What to Look for When Hiring an Associate

How do you know when to hire an associate in your practice? When is it worth it to hire someone? Luke Hunter, DPM, addressed these concerns at the American Academy of Podiatric Practice Management Conference.

Q: What are a few top signs that a practice is ready to hire an associate?

Dr. Hunter cites many different reasons why a practice needs an associate. He suggests considering the following:
·      Is your practice booking out over 3 weeks?
·      Are the providers considering themselves overworked?
·      Is a provider looking at replacing a soon-to-be retiring practitioner?

All of these are valid reasons to hire a new associate, but Dr. Hunter says they each require a different approach if your hiring is to be a success.

Q: What are a few of the most common mistakes you feel practices make when deciding to hire an associate?

One of the biggest mistakes Dr. Hunter sees is expanding for “potential” new business that may not materialize. For example, a DPM who doesn’t do surgery may want an associate to expand into surgery, or may want an associate to fill a need in nursing homes. He says some DPMs may believe that since they work part-time, there may be plenty of room for growth and they will hire an associate to fill that void. While these may look like solid business plans, Dr. Hunter has seen a new associate typically take on a disproportionate amount of the risk of starting a new practice and rarely lasting more than a year or two.

“I've seen it happen many times—a practice hires a new practitioner and agrees to pay them a percentage of collections, yet the potential for earnings is drastically over-estimated,” says Dr. Hunter. “This type of hiring is more based off greed than need, as in the practice is trying to make more money rather than fill an established need in the community.” 

Dr. Hunter also sees aging practitioners looking to bring on an associate, but with no clear-cut pathway to transitioning. He has at least a half dozen colleagues who were brought on at less than favorable salaries with promises of ownership, only to have the old practitioner decide not to retire.

Another common scenario, Dr. Hunter notes, is when it’s time to settle on a purchase price, the retiring practitioner overvalues the practice to the point it's not worth purchasing.

“Either of these scenarios almost always ends in bad blood and the associate eventually leaves,” cautions Dr. Hunter.

Q: What are a few key traits or features of a prospective associate that a practice should look for?

Communication skills are a must, says Dr. Hunter. As he notes, if an individual is good at returning phone calls, emails, and texts and uses professional language in all forms of messaging, this shows good signs that they are a qualified applicant.

“I remember the last time I advertised for an associate, I had one applicant message me on Facebook, ‘Hey I sent you my resume,’ and in their email there was only an attachment, no greeting or text,” says Dr. Hunter. “Needless to say, that level of casualness in the beginning stages of interviewing was a huge red flag.”

Dr. Hunter adds that another sign of a good prospective associate is in their resume—what podiatric extracurricular activities or organizations do they participate in? He cautions that an individual who goes beyond the bare minimum expected of them is showing signs that they will view their position as a career, not a job.

“Even though I personally believe we weren't meant to live to work, to be successful in health care these days, especially in private practice, requires a mentality to do what is necessary,” says Dr. Hunter. “Often that requires more commitment than a normal 8–5 schedule.” A screening question Dr. Hunter likes to ask potential associates is, “What do you think is a fair salary?” He asked one third-year resident this question, and they immediately launched into a rant about the “old eating the young” and not being fair with compensation.

“Seeing as I was only 6 years out, I did somewhat sympathize as I've heard the horror stories but I definitely didn't consider myself ‘old.’ After the interview, I realized that this type of individual would likely never be happy in an employed setting, and wished them the best of luck,” says Dr. Hunter. “I recommended he become his own boss, so he'd really understand what is fair or not fair.”