Associateship - Small Practice

For many new dentists, a small practice associateship is the first step in building a career. It provides an opportunity to gain clinical experience, build confidence, and begin practising without the financial commitment of purchasing or starting a practice.

Many dentists choose this path because they are managing student debt, want to strengthen their clinical skills, or prefer to learn about practice operations before considering ownership.

Common Associateship Arrangements

Associateship arrangements vary from practice to practice. Common models include:

Independent Contractor

The associate provides clinical services and is compensated based on an agreed-upon percentage of patient billings.

Employee

The associate is employed by the practice and receives a salary or hourly wage. Depending on the arrangement, standard employment benefits may also be provided.

Transition/Buy-in

The associate joins an established practice with the possibility of purchasing part or all of the practice in the future.

Advantages of a Small Practice Associateship

A small practice associateship may offer:

No upfront investment in purchasing a practice
Immediate access to an established patient base
Early income generation
Time to develop clinical skills and patient relationshipsExposure to practice management without primary responsibility for running the business
Support from an experienced dental team
Potential opportunities for future partnership or practice ownership
An opportunity to learn about the community before making a long-term commitment

Things to consider

A small practice associateship may also present some challenges, including:

Disadvantages of a Small Practice Associateship Include

Limited choice of practice location or working hours
Clinical or practice policies established by the practice owner
Limited influence over staffing, scheduling, or office procedures
No opportunity to build equity in the practice unless a future ownership arrangement exist
Compensation that may differ from practice ownership
Restrictive clauses within the associateship that may affect future practice opportunities
The Importance of an Associateship Agreement

A written associateship agreement helps establish clear expectations for both the practice owner and the associate. It should outline key terms such as compensation, responsibilities, patient records, and any post-departure obligations or restrictions.

Before entering into an associateship, both parties should also consider whether their professional goals, communication styles, and practice philosophies are compatible. Taking time to discuss expectations early can help establish a positive and productive working relationship.

Key Questions (+Answers)

Choosing an associateship is an important career decision, and it's natural to have questions along the way. The information in this section addresses many of the common questions new dentists ask, highlights the importance of a written associateship agreement, and explains when it may be appropriate to seek legal or other professional advice before signing a contract.

General Information

Why should I have an Associate Agreement?

An Associate Agreement sets out the rights, responsibilities, and expectations of both the practice owner (principal) and the associate. It helps clarify important terms, such as compensation, responsibilities, and how the relationship will end, before issues arise.

A clear, written agreement can help prevent misunderstandings and provide a framework for resolving disputes. Where a practice has multiple owners or corporations, it should also identify the legal entity entering into the agreement.

Should I Seek Legal Advice Before Signing a Dental Associate Agreement?

Yes. Before signing an Associate Agreement, it is strongly recommended that you obtain independent legal advice.

An experienced lawyer can explain your rights and obligations, identify clauses that may affect your future practice, and help you negotiate terms where appropriate. Depending on your circumstances, you may also wish to seek accounting or other professional advice.

Wouldn’t it be easier to work without an Associate Agreement?

Although it may seem simpler, working without a written agreement can create uncertainty for both parties.

A well-drafted agreement establishes clear expectations from the outset. Without one, or if important issues are not addressed, disagreements over compensation, responsibilities, restrictive covenants, or the end of the relationship can become difficult and costly to resolve.

What should an Associate Agreement include?

Every associateship is different, but your agreement should clearly address topics such as:

the nature of the working relationship (independent contractor or employee)
compensation, billing arrangements, and payment schedules
hours of work, vacation, and continuing education
responsibility for laboratory fees, supplies, equipment, and other practice expenses
patient allocation and referral processes
professional dues, licensing fees, and malpractice insurance
ownership and management of patient records
opportunities for future practice ownership, if applicable
restrictive covenants, including non-competition and non-solicitation clauses
termination provisions, notice requirements, and professional liability

Before signing, ensure the agreement reflects your individual circumstances and professional goals.

Nature of the Relationship

Am I an employee or an Independent Contractor? Many dental associates work as independent contractors rather than employees, although either arrangement is possible. The distinction has important legal, tax, and professional implications, so it should be clearly defined in your Associate Agreement. Before agreeing to either arrangement, consider seeking independent legal and accounting advice.

Can I choose the materials, equipment, or technology I want to use?

This should be discussed before the associateship begins and clearly outlined in the Associate Agreement.

Your agreement should address:

what equipment, materials, and supplies the practice provides
whether you may purchase and use your own materials or technology
who is responsible for those costs
what happens to equipment or materials you purchase if the associateship ends

While associates should have the tools needed to provide appropriate patient care, these decisions must also consider the operational needs of the practice.

Engagement & Services

Will there be limits on the types of treatment I can provide?

Possibly. Your Associate Agreement should clearly define your scope of practice within the office, including:

the procedures you will perform
patient allocation
expectations for production or patient volume
responsibility for treatment planning and ongoing patient care
referral processes to specialists or other providers

Any limitations should reflect your experience, education, and level of clinical competence, with the patient's best interests always taking priority.

How are patients assigned?

Patient allocation varies from practice to practice. Before accepting an associateship, discuss how:

new patients are assigned
patients are shared between dentists
continuity of care is managed
referrals within and outside the practice are handled

These expectations should be reflected in your Associate Agreement where appropriate.

How is scheduling managed?

Treatment times and scheduling should allow you to provide safe, high-quality patient care while supporting the efficient operation of the practice.

Discuss expectations for appointment lengths, scheduling flexibility, emergency appointments, and production goals before signing your agreement. As your experience grows, your scheduling needs may change, so ongoing communication with the practice owner is important.

How is professional courtesy handled?

Practices may have different approaches to professional courtesy, such as replacing recent dental work or providing reduced-fee treatment in certain circumstances.

Discuss these situations in advance so both parties understand how retreatment, reduced-fee care, and any associated compensation will be managed.

How should differences in treatment planning be handled?

What is the protocol for discussing failed treatment with patients when it’s done by another dentist within the practice?

Dentists may occasionally have different opinions about diagnosis or treatment. These discussions should take place professionally between colleagues before they are discussed with the patient.

Avoid criticizing another dentist's work, as the circumstances surrounding previous treatment may not be known. When concerns arise, the patient's best interests should guide all decisions, and practices may have protocols for managing these situations.

Term of the Agreement

How long does an Associate Agreement last?

An Associate Agreement may be for a fixed term or continue indefinitely until ended by either party. The agreement should clearly state:

the start date
the term of the agreement, if applicable
how the agreement may be renewed, extended, or amended
how either party may terminate the agreement

Clearly defining these terms at the outset helps both parties understand their rights and expectations.

Should the agreement include a probationary period?

Many associateships include a trial or probationary period, allowing both the practice owner and the associate to determine whether the relationship is a good fit.

During this time, either party may be able to end the agreement with shorter notice, depending on the terms of the contract. A probationary period also gives the associate an opportunity to become familiar with the practice, its patients, and the dental team.

At the end of the trial period, both parties may wish to review the agreement and discuss any adjustments. A probationary period of approximately three months is common, although the length may vary.

What qualifications should I maintain?

Your Associate Agreement should confirm that you:

are registered and in good standing with the appropriate dental regulatory authority
hold any required specialty registration, where applicable
maintain the licences, memberships, and professional liability coverage required to practise

The agreement should also specify who is responsible for the costs of licensing, professional memberships, and related fees, and whether proof of registration or insurance must be provided on an ongoing basis.

Practice Operations

Beyond the Associate Agreement itself, it's important to understand how the practice operates on a day-to-day basis. Many of these expectations should be discussed before you accept a position and, where appropriate, reflected in the agreement.

Facilities, equipment, and support

Discuss what the practice will provide, including:

treatment rooms and equipment
dental assistants and administrative support
supplies and laboratory services
marketing and advertising responsibilities

If you will be responsible for any of these costs, they should be clearly identified in the agreement.

Scheduling and time away from practice

Your agreement should outline your expected:

days and hours of work
evening or weekend responsibilities
emergency coverage
vacation and continuing education leave
notice required before taking time away

If you plan to practise in another office, ensure the agreement addresses any restrictions that may apply.

Practice resources

Every practice is different. Before accepting an associateship, discuss practical considerations such as:

how many operatories and dental assistants will typically be available
whether you may choose your own laboratory or specialist providers
whether the practice has plans for expansion or additional locations that could affect your role

Having these conversations early helps establish clear expectations and can contribute to a successful working relationship.

Patients, Records, and Compensation

Patients and Patient Records

Who "owns" the patients and patient records?

The Associate Agreement should clearly address what happens to patients and patient records during and after the associateship.

In many practices, patients are considered patients of the practice, regardless of which dentist provided their care. However, the agreement may make specific provisions for patients the associate brings to the practice, such as family members or existing patients.

The agreement should also outline how patients will be managed if the associateship ends, including how ongoing treatment and continuity of care will be handled.

Can I tell patients I'm leaving the practice?

This will depend on the terms of your Associate Agreement. In many practices, associates are not permitted to actively notify patients that they are leaving, as this may be considered solicitation.

If patients ask about your new practice location, the practice may provide that information where appropriate. Discuss these expectations before signing your agreement.

Dental Team Support

Your agreement should outline the support provided by the practice, including dental assistants and dental hygienists.

It should also clarify:

who is responsible for hiring and managing support staff
how hygiene and assisting services are provided
how fees generated by those services are allocated, where applicable

Compensation and Billing

How are associates typically paid?

Compensation varies from practice to practice and should be clearly outlined in your Associate Agreement.

Associates may be compensated through:

a percentage of collections or production
a salary or daily rate
performance-based incentives or bonuses

The agreement should specify:

how compensation is calculated
any deductions, such as laboratory fees or material costs
when payments will be made
how outstanding accounts and collections are managed if the associateship ends

If productivity targets or bonus structures are used, ensure you understand how they are calculated and whether they are realistic and appropriate.

How can I track my billings and collections?

You should have access to information that allows you to monitor your production, collections, and accounts receivable.

Discuss what reports will be available, how often they will be provided, and who is responsible for managing outstanding accounts. Understanding the practice management software and reviewing your financial information regularly can help identify and resolve discrepancies early.

Can I adjust fees or offer discounts?

Fee adjustments and discounts are determined by each practice. Discuss the practice's policies before you begin and ensure any expectations regarding billing authority or production goals are clearly understood.

Clinical decisions should always be based on the patient's best interests—not financial targets.

Retreatment, Holdbacks, and Patient Complaints

What happens if treatment needs to be redone?

Your Associate Agreement should explain how retreatment will be managed, including responsibility for treatment that must be repeated after you have left the practice.

Some agreements include a holdback, where a portion of the associate's compensation is temporarily retained to cover potential retreatment costs. If a holdback is used, the agreement should clearly state:

the amount being held
how long it will be retained
when any unused funds will be returned

What if a patient complaint is made after I leave?

Professional complaints remain the responsibility of the treating dentist, even after an associateship has ended.

If a complaint is filed, follow the processes established by your provincial or territorial dental regulatory authority. If questions arise about financial matters or patient claims, discuss them with the practice owner and seek appropriate professional advice where necessary.

Confidential Information

Your Associate Agreement will typically include a confidentiality clause requiring you to protect confidential information about the practice, its patients, employees, and business operations during and after your associateship.

Before signing the agreement, ensure you understand your ongoing responsibilities regarding patient information, practice records, and other confidential business information.

Restrictive Covenant

What are restrictive covenants?

Many Associate Agreements include restrictive covenants designed to protect the practice after an associateship ends. The two most common are:

Non-competition clauses, which may limit where you can practise for a specified period of time after leaving the practice.
Non-solicitation clauses, which generally prevent you from actively recruiting the practice's patients or employees after your associateship ends.

These provisions are intended to protect the practice's patient base, staff, and business interests.

How do I know if a restrictive covenant is reasonable?

There is no standard answer. Whether a restrictive covenant is reasonable depends on the specific circumstances, including the community, geographic area, and the terms of the agreement.

Because these provisions may affect your future practice opportunities, it is strongly recommended that you obtain independent legal advice before signing an Associate Agreement.

How can the restrictive covenant be enforced?

Restrictive covenants are contractual provisions. If one party believes the agreement has been breached, the matter may ultimately be resolved through the courts.

Courts generally consider factors such as:

whether the restriction protects a legitimate business interest
whether the geographic area and time period are reasonable
whether the terms are clear and specific
whether the restriction allows the associate a reasonable opportunity to earn a livelihood
the public's interest in maintaining access to dental care

Non-solicitation clauses are often treated differently from non-competition clauses and may be more readily enforceable, depending on the circumstances.

What happens if patients or staff choose to follow me?

Patients and employees are free to make their own decisions. However, actively encouraging or soliciting patients or staff to leave the practice may breach the terms of your Associate Agreement.

Some agreements also include provisions addressing patients who choose to follow an associate after they leave the practice. Review these clauses carefully before signing.

Ending an Associateship

How can an Associate Agreement be terminated?

Every Associate Agreement should clearly explain how the relationship can end. This includes:

when the agreement expires, if it is for a fixed term
how either party may terminate the agreement
the amount of written notice required
circumstances that may allow immediate termination
the responsibilities of each party after the agreement ends

The agreement may also address situations such as the retirement or death of the practice owner, and how patient care will continue if this occurs.

If you are employed rather than engaged as an independent contractor, provincial employment legislation may also apply.

How much notice should I give if I resign?

The required notice period should be specified in your Associate Agreement.

Providing reasonable notice helps the practice maintain continuity of care and allows patients to transition appropriately. Before signing the agreement, ensure you understand both your obligations and those of the practice owner if either party chooses to end the relationship.

Employment Status and Professional Responsibilities

Your Associate Agreement should clearly define whether you are practising as an independent contractor or an employee, as this affects your legal, tax, and professional obligations.

If you are an independent contractor, you are generally responsible for your own:

income tax and statutory remittances
professional licensing and registration requirements
business expenses, where applicable

If you employ staff directly, you may also be responsible for payroll deductions and other employer obligations.

Employment standards, workers' compensation requirements, and related responsibilities vary by province and territory. Ensure you understand the requirements that apply to your situation before entering into an agreement.

Other Important Considerations

Your Associate Agreement may also include provisions addressing:

how disputes will be resolved
which province's laws will govern the agreement
insurance responsibilities for both parties
professional liability and indemnification
legal remedies if the agreement is breached

Review these provisions carefully so you understand how they may affect your rights and responsibilities.

Future Opportunities

Can I purchase the practice in the future?

If practice ownership is one of your long-term goals, discuss this early in the relationship.

Some Associate Agreements include provisions such as:

an option to purchase the practice
a right of first refusal if the practice is offered for sale
how the agreement will be handled if ownership changes

If these provisions are included, both parties should ensure they understand the legal and financial implications before signing the agreement.

Professional Courtesy and Due Diligence

Before accepting an associateship, take time to learn about the practice and determine whether it is a good professional fit. Consider the practice culture, reputation, patient population, and working environment, and ensure your professional goals align with those of the practice owner.

If you plan to provide complimentary or discounted care for family members or friends, discuss this in advance and ensure any expectations are reflected in the Associate Agreement.