Every week, smart, well-intentioned chiropractors tell me their associate train-wreck stories. Let's talk about four of the most common and costly mistakes you can make when it comes to an associate, and then see what it looks like done right.
Mistake #1: Failure to Follow a Win-Win Associate Recipe
Whether it's putting together IKEA furniture or grandma's meatloaf, there's a ton that can go wrong if you don't follow instructions or recipes.
With associates, there is a recipe for producing helpful, profitable and content members of the team. If you miss even one of the critical steps, you may have to scrap your assembly and start all over again.
Throughout the entire process of interviewing, hiring, bringing an associate into your clinic culture, up to profit and then full production – there are correct steps to take. Each one of those steps leads to another, is logical, keeps you in control and most importantly, works for both director and associate.
The wrong way is to hope for blind luck. Throwing the latest candidate against the wall, hoping they stick, seldom, if ever works; and can be so damaging to the practice it's not worth the risk. Get the best recipe(s) you can. A great associate is worth the search.
Done Right: Dr. Brian Morris of Ohio "did everything wrong" the first time and ended up with more trouble and losing money. This time, he followed a successful recipe, selected the right person (shared goals), and trained him in his technique and procedures.
Result: Dr. Morris was able to take two full, week-long summer vacations without a hitch. In fact, things are working so well, Dr. Morris has hired a second associate.
Mistake #2: Failure to Construct an Associate Business Plan
Most associateships end badly because the clinic owner does not think of the business implications of hiring an associate. As I mentioned, you may hire an associate just because you're busy, but I can't tell you the number of clinic owners I've talked to who are pulling their hair out because they failed to do an associate business plan and the "business" part of having an associate is not working.
The most common associate business failure is the associate costs more money than they produce. In addition, the associate is taking a portion of the clinic owner's new patients, and the clinic owner experiences a drop in gross and net income.
When doing an associate business plan, you should ask yourself the following questions:
- How many new patients does my associate need to generate to pay for themselves?
- How many patient visits a week does my associate need to see to pay for themselves?
- What additional services can the associate do for me to generate additional income to cover their salary and related expenses?
Done Right: Dr. Leah Meadows of Washington calculated that her associate could collect more than his base salary in his first month because of a unique marketing opportunity. She was right and because of a good business plan with sharp marketing, her associate never cost the clinic money he hadn't collected first.
Result: That associate ended up in bonus in just five months. Everyone wins!
Mistake #3: Failure to Solve the New-Patient Problem Beforehand
This is a big error and it's expensive. Let me explain: You build your practice over five to 20-plus years and you need an associate to help you care for all the people you've acquired over that time. The associate comes in and suddenly you notice your practice volume was primarily due to a high PVA and you don't generate enough new patients for two doctors. In just a few months, you notice that the practice is no longer busy and you have an extra salary to pay, plus everyone is getting tense and irritable.
I have been on the phone with very bright doctors who were scratching their heads and wondering where half their net income went. These doctors did not solve the new-patient problem beforehand.
Here's how to correct that error. Let's start with a few questions:
- Do you have new-patient marketing opportunities that you have to pass on because you're too busy?
- Can you think of two or three events or programs you could do each week if you had any extra time?
If you can say an honest "yes" to these questions, you have a chance of solving the new-patient problem beforehand. Why is this important? Because you want your associate to succeed, pull their own weight and learn to build their own practice, rather than share yours with them. By the way, more associates are harmed by clinic owners not training them (requiring they learn) to generate their own new patients than anything I know. The associate ends up "new-patient disabled."
Done Right: Dr. Jeff Schels of Texas trained his associate how to produce his own new patients "fresh out of the egg" to the extent that his associate has built a 200-plus-patient-visit-a-week practice and continues to produce his own new patients.
Result: Dr. Schels has developed (trained, coached and mentored) an associate who has earned a special long-term associate arrangement. Now his only worry is keeping just a little bit ahead of his associate.
Mistake #4: Failure to Have the Associate's Best Interest at Heart
Who are the people who bring out the best in you? I'm just guessing now, but no matter how long or short a list you come up with, I bet these people have your best interest at heart. It's so simple: We give our best efforts for the people we know want to see us succeed.
When developing associates, you need to have your associate's successful development at the top of your list. In short, they need to know you're just as interested in their success as you are your own. Some clinic directors take a look at associates as "exam and X-ray dogs" or "drones" who "just do what they are told to do." This does not inspire loyalty or "above and beyond" effort on your associate's part.
One of the ways to have the associate's best interest at heart and help your associate business plan at the same time is to take time out of your schedule to train your doctor. Share the knowledge you've accumulated over the years. Remember, so much of the information you take for granted today came at a price over years. When you spend time training your associate, they know you care. The right associate will take that to heart and give you their best efforts.
Done Right: Imagine that your son or daughter was just getting out of chiropractic college, but not practicing with you. What would you want their clinic director to do with them? Put them in a contract with a pay structure where they could make great money – if they earned it? Then train and teach them? Require your kid give the best they have? Hold them accountable? Praise and reward good work?
Result: I'm a dad and I know what your answers were. My older boy works for my best friend and is in a training program just like that. Both my son and I are thrilled.
Create a win-win associateship, become the coach, cheerleader and referee, and you won't make these four errors. Here's to your success.
Dr. Noel Lloyd graduated from Palmer College of Chiropractic in 1971 and became the youngest practicing chiropractor in Washington. He is the founder and head coach of Five Star Management, a professional training, coaching and consulting service based in Seattle, Wash.