Dr. Steven W. Seibert answers questions about his experiences joining a practice as an associate...

2005 Annual Meeting Student Event
STARTING AS AN ASSOCIATE

Below is an interview with Dr. Steven W. Seibert, D.M.D., who practices in Champaign, Illinois, and completed his periodontal residency at University of Nebraska in 1984.
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What is the most rewarding part of what you do everyday?

I enjoy taking care of my family, staff and patients. I love the interaction with the people and hope that I get to do this for many more years.

What was your ideal plan after graduation?

When I graduated my plan was to return to my hometown area and start a practice. I sent out surveys and found some interest, but another periodontist was taking on an associate at the same time. The population base seemed too small for three people so this gave me some concerns. The interest rate was 19.5% and the risk seemed too high. So I began to look for associate opportunities. I found a gentleman who was interested in an associate in Champaign, IL. After considering my options, I joined him as an associate with buy-in arrangements already established.

What appealed to you about starting as an associate?

Starting as an associate meant I could avoid significantly increasing my debt load at that time. I could share space, have some guarantee on my income and maybe pick up some practice management skills from an established person. In theory, there should be a referral base to start with to help one be busy from the start. In this case there was some base, but I had to go out and build more referral sources which were a good thing later on in the relationship.

How did you go about searching for an associate’s position?

I didn’t, I heard about the opportunity I chose from another resident in my program. If I were going to search, I would write letters to the practicing Periodontists in the areas I was interested in and see what kind of response I got. If I really wanted to live somewhere and I didn’t get a response, I would consider starting on my own practice renting from someone for 6 months to a year and assess how the practice was working. This way the overhead would be lower and changing locations would be easier.

Was location an issue for you?

Yes, I wanted to stay close to the St. Louis area where my family lives. The opportunities available at that time were not in that area.

Did you have a niche to assist in marketing yourself (i.e., cosmetic surgery, dental implants, etc.)?

Implants were just beginning to be done back in 1984. I had just started to do them and that helped me to establish myself. I was very conservative with case selection and spent a great deal of time working with the GP dentists to insure the success of the case.

What were you looking for in a practice?

I wanted a partnership that we both could be on equal footing. I did not want to be the “underling” nor did I want to go in with a dinosaur. I think for the relationship to work both parties have to feel that they can work on a similar level. I have seen several associateships be terminated because the two people can’t come to some agreement on the relationship’s interaction level. If one person feels that the other is not putting in the same level of effort or can be equivalently involved in the practice, the relationship will fail.

What realities did you encounter?

In the beginning everything was great! We worked hard to build a larger referral base. Study clubs, lunches, etc. After awhile the referring doctors started to want one doctor over the other, which caused some difficulties with my senior partner. We tried to work out a system, but the best plans don’t always come to fruition. Ultimately a number of issues led to us separating and having separate practices. After 5 years, we separated our practices and ultimately he left our town and moved to another community.

How did you obtain new patients?

I worked to build solid professional relationships with my referring Doctors. I checked with the referring Doctors after each case to see if there was anything else they would like for me to do for them or to communicate with them. After awhile your reputation is established and your referral relationship is solidified.

What is your situation now?

I am in a solo practice with a satellite office. I am looking for an associate to join me. It has been difficult to draw someone to a city the size of Champaign, Il. and the satellite. I hope to find someone to join me soon. I would like to practice for 15 – 20 years if my health allows, but at a slower pace in about 7 – 10 years.

What factors affected your plans and decisions about your career and future?

The economy and debt that I possessed at the time I finished my training. I think that is an issue when anyone completes their training. I wanted to have some security and yet room for growth professionally and personally. The associateship appeared to be a way to do that. No one can see all the evolutions that come in a relationship, but they have to keep their eyes open. As my partnership evolved my partner had different plans as he went through his life. These changes resulted in the relationship having to be terminated in order for both of us to provide for family and keep our plans working. No one plans that they will want a divorce and want a new life. It evolves!

What risks were involved?

When my partner reached a certain point in his life he felt he needed a change in his life. I did not see it coming! In the end I had to assume more debt to keep my goals and plans working. It has made me work harder than I had planned. The struggle has taught me a great deal about life, relationships, and planning for my family dreams.

How did you assess and manage those risks?

I always figured how much I could produce, how much I would need to work and how much extra effort the plan would take.

What resources (i.e., people, publications, web sites, groups) did you find the most helpful?

I work with my predecessors and friends. There were no Web sites back then.

What suggestions do you have for individuals transitioning as an associate into practice?

Always pick where you want to live as the primary target. If you can be in a partner relationship I think it is better. Sharing expenses, space and ideas about therapy makes it more rewarding. and less stressful. When you get ready to buy-in make sure to get all ideas on paper and seek good legal counsel. Be sure to look at it from both the best case and worse case scenarios. All things need to be considered because when relationships go bad it’s too late to “Be Fair” about it.

Did you and your partner work with an attorney to develop a solid employment contract?

Yes we did, trying to think about the contingents before we signed on the dotted line. The separation was still ugly because my partner had some loop holes in the process which was not spelled out clear enough in the original document. It is very hard to think about everything when you are setting up the relationship. It’s like courting, you’re not thinking about the divorce before you get married.

What did you learn from this process?

All relationships are an evolution. When one member decides to take advantage of the other, if you don’t think ahead and/or don’t see it coming, the trauma is intense. Only the strong one survives the pain and gets on with the plan of their life.

Please explain your financial compensation arrangement, using real or fictitious figures.

We had a phased in buy-in to allow me time to pay him and not take out more loans. Over a five year period, I bought in with the percentage of hygiene income increasing over that time at 10% increase in percent per year along with a monthly payment. Expenses were paid on a pro-rate of total percent of practice production.

What was your biggest mistake as a new practitioner?

Trusting that my partner would always be honest and never try to take more than his share.

How many employees were in the office at which you were an associate?

10. Two front desk people, an office manager, three chair side assistants and four hygienists.

What is the most important thing you have learned?

In a relationship you must put all the cards on the table as to what you want and keep your eyes open for the changes that some people go through as their lives are evolving.

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