III. I Am What I Am, but What Exactly is an "Associate"?
"The Associate." "My Associate." "I am an Associate." Yes, but what does it mean, legally? Not much, if anything at all.
About the only meaning this particular term has is that is does seem to imply some kind of working relationship exists, or is being contemplated. It also usually means that the "associate" is most likely not the boss!
Words that do have legal meaning are employee, independent contractor, partner, shareholder, manager and member. Unfortunately, they are not used very often between dentists and their "associates".
So, why is this important? In the most common use of the word "associate", dentists are trying to describe an employer-employee relationship, or an independent contractor relationship. Employees and independent contractors have vastly different rights and obligations under the law. It is also true that employers may have liability for the actions of their employees.
Example 1
Dentist A owns a busy dental practice and needs another dentist to help see patients. Dentist A hires Dentist B to see patients as his new "associate". Dentist A provides all the patients, all the equipment and supplies, and all the support staff. Dentist A determines when Dentist B will work. Dentist A pays Dentist B a base salary based on hours worked, not based on billings or collections from work produced. Dentist A's staff schedules all of Dentist B's patients based on the first available openings in the schedule, not based on any patient continuity of care concerns with Dentist B. There is no written contract.
What is Dentist B? What are Dentist B's employment rights? What are Dentist A's obligations and liabilities?
Example 2
Dentist C owns a busy dental practice and needs another dentist to help see patients. Dentist C hires Dentist D to see patients as his new "associate".
Dentist C provides some patients to Dentist D, but Dentist D also has a patient following she treats at the practice. Dentist C supplies some of the dental equipment and supplies, but Dentist D has certain pieces of dental equipment and certain supplies she prefers to use that Dentist C does not have available, and is not willing to purchase. Dentist D, at her own expense, buys these items. Dentist C supplies all the support staff needed by Dentist D. Dentist C determines when Dentist D will work. Dentist C pays Dentist D based on a percentage of billings collected. Dentist C's staff schedules all of Dentist D's patients based on patient continuity of care concerns with Dentist D. There is no written contract.
What is Dentist D? What are Dentist D's employment rights? What are Dentist C's obligations and liabilities?
Example 3
Dentist E owns a dental practice that has an "empty chair" and wants that chair to produce some income. Dentist E hires Dentist F to see patients as his new "associate". Dentist E provides a minimal number of patients to Dentist F, mostly when he is not available to see them himself. Dentist F has a large patient following of his own that he treats at the practice. Dentist E supplies all the dental equipment and supplies. Dentist F is satisfied with what is stocked in the practice currently, and does not require anything additional to meet his needs. Dentist F will pay 100% of any lab bills incurred from treatment of any patient. Dentist E will supply all the support staff Dentist F requires. Dentist F determines his own working times, and also determines when patients are scheduled. Dentist E will pay Dentist F based on a percentage of collections. There is a written contract that identifies Dentist F as an independent contractor.
What is Dentist F? What are Dentist F's employment rights? What are Dentist E's obligations and liabilities? (Does an "employment" relationship exist at all, or is there a better way to characterize this relationship that minimizes risk for all concerned parties?)
Lillian Obucina, Inc. is a resource for dental professionals on the law, regulations, and codes of ethics in dentistry. Education, information, insight, and motivation can avoid legal and ethical problems, and eliminate much uncertainty in dental office operations and patient management.