Competitor or Associate? Part 2

Last month, I described how you should have a plan to expand your practice with associates, regardless of the current size of your practice because as a solo practitioner, you are limiting its size. I also noted that failure to develop associates for your brand of chiropractic will impact the following:

• Hamper and restrict your personal lifestyle choices
• Affect patient-centric care access and protocols
• Limit your exit strategy
• Increase you inability to develop affiliate sites
• Increase the number of competitive colleagues in your marketplace

Moving Forward With the New Person

Assuming that you have already followed the steps I described last month, you have recruited, screened and made an offer for your top candidate. Upon acceptance, you've submit your associate employment agreement for approval, along with the effective date of employment.

The Associate Agreement

You should have an employment agreement that has been approved by your legal counsel to ensure compliance with both federal and state laws, as they can differ. The basic agreement outlines the terms and conditions of employment, which form the legal basis for employment. Along with the employment agreement, you affix addendum, which includes the job description, compensation, incentive plan and trade-secrets agreement.

It is not recommended that you include a not-to-compete clause in the agreement, but instead, that you have an addendum agreement regarding trade secrets. In most jurisdictions, the courts will not enforce a restrictive covenant preventing someone from practicing their occupation. However, a trade-secrets agreement will provide enhanced protection for your practice in the event of unfair competitive practices by your associate.

The Training Period

You should have a structured and formal training protocol for your office that begins on the associate's first day and continues for six months. During the initial six months, the associate is an intern and does not have permanent employee status.

During this period, you are evaluating performance daily; if you are unable to correct any deficiency after three corrective counseling sessions, you must terminate. Do not invest months and months unless you have a high degree of confidence that you've made the right decision for you, your team and your patients. The only acceptable performance during the internship is 100 percent. The time to hold any new employee accountable to your standards of excellence is in the beginning. Of all the elements for having a successful experience with an associate, training is the most vital.

In many cases, too many corners are cut to speed up the process and let the associate function as a qualified doctor. Yes, you are eager to reap the rewards of having an associate, but this is one area in which you need to dial back your enthusiasm and make the investment needed to have a competent and qualified caregiver before you look the other way. It can take weeks to ensure they meet your standards of excellence and have passed the training modules you've provided. Do not rush to turn the associate into an overnight success; the process should take three to six months.

Your New Associate

Once an associate has completed their internship, they have earned full-time, permanent employment status and now are part of the health care team. They are entitled to all of their promised compensation, incentives and benefits that were reduced or not available during their internship. Treat them with respect, of course, and as a "partner," but avoid becoming friends. Keep the relationship cordial, professional and business-like. Your practice is not a social club.

A Word of Caution

In closing, there are two type of associates: technician and entrepreneurial. You must have clarity on which one you desire for your vision. Hiring the wrong type for a position will only end up in failure and frustration. A technician associate focuses is patient care. They want to treat; they do not want to be a rain-maker, worry about practice operations or the myriad of tasks needed to manage a practice. The majority of candidates will be technicians.

On the other hand, the entrepreneurial associate is a sponge. They want to learn everything there is about the practice. They will work extra to learn how to bill, how to lead, how to get new patients, how to keep patients; in fact, they enjoy the operation of the practice more than they do the actual patient care component of practice. They are rain-makers, but if you don't have a career growth path for them, they will resign and open their own practice once they figure out how you do it.

Lawton W. Howell is the founder and chief executive officer of WellnessOne Corporation, a chiropractic alliance marketing group based in Las Vegas. Direct questions and comments regarding this article to 877 WELNES1 (toll free), send an e-mail to , or visit www.growmypractice.wellnessone.net.