test yourself against (click on the image to access the spreadsheet)
It is my contention that by scoring above 50 on this framework you will certainly experience a more fulfilling and rewarding associate role.
I hope this helps level the playing field, so all associates can enjoy self-employed success in the modern dental workplace.
Here are two of my top tips for making it work:
It's your career. Build work skills for which you will be rewarded for in the future, and don't become distracted by whether your current principal deserves your effort. In a real-life example, an associate was asked to provide induction training for a new nurse by an overworked and absent principal. His first instinct was to lead an associate revolt against this contractual unfairness. Instead of dissociating, he decided to engage with this new learning opportunity. He is now so proficient at nurse training that he can count on first-class support whenever he turns up for work giving him greater confidence to complete the clinical work he most enjoys. Ironically, lack of nurse support was previously his biggest grievance.
Be proud. To arrive as a GDP, you will have demonstrated many abilities, e.g. resilience and resourcefulness, thus putting associates in the top five per cent of UK earners and the top one per cent globally. Repurpose your ambition for your current challenges. I have seen a situation where a super-skilled specialist was frustrated by gaps in her day. Instead of dissociating, by placing demands on the principal, she decided to learn how to increase her own referrals. This consumed much her own time and expense but, within 18 months, her new non-clinical referral skill was so successful she could start her own specialist referral clinic.
With dental business pressures set to increase, the scene is set for a new breed of associate to succeed: associates that avoid career gridlock by creating value; associates that side-step conflict in favour of engaging opportunity; associates that update obsolete operating systems for a fast-evolving dental industry.
You need to choose wisely when faced with the inevitable question: do I associate or dissociate?
Former dentist, now full-time dental business strategist
Adapted from an article by Syed A. To associate or dissociate. BDJ In Practice 2018; 9: 18-19.
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