Should I consider an Associateship?

The current positive trend toward group dental practices will likely continue. Reasons for this include decreased practice overhead, improved office coverage with expanded treatment times, greater personal freedom for doctors, higher percentage of graduating female dentists who, according to some studies, are less likely to own a practice than their male counterparts, and the massive debt of graduating dental students. In 2016, the average debt for graduating dental school seniors was $262,119.1,2 This does not account for additional debt likely incurred while attending an endodontic residency program.

These same trends also are increasing the number of corporate dental practices. With tightening lending policies, many graduating dentists are reluctant to go further into debt to start or buy an existing practice. I favor the private group practice model for endodontists, yet believe there is room for both corporate and private group practices. Demand will continue to drive practice models that offer the consumer expanded treatment times and greater ease of business.


Associates benefit the practice with reduced overhead costs such as the building lease, equipment, utilities and even staff salaries. Greater personal freedom and peace of mind are another major benefit. The practice can continue to operate despite vacations, continuing education absences, family emergencies, or illness.

Owner considerations

  • Is the practice busy enough to support two endodontists?
  • Will the associate be willing to work part-time while the practice grows?
  • Am I willing to make less short-term money for spare time and greater autonomy long-term? Does the new associate share the practice vision?
  • Is the associate clinically competent, and how will he/she be received by referring dentists?
  • Would the associate make a good potential partner or future practice buyer?

Associate considerations

  • Do I share the owner’s values and practice philosophy?
  • Will my salary meet my financial obligations?
  • Is the non-compete clause reasonable?
  • Will I (and my spouse) assimilate well to this location?

Final recommendations

For most practices, associates should be paid a percentage of collections, and the associate should check that the practice ideally has 98% or higher collection rate. A reasonable amount for the endodontic associates earnings is currently between 35%-45% collections. For most practices, this will fairly reward the associate and ensure the practice isn’t losing money by having them onboard. We also recommend working together at least 6-12 months prior to any buy-in or purchase. It’s like dating before marriage and you need to ensure you are both a good match. If done right, Associateships can be both personally and professionally rewarding.

Garth W. Hatch, DDS, is President and Founder of Dental Specialist Institute, a dental consulting firm committed to helping specialists receive more referrals, profits, and freedom. As an actively practicing endodontist, Dr. Hatch is aware of the challenges specialists face in today’s dental and economic environment. He is a native of Riverside, California, and earned a BS in Exercise Physiology from Brigham Young University and his DDS from Indiana University School of Dentistry. Following graduation from dental school, Dr. Hatch entered the U.S. Army Dental Corps and completed a 1-year AEGD residency at Fort Jackson, South Carolina, and later completed an endodontic residency program at Fort Gordon, Georgia. After serving in Germany, he left the military and purchased an endodontic practice in Kennewick, Washington, where he still practices.

  1. Annual American Dental Education Association Survey of Dental School Seniors, 2016 Graduating Class:  Table 17. Level of senior’s educational debt* by type of school, 2016.
  2. Annual American Dental Education Association Survey of Dental School Seniors, 2016 Graduating Class:  Table 18. Average graduating educational debt* of 1996-2016 graduates with debt, by type of school.

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