The practice you work in is fine. The owner is fair and the paycheck is solid, and you still can't stop thinking about what comes next.
If you're an associate dentist and practice ownership keeps coming back to mind, that pull is worth paying attention to. Stephen Trutter, CEO of Ideal Practices, took it on in a recent episode of The Startup Dentist Podcast: the subtle signs an associate position has run its course, and how to tell a temporary bad season from a real signal that it's time for the next chapter.
He's clear up front that nobody should walk in and resign tomorrow. The point is recognizing when your current position no longer lines up with where you want your career and your life to go.
You start thinking like an owner
The first sign is subtle. You start noticing how patients are scheduled, or wondering why there isn't a better recall system. Stephen has heard from associates who wanted to run community events to attract new patients, only to have the owner pass on the idea.
Soon you're asking yourself what you would do differently if this were your practice. At that point you're thinking about building a business instead of only doing dentistry, and that's often where an ownership mindset begins.
Income isn't the same as ownership
The sign Stephen hears about most is a lack of control. You can be making good money and still realize, in his words, that "income isn't the same thing as ownership." Someone else controls your schedule, your team, the technology, the marketing, and the clinical philosophy, and strong production can still leave you building somebody else's asset.
That's when a new question shows up, and Stephen repeated it on the episode for a reason: "If I'm going to work this hard, why am I not building something that is mine?" It's a very different question than how to make more money.
Stuck with the leftover cases
Stephen hears this from clients all the time. They're in a practice where the senior dentist takes the bigger cases, and they get the leftovers. After dental school, maybe a residency, and years of continuing education, they're doing basic dentistry that isn't the work they want to do or the patients they want to serve.
His warning is direct: stuck with the leftovers, you're stifling your clinical ability. That's usually when associates start picturing their own practice, down to the kind of dentistry they'd do if the choice were theirs. As Stephen sees it, ownership often begins long before the paperwork, with vision.
Things that never bothered you start to
Every practice has problems. What changes is your tolerance for them. An inefficient schedule or a team member who isn't performing used to roll off your back, and now you catch yourself thinking, I wouldn't run my practice this way.
Stephen is careful to add that your current practice may be perfectly fine, and that your expectations are what's changing.
You're not growing anymore
Ask yourself whether you're still learning, and not only clinically. Are you picking up anything about leadership, finances, case acceptance, or operations?
Stephen compares a great associateship to minor league baseball, where you hone your skills before the call-up to the majors. A good associate position should prepare you for what comes next.
You've been "just curious" for years
Maybe you've been scanning practice listings, asking colleagues what their practices are worth, or driving past buildings wondering if one could be your office. Stephen's standing line on that: don't call the number on the sign.
But he offered a reality check: "if you've been curious, just curious for a couple of years, you might actually be preparing." There's never a perfect opportunity, and after a couple of years of exploring without action, the thing holding you back may simply be fear.
Afraid to leave, more afraid to stay
Fear is normal, and Stephen names the usual ones. What if I can't get enough patients? What if I lose money? Then a second thought shows up: what if you stay an associate for another 5 years?
If you're "afraid to leave, but even more afraid to stay," Stephen says that's when it's time for a serious conversation with yourself, your spouse, or your family about ownership. At Startup Practice Blueprint™ he asks the room, "If nothing changes and you take no steps today, how will you feel?" One answer he hears is "stuck building somebody else's dream."
Leave with a direction
This was the distinction Stephen most wanted listeners to take away: "Don't leave simply because you're frustrated. Leave because you have a better direction." Getting out is an emotional decision. Knowing where you want to go next is a strategic one.
A 90-day way to find out
If this sounds like you, don't resign. Give yourself 90 days to investigate ownership. Month 1 is about what you actually want, like a startup or an acquisition, in network or out, and what kind of dentist and owner you want to be. Month 2 is about what it takes, starting with where you need to be financially. Month 3 is about building a realistic roadmap.
Stephen says month 3 is where Ideal Practices meets a lot of its clients, when they stop dreaming and start planning. Starting or buying a practice is a 12 to 18 month process, so the real question becomes where you want to be in a year and a half.
Outgrowing a good job
As Stephen put it, "You don't have to hate your associate position to outgrow it." Your associateship may have done exactly what it was supposed to do by teaching you what kind of practice you want to build next.
Stephen walks through every sign, and the full 90-day plan, in the episode.
Listen to the full episode
