How do I find a practice to join and when should I start looking?

Many residents and miltary surgeons have called wanting to know the best way to go about trying to find a practice to join and when should they start looking. You should start evaluating desired cities you want to live in your 1st year in residency, start setting up interviews and have everything narrowed down to 1-3 practices in your 2nd year of residency, finish up negotiations of your contract your 3rd year of residency, this way your 4th year you have an employment contract and can show this to a bank which will allow you to buy a house and have a smooth transition to your future city. If you wait until your 4th year to start looking for a practice to join, you have significantly decreased your chances of finding an equally minded, good practice to join. You will feel rushed, the practices you are approaching will know you have only a year to decide who you’re joining, and therefore, in many cases, provide you a contract that is less than desirable. This essentially makes you decide on a practice by picking “The Best of Worst” rather than “The Best of the Best” associateships available.

Although there are many ways to consider, below is our 10 Step recommendation on how to find, evaluate, and ultimately choose a practice to join:

Step 1:
Get with your spouse/significant other and come up with a list of 5-10 cities you both would most like to live in and if applicable, raise a family. You should rank the cities, at this point, purely based on personal wants and desires.

Step 2:
Determine what your professional aspirations are: Do you prefer a large group? Do you prefer solo practice? Do you prefer a small 1-2 man group? Research the Oral Surgeons in each of those communities you have listed based on your professional wants and desires. Start with the practices who have the oldest oral surgeons because these guys will be the most interested in selling or bringing on a partner, not to mention the most willing/open to discuss the local landscape as it relates to the dental profession.

Step 3:
Setup a time to visit with these folks one on one. If a practice says “sure stop on by anytime, were in the office everyday” then I would immediately cross it off your list. If a practice is serious then something positive should be said like, "Let me know when you are coming, so I can set aside some time at lunch or during the day, I would like to meet you". You are not looking for a friend, you are looking for a place to practice Oral Surgery, a business to support yourself and a family. If they are lackadaisical in meeting you, I can assure you the contract negotiations will go along the same route. If the effort/interest of the practice is not equally matching yours at anytime throughout the process, then you should move on.

Step 4:
Setup a “Roadtrip” (not the college kind). By getting in your car and driving, you allow yourself more time to drive the state, the city, and get a better feel for the area. You also allow yourself to hit more cities and towns without incurring excessive costs. It allows you time to sit and digest the information you just received versus gathering up everything and flying back home where your colleagues have already started piling up work on your behalf. Try and visit as many cities as possible on this roadtrip.

Step 5:
Make sure you have a fresh suit to where or at minimum professional attire. Have some paper and pens for notes, come prepared with questions, and have copies of your CV with a cover letter stating your intentions and goals. This will all make for a very productive meeting. The last thing you want to do is leave with a bad 1st impression, be unprepared, and come back saying, I didn’t really learn much. Each interview you will get better at so you should theoretically start your roadtrip with the least desired city first and keep your most desired city last.

Step 6:
What to look for? Just because a practice says they want a partner doesn’t mean they are ready for a partner. If you visit the office and all they have is 2 OR’s, 1 exam room, and a consult room where on earth are they going to fit in your patients? This is why you should start your practice research early, in that maybe they know where to put a lucrative satellite office that would then more than accommodate your patients and services. They can’t do this if you wait until your chief year in December to start looking for a practice to join. Evaluate his equipment, staff, infrastructure, business philosophies. What are the neighborhoods like, the schools, the shopping, are the major employers of the area stable? If you like the practice, you should setup a hard date and time (get their cell and home #’s) to reconnect so that you are not just playing phone tag through the practice office staff.

Step 7:
Take good notes, take a Dictaphone, and talk into it after meeting with someone while in your car driving to the next appointment. This will allow you to report your findings/information accurately to your spouse/significant other and will no doubt remind you about the questions you didn’t ask but would like to get answered when you speak to that office again.

Step 8:
Once you get back, it is important that you send hand written notes to the practices you are most interested in (send certified mail or Fedex to make sure the doctor gets it) and at least an email to the offices that didn’t make the cut. Remember you are establishing a professional reputation when you start these evaluations, the OMS community is small and people talk! Also, follow up with your spouse/significant other, make a list of all the pro’s and con’s, and then rank your practices. In a perfect world you have at least 3-4 legitimate practices you are very interested in, all of which are in locations you are WANTING to live in.

Step 9:
Then reconnect with the practice and start figuring out who liked you equally as well, and wants to move forward in bringing you on board to the practice. Schedule a formal trip with your spouse this time to meet and tour the city. You should have the practice recommend a real estate agent who can show you a few houses in the most desired school districts and call the local chamber of commerce to request a relocation package that gives you detailed information on the town/city. Try and plan at least 1 social event with the spouses/significant others/families not necessarily to be best friends, but to get a better feel of who your potential partner is outside the office. Remember, you will be spending more time with your partners than you will your own spouse and kids, so it is important to make sure you know as much about the person/people you are joining as possible! Finally, make sure you schedule some time to talk business and general terms.

Step 10:
This last step can be done a 100 different ways, but here is just 1 way. Now that you have decided on 1-4 practices you should start negotiating general terms of a contract and determine which of the practices will offer you the best opportunity. We strongly encourage you to remain open and honest with the practices by telling them you are communicating with other practices, and if the practices are in the same city this becomes even more imperative in that you want to do everything possible to establish a good reputation of professionalism within the Dental/OMS community. After you have general terms from the practices you are considering, evaluate which is the best opportunity for you and your family.

If you find a practice you plan on “buying into” or “purchase outright” immediately or in the future, you should have the practice evaluated by a 3rd party, we offer these services at The Practice Advisory Group, to help determine practice worth, associate terms, and future structure of partnership/acquisition.

If you have any questions, comments, or ideas you would like to discuss please feel free to contact us at anytime via email barry.williams@practiceadvisorygroup.com or via phone 713.624.4203. If you would like more information about the Practice Advisory Group please visit our website at www.practiceadvisorygroup.com.