An Associateship that Works

The Tandem Associateship, Two Doctors Successfully Treating The Same Patients.

In the previous article of this, “How To Start A Practice” series, I discussed the “Associateships from Hell.” Unfortunately, most starting doctors get trapped in bad associate arrangements like these. However, this article describes an associateship structure that’s very successful, an associateship in which both the established doctor and the associate doctor benefit. It’s called a “tandem associateship,” an arrangement where two doctors treat the same patients.

In a “tandem associateship,” the established doctor’s practice is so full that he finds himself skipping procedures, turning away new patients, prematurely stretching out the care of existing patients, etc., because he quite simply has more patients than any one doctor can handle. To alleviate this problem, he hires an extra set of hands (an associate), to take care of all the patients he can’t get to. By doing so, the established doctor can grow his practice larger. This type of associateship works well for both doctors.

“Tandem Associateship” Criteria

In this type of relationship, the established doctor, being very successful, is willing to teach the associate doctor everything he knows. The associate doctor, in a “tandem” relationship, must be an extremely willing student and learn everything the established doctor has to teach. The associate doctor must swallow his ego in order to welcome and accept constructive criticism. How else is he going to learn? The associate doctor must totally agree with this concept; otherwise, the tandem associateship will not work.

The “tandem associateship” is a teacher-student relationship. All good teachers want their students to learn everything they have to teach. All good students want to learn everything the teacher has to teach. When this symbiosis occurs, the associate relationship will become successful.

The associate doctor must understand that he’ll have to work hard, go the extra mile and work more hours than the established doctor; however, the associate will still be working fewer hours than if he owned his own practice.

Financial Arrangements for a Tandem Associate Practice

In a “tandem” associateship, the associate usually receives a guaranteed weekly or monthly compensation amount, which is a draw against commission. The commission is usually a percentage of the services or collections the associate doctor renders.

The associate doctor should expect to make 25% of collections on his services. An associate who feels he should make 50% or more is totally unrealistic. The average chiropractic practice has a 50% to 60% overhead, which leaves an average net profit of 40%. The established doctor must earn compensation for the time he dedicates to training his associate and for the patients he turns over to his associate. The established doctor can only share the net of his practice, and it’s fair that he make 15% for his efforts, while the associate makes 25%.

Non-competition Agreements

There is always a genuine and legitimate concern on the part of the established doctor that, after he provides an associate with valuable training, experience and patients, the associate will leave him and open a practice next door. If this happens, it will rob the established doctor of patients and income, while at the same time his overhead will not decrease, thereby forcing the established doctor into an unfavorable financial situation. To keep this from happening, the established doctor will require a non-competition agreement from his associate.

Believe it or not…non-competition agreements are in the best interest of both the established and the associate doctor. This type of agreement will help eliminate any hesitation the established doctor may have in turning over a large volume of his patients to the associate doctor. After all, the entire purpose of the “tandem” associate arrangement is for the established doctor to increase and improve his practice by using his associate’s skills while, at the same time, seeing that the associate has plenty of patients, learns correct and successful practice habits, including how to run a large practice, and earn a respectable living in the process. The only way all of this can happen is if the associate doctor signs a non-competition agreement.

When you’re through being an associate and are ready to start your own practice, hire a consultant who specializes in starting practices to guide you. Don’t think that you now have the experience necessary to start and build a new practice…you don’t! Yes, you’ve gained the experience of caring for patients and learned some good office procedures, but that’s not enough knowledge to start a successful new practice. You still have to learn how to find a great office location, learn effective bank negotiating strategies, cost-cutting remodeling negotiations, how to market a new practice, etc. It’s the lack of this specialized knowledge that dooms new practices, not the lack of knowledge regarding patient care.

Dr. Peter G. Fernandez is the world’s authority on starting a practice. He has 30 years’ experience in starting new practices, has written four books and numerous articles on the subject, and has consulted in the opening of over 3,000 new practices. Please contact Dr. Fernandez at 10733 57th Avenue North, Seminole, Florida, 33772; 1-800-882-4476; [email protected] or visit

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