The Associateships from Hell

Five Types of Associateships To Avoid…and Why.

Becoming an associate doctor is not a demeaning career move. Trying to open a new practice when you or your finances are not ready…is. Being an associate should be an honorable, rewarding and learning experience. You will hit net profit your first week in practice (your paycheck), you will work fewer hours, and you will have less responsibility and stress than if you had your own practice. For example, an associate’s main functions are to diagnose, adjust and occasionally do some paperwork. These tasks are the easiest part of any doctor’s workday. Being an associate is easier and it’s profitable.

I’m sure you have heard stories about “Associateships From Hell,” associates who were taken advantage of, paid “slave wages,” etc. While these types of associateships occur, they can be avoided. This article will explain what you should look for in an associateship, what you should accept and what you should reject. I was an associate for three years and had a great boss and mentor. I owe the majority of my success to him. Just as I was able to find an “Associateship from Heaven,” the next article in this series will show you how to find yours.

Should You Become an Associate?

An associateship is appropriate:

• If you are insecure and unsure of your skills in finding and reducing subluxations.

• If you’ve declared bankruptcy, have a terrible credit rating and no alternate way of getting the money needed to start a practice. Continue in an associate position until you have corrected your credit problems and saved enough money to start your practice.

• If you’re looking for specialized knowledge; i.e., if you want to learn the flexion distraction technique and have the opportunity to practice with Dr. James Cox, the originator of the technique, you’d be wise to do so. You’ll learn ten times more about the technique by working for him than you ever would by attending seminars.

If your motive to become an associate is not supported by any of these three criteria, you are better advised to hire an experienced consultant to teach you how to successfully start and run your own practice.

There Are Five Types of Associateships

The word “associate” is defined many different ways by chiropractic professionals. It can mean employment, sharing another doctor’s overhead, or starting your own practice in someone else’s facility. The following scenarios are brief descriptions of some of the various types of “associateships.”


Salaried Employee

This type of associateship occurs when an established doctor pays a junior doctor $1,500-$2,000 a month to do as he is told. The junior doctor is not given any opportunity or incentive to increase his salary. The junior doctor is, basically, a “gofer” or a flunky. Of course, this type of relationship fails quickly. If you are offered an associateship like this, pass on it.


Sometimes, an established doctor practices Monday, Wednesday and Friday and wants a junior doctor to practice Tuesday, Thursday and Saturday. Or, the established doctor practices in the mornings and wants a junior doctor to practice in the afternoons. Most time-sharing relationships blow up, due to the following reasons:

• The doctors are in competition with each other. When you are in competition with your partner (this is a pseudo-partnership), the partnership won’t last.

• Time restraints restrict practice growth. When the junior doctor’s practice fills up, he will attempt to encroach on his pseudo-partner’s time; or, if the established doctor’s practice grows and he needs the extra practice time, he’ll encroach on the junior doctor’s time. Either way, the junior doctor will be thrown out.

• There’s no managerial strength in a time-sharing practice. Managerial strength is what builds large practices. In a time-sharing scenario, you’ve got two doctors with a 50-50 vote, no tie-breakers. It can’t work.


In this practice, two doctors practice together, place all their money in one pool and share income and overhead 50-50. Unfortunately, there are no two doctors with the very same goals and levels of ambition regarding overhead, hours to be worked, marketing, number of patients to be seen, etc. Inevitably, one doctor will be more ambitious and work harder than the other doctor, but the income will still be split 50-50. The partner that does most of the work will eventually call an end to this cash-splitting relationship.


This arrangement occurs when an established doctor brings in a second DC to help him pay his overhead expenses. Think about it. If the established doctor’s location and practice is not good enough to support one DC, how is it going to support two?

This type of practice is also doomed by the competition it creates between the two doctors. Competition between two partners destroys a practice…and a friendship. In addition, there’s no managerial strength in an expense sharing relationship. And, without managerial strength, a practice flounders and soon dies.

There is an exception to this rule: This type of relationship can work when family members practice together. However, even a family practice will fail, if the senior doctor is so set in his ways that he refuses to consider any changes suggested by the junior doctors; i.e., modernizing equipment or instituting new and improved office procedures. The senior doctor who does not acknowledge and respect his children’s learned and professional abilities soon kills the family-run practice.

Renting Space

Beware of this type of arrangement. When an established doctor rents space to another doctor, it’s usually because he has a very small practice that leaves him with unused space that he rents out to help him cover his expenses.

If the practice location is not good enough to fill up one doctor’s practice, why would you think it would fill up two? It won’t.

This arrangement is similar to the “time-sharing” associateships described in a previous article, except that both doctors can schedule patients seven days a week. This type of relationship usually fails because the office’s location can only support one DC, there is competition between the two doctors, and there is no managerial strength.

If you decide to rent space in an established DC’s office, make sure that you do not sign a non-competition agreement. Eventually these relationships break up and you want to be able to move your practice with no restraints. Also, immediately start saving money. When this pseudo-partnership breaks up (as it most certainly will), you’ll need money to build-out an office space, etc.

(This is similar to the “Independent Contractor” style of practice, which I will discuss in a future article.)

Caution: All of the previously described methods of practice, while being called associateships, are not true associateships. Starting a practice in someone else’s office is a pseudo-partnership, and pseudo-partnerships do not work. If you choose to enter into practice utilizing a relationship of this type, immediately start saving your money. You will either be evicted or will walk out and need money to remodel another facility.

If you choose any of these unfavorable types of practice relationships, you need to make sure you are not restricted by a non-competition agreement. If you are evicted (chances are you will be), you’ll need to quickly relocate nearby. If you have to relocate outside of a non-competition radius, your patients will transfer to the established doctor. In addition, in choosing one of these relationships, it is important that you make sure you can put up your own outdoor sign. If any of these criteria is not met, don’t practice there.

“Associateships From Hell” not only don’t work, but will trap and hurt you. In the next issue I will tell you how and where to find a successful associate relationship.

More information on becoming an associate is available online at, Associate/Doctor Practice.

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. Contact Dr. Fernandez at 10733 57th Avenue North, Seminole, Florida, 33772; 800-882-4476; [email protected] or visit

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