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Adding a second or third dentist is the point where a clinic stops being one person's practice and becomes an organisation. Most of the difficulty is not clinical — it is that everything previously held in one person's head now has to exist somewhere else.
Agree the commercial terms in writing first
Whatever the arrangement — salary, percentage, room rental — write it down before the first day, covering:
- How and when they are paid, and on what basis exactly
- Who pays for materials and lab work, and whether that is deducted before or after their share
- What happens to work in progress if they leave
- Whose patients they are, and what happens to those records
- Notice period on both sides
That fourth point causes more disputes than the rest combined. Decide now, calmly, whether a patient treated by the associate is the clinic's patient or theirs, and what may be taken if they leave.
Set up their access on day one, properly
Their own account, from the first morning. Never a shared login, and never "use mine for now" — that phrase reliably becomes permanent, and it destroys any ability to say who recorded what.
Set their access to what they need: their own patients, the schedule, treatment records. Access to financial reports and to other dentists' patients is a separate decision, not a default.
Write down the standards that were previously assumed
In a single-dentist clinic, the standard is whatever that dentist does. With two, it has to be explicit — otherwise patients get visibly different answers depending on who they see.
Write down, briefly:
- What a clinical note must contain
- Which cases get radiographs, and when
- Recall intervals for different risk levels
- When treatment is offered in stages versus all at once
- Which cases get referred out rather than treated in house
- The consent process for major treatment
This does not need to be long. Two pages that exist beat twenty that were never written.
Structure the first month
Week 1 — they observe and work alongside you. Not because they cannot treat, but because everything else is unfamiliar: where materials are, how the schedule is built, how payment is taken, which lab you use and how orders go out.
Weeks 2–3 — a lighter schedule with longer appointment slots. A new dentist in an unfamiliar clinic is slower on the same procedure, and booking them at full pace produces late-running days that patients notice.
Week 4 — normal schedule, then a review.
Book that review before they start. "We will sit down on the 28th" is a commitment; "we should catch up sometime" is not, and the problems that surface at four weeks are the cheapest ones to fix.
Introduce them to patients deliberately
The most common failure in adding an associate is that existing patients feel handed off.
Do not simply move patients across. When you first book a patient with the new dentist, say so and say why — "Dr. X has more availability, and she's excellent with this kind of treatment." A patient who hears that from you accepts the change; one who discovers it at the desk resists it.
Put the new dentist on the website and Google Business Profile in the first week, with a photograph. Patients look them up.
Watch three numbers
For the first three months, track for the new dentist specifically:
- Treatment plan acceptance. A lower rate than the rest of the clinic is usually presentation, not skill, and it is coachable.
- No-show rate. A high rate often means patients were booked with them without being introduced.
- Appointment overruns. Persistent overruns after two months means their appointment durations need adjusting, not that they need to hurry.
Discuss these as scheduling questions, not as performance judgements, because that is what they usually are.
The handover that gets missed
Agree how a patient moves between dentists inside the clinic — for a holiday, an emergency, or a referral for a procedure the other does not do.
Without a rule, either nobody wants to touch another dentist's patient, or everyone does, and neither is good. Write one line: the treating dentist stays responsible unless the record says otherwise.
In DOQ, each dentist has their own account, their own schedule and their own patient scope, so a second dentist is a configuration change rather than a shared login.