Understanding and Evaluating Associateship Opportunities
Current Trends in Associateships

Course Author(s): David G. Dunning, MA, PhD; Robert D. Madden, DDS, MBA

Current Trends in Associateships

With DSOs having approximately 15% of the market share,7 it is understandable more and more dentists in transition; especially recent graduates are considering associateship DSO opportunities. DSOs have a reputation for a higher base, guaranteed compensation, richer benefit packages, and considerable continuing education opportunities. Combined, these match up well for students saddled with increasing student loan debt. It is our observation the presence of DSOs have also created a competitive increase in overall compensation packages being offered by private practitioners. This is good for associates but also puts a potential squeeze on the profit margins of employing dentists in private practice.

For some context before considering negotiation issues for an associateship, here are some additional trends based on surveys conducted by Insurance Solutions and the ADA:27

  • Most recent graduates are in associateship positions as employees, with fewer as independent contractors.
  • The vast majority of recent graduates are not owners or co-owners of practices.
  • Male dentists tend to be owners compared to women dentists. This could be because of lifestyle/child rearing choices. Also, over time it is reasonable to expect this previously observed gender-gap in ownership close, if indeed it hasn’t already, in part to the work schedule flexibility offered by multi-practitioner models.
  • Dentists are more likely to move into ownership positions over time (that is, fewer remain as associateships over the long-term of a career span).
  • Forty-six percent of associates work with a one-owner dentist; 25% work with one owner-dentist and multiple associates; 11% work as a one associate with multiple owners; 9% work with multiple associates and multiple owners; 7% work for non-dentist owners with multiple associates; and <2% work as individual associates for non-dentist owners.