Simon Palmer, April 2009 - You have finally found your ideal Dentist to employ after a long recruitment and interview campaign process. You both agree on remuneration and have a work agreement put in place that you both sign and are happy with. For most practices the recruitment process would end at this point and be deemed a success.

Unfortunately whether you like it or not the hard and stressful part of recruitment – the integration - is only just about to begin.

The integration of the Dentist into the practice involves significant changes for the team, for the patients and for the Dentist themselves. With this much change, careful thought and planning needs to be undertaken in order to make sure that the transition period is as smooth as possible and that it leads to stability for your practice and everyone in it.

The Team
If hiring a new Dentist is going to represent an increase in the number of clinicians at your practice it will mean that:

• The practice will be dealing with more patients than ever before
• Often another dental assistant and/or receptionist are needed all of whom will need to learn the office procedures,

Your existing staff may be overwhelmed trying to hold everything together, unless they had lots of spare time previously (a rare occurrence). The owner of the practice must have confidence in the team members to adapt, but it is important that you communicate in advance about the transition process.

Make sure that every member of the practice team knows about the incoming Dentist, their background and the Dentist’s attributes that make them an asset to the practice. Ask your team to make the Dentist feel as welcome as possible and to be patient, but emphasize that you are always interested in their concerns. Make sure you regularly ask the team members how they are managing with the new Dentist, and don’t assume that everything is fine just because they haven’t approached you.

A potential issue with existing and new team members is authority and delegation. Both the owner and new Dentist need to make it clear who has authority in the practice. The owner Dentist must impress on the staff that the new Dentist is a fully qualified Dentist who understands and can serve patient needs. However, management of the practice is still the responsibility of the owner Dentist. If the new Dentist does participate in the management, the delineation should be clearly defined for the staff.

The Patients
If you have a new Dentist starting in the practice you need to make sure the practice has enough work either through existing patient management or marketing. Methods of referring patients to the new Dentist include:

• those that do not wish to wait for an appointment,
• those that require lower-risk dentistry (when they are not experienced),
• those that are in for emergency procedures,
• as a proportion of all new patients to the practice,
• reactivation of old patients that are no longer coming in regularly,
• if the new Dentist has some skill, expertise or desire to do specific procedures and you could refer patients on that basis. (eg endodontics, extractions etc)

Once the trial period is over, it is important that you begin to present the Dentist as a significant member of the practice. The owner Dentist can create this impression in a number of ways:

• the new Dentist’s name should be placed on practice letterheads/ brochures, websites and signage.
• the practice could send a letter out to all patients announcing that the Dentist has joined the practice. The letter should emphasise the care the owner Dentist has taken selecting the Dentist, and his/her confidence in the Dentist’s abilities.

Of course, a small percentage of patients will insist on being treated by their previous Dentist even with such an introduction. The verbal skills of both the owner Dentist and new Dentist must be carefully developed so that communication with the patient is effective for patient transfer. Without effective patient transfer, the Dentist will find it impossible to establish a patient base and afford a buy-in. On the lists of stress-inducing events in a person’s life, moving and starting a new job are usually two of the highest. In our experience, any time that you can find in the first week or so to introduce and make the Dentist feel welcome in the practice will be time well spent in that it will create rapport and long term stability. Below are some suggestions that may help build rapport and orient the Dentist to the area and practice:

Upon arrival

1. It is probably better not to have the Dentist start work immediately after arriving in the practice on his/her first day. Make sure that someone takes the time to give them a tour of the practice and introduces them briefly to each member of the team, and shows him/her around the equipment they will be using.
2. Within the first couple of days have a welcome lunch or morning tea for the staff of the practice to get to know the new person
3. On a regular basis (every couple of weeks or so) for the first few months check up on the new Dentist asking how things are going and if there is anything you can do to help them settle in.
4. Make professional introductions. Local study groups, places that you regularly refer to, places that you regularly get referrals from.
5. Give them a rundown of the area. Show him/her where the services like banks, post offices and good places for lunch are.

Similarly, you must ensure that the new Dentist takes the time to learn about your practice’s clinical ways of doing things and levels of service in your practice culture. Two ways to ensure that this takes place include:

1.  For at least a few months (for a new graduate maybe longer) setup an expectation that you will be having clinician meetings for at least one hour once a week (preferably at the same time every week) for clinical mentoring. At that meeting ask him to bring along x-rays and study models of cases, preps done, root canals that have been finished, etc. You bring along the same. Compare them. Set up a culture of giving each other feedback without being defensive. Most Dentists who coach and mentor a new employed Dentist comment that their own learning curve would have been shortened, and that possibly they would have attained greater heights in their career if someone would have taken the time with them when they were younger. Maybe they would have stayed in that employed position longer
2. Have the most experienced DA work with the new Dentist with two stated and transparent agendas. First you want to give the new Dentist every chance to succeed at the practice and second that you will be asking for feedback from the DA as to where you may need some support.

Bringing a new Dentist on board at a practice represents the potential for growth but also risks throwing your practice into chaos. By having a well thought out plan in place for managing the transition for the team, patients and Dentists, you are giving your practice every chance to succeed, grow and have long term stability.