It’s no surprise: We know our associates are going to leave

I know an associate won't stick around for very long. I know because it happened to me several times for various reasons. It is not unusual for associates to leave the first position they take.

I had seven associates over 40 years and experienced most every circumstance I can think of, with associates coming, staying for a year or two, and then moving on. I lost some to better opportunities, and I fired some for working against the culture of our office. I had some who just couldn’t make the jump to buying in, and I even had some with medical issues who could not perform the tasks needed to practice.

New graduates have incredible debt and often don’t stop to realize the investment a senior doctor has to make and the financial risk the senior doctor takes to create a position. This can result in the new doctor only looking at the amount of money they can make, right now, in an associateship, and not looking at the chance to have an excellent long-term job.

More than once, I was not to the point of breaking even on the new doctor before he jumped ship. I had enlarged our reception area to go from one to two doctors. I have remodeled the office to upgrade. I obviously have bought more equipment, outfitted new operatories, bought extra instruments and hand pieces the list goes on and on.

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That does not take into consideration the additional staff, the training of the staff, the diverting of new patients to the new doctor and the learning curve of speed and skill. Usually I had to subsidize the doctor’s salary the first few months to give them a living wage. Luckily they usually stayed long enough to get above the subsidy.

The strange thing is that I continued to repeat this behavior for most of my career. Isn’t that the definition of insanity, repeating the same behavior and thinking I would get a different result? Or maybe it is just optimism.

In retrospect, I don’t really blame the associates, except for the ones I fired. Most of them come in with good intentions, but are so scared of the debt; they may see something in the match at first that really doesn’t work for them over time.

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They bear down, try to learn, try to get faster, but they have their eye on another opportunity that is a better fit for them. Once their initial fear is overcome, they can focus on what their real priorities are, where they want to live, how their social life is to be lived and how their family feels about what they are doing. It takes a while for those priorities to become clear.

I somehow survived all the associate wars, the training, the parade of new faces in and out of my office, the financial setbacks and the disappointment of failed relationships.

The irony of the story is, I never got an associate to stay more than three years, but two young entrepreneurs came along, bought my practice, and I became the ideal, compliant, productive associate I had been looking for all those years.  

Then I, like all my associates, got my eye on a better deal. After four years as an associate, I moved on to the next opportunity: Retirement!