Every fall, I talk with residents and associates holding one or more offers. Almost every conversation starts with the same question: "Is this percentage fair?"

It is a reasonable question, but it is the wrong place to stop. Two offers with the same percentage can be worth very different amounts. An offer with a lower percentage can easily be the better opportunity.

Whether you are an associate evaluating an offer or an owner preparing to make one, these are the terms that decide whether an agreement works for both sides.

• How associate compensation is typically structured in endodontics

• Why expected case flow matters as much as the percentage

• Seven terms to compare before you sign

• What owners should have in place before making an offer
  
  

1. The percentage, and what it is a percentage of

Most associate agreements in endodontics pay a percentage of collections, commonly in the range of 40% to 45%. Some offers include a daily minimum or guarantee during the first months while the associate builds a schedule.

Pay close attention to the base. A percentage of collections reflects what the practice is actually paid after insurance adjustments. A percentage of production can sound more generous, but it may be calculated differently. Ask exactly how the number is determined and when it is paid.

This is the term most associates overlook. Your income is the percentage multiplied by what you collect, and what you collect depends on how busy the practice can keep you.
Consider two offers. One pays 40% in a practice where you can realistically collect $900,000 a year. That is $360,000. The other pays 45%, but the practice can only support $600,000 in collections. That is $270,000. The lower percentage is worth $90,000 more.

Ask how many cases per day the practice expects you to complete in your first year, how new patients will be assigned, and what the practice is doing to grow referrals.
Forty-five percent of an empty schedule is worth less than forty percent of a full one.

Your classification affects your taxes, your benefits, and how much control the practice has over your schedule. Neither is automatically better, but the difference should be reflected in the overall offer. Review classification with a CPA and an attorney.

How many days will you work? Will you have trained assistants? How are emergencies and same-day cases handled? A well-supported associate completes more cases with less stress, which benefits everyone.

Most agreements include a non-compete or non-solicitation clause. Look closely at the radius, the length, and what triggers it. Laws vary by state, so have an attorney familiar with dental agreements review these terms before you sign.

If ownership is your goal, ask about it directly. Is there a defined path to buy in? On what timeline? How will the practice be valued? A vague promise of "we can talk about that later" is not a path.

Compare health insurance, retirement plans, malpractice coverage, licensing and dues, and continuing education allowances. Together these can add meaningful value to an offer.

A fair offer attracts strong associates and keeps them. But hiring before the practice is ready can reduce profitability instead of increasing it.

Endo Mastery generally considers a practice ready for an associate when the owner is personally busy, typically completing around six cases per day, and the referral base can support more clinical capacity. If you are not there yet, there are usually faster ways to grow profitability by improving your own productivity first.

Write down the realistic annual collections for each position, then multiply by the offered percentage. Compare dollars, not percentages. Then list the three non-financial terms that matter most to you.

• Associate pay in endodontics is commonly 40% to 45% of collections

• Expected case flow can matter more than the percentage

• Know whether you are paid on collections or production, and when

• Have an attorney review restrictive covenants before signing

• If ownership is your goal, ask for a defined path in writing

More on this topic

• Hiring and Keeping Great Associates

• Every Owner Was an Associate Once

​​​​​​​Compare Your Offers Side by Side

Download the free Associate Offer Comparison Worksheet to compare up to three offers on compensation, case flow, schedule, covenants, and path to ownership.

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