Staff Management

Climb the Associates Ladder: Seven Steps Toward Ownership

By Chad Fleming, OD, FAAO


For an associate intent on a partnership, performing seven steps well adds value to the practice—and gets you closer to your goal.


PUBLICIZE PRACTICE. Post events on social media, promoting thepractice, attend community events like health fairs.
COME IN EVEN WITH NO PATIENTS SCHEDULED. Keep yourself busy while waiting for possible walk-ins or eyecare emergencies.

MEET WITH PRACTICE OWNER REGULARLY. Review clinical cases and office improvements you are working on. See if there is anything you could do differently.


Going from associate to partner isn’t so hard–if you have the right plan. That includes taking a proactive role in the practice rather than waiting for the owner’s marching orders. Here are seven ways you can take the lead in making the most of your role as associate to advance to partner. As a practice owner, these are the things I’ve noticed make for a successful associate. Sharing these expectations with your associates, or even making some of them part of your associate’s agreement, may result in a more productive practice.

Take Initiative to Grow Practice

Sitting in your office watching the schedule on your computer and hoping patients will magically be dropping in will not impress the owners. Associates who are actively working to grow the practice by being involved online and in the community are the ones who will be sitting at the table with the owners signing a purchase agreement.

For example, with the practice owner’s consent, use Facebook, Twitter, Google+, Yelp, Pinterest, LinkedIn and local social channels (specific to city or state) to promote your practice. Post regularly about eye education and recommendations regarding sunwear, how often to have your eyes checked and interesting research about the eye such as computer use and blue light risk.

Community involvement opportunities for associates includes health fairs and educational programs. For example, offer to speak to children about the eyes in science class or visit with the manager of a retirement home to do a seminar about macular degeneration.

Monetary costs of the associate doing these things are minimal when the associate does it as part of their job requirement.

Be at Office Even When You Have No Patients Scheduled

Being a doctor has many advantages, one of which is a very nice income. However, nothing comes easy. Expecting to show up at the office late and leave early because your schedule is light will result in you practicing in multiple locations–because no one will want to keep you in their practice very long, especially if they are looking for a partner.

If an associate’s schedule is not full, they should expect to carry on other practice supporting tasks, like staff training, social media management and external marketing events like participating in health fairs.

An associate who desires to grow their practice should expect to meet expectations in their employment agreement, and then to exceed those once they are met. Too many associates have the mindset of an hourly worker who has limited buy-in and does the minimum job requirement. When an associate has regularly gone above and beyond their employment agreement, they have the greatest chance of increasing their compensation and potentially being offered a partner position.

Take Time Implementing Major Changes

Great ideas about optometry practice are in your head when you graduate optometry school. Don’t let all these ideas escape at once. Pace yourself. Many practices will be less than anxious to jump on board with all the ideas you learned in a classroom. This doesn’t mean you don’t have great ideas, such as a major practice web site upgrade; it just means that the practice staff and doctors will not care about how much you know until they know how much you care.

Building relationships with other local doctors is one way to make a positive change. I’ve seen associates who have invested time and their own money into getting involved in the community by building a strong network with primary care providers, which, in turn, has increased the number of diabetic patient referrals for primary eyecare.

I remember one associate who used a day of the week when they were not working for the primary employer, to apply for a position in the ophthalmology department at the university nearby. They received the position as a contact lens/optics adjunct and ended up as the resident instructor for all primary care. Through all this the associate ended up being asked to join as partner. The associate was successful because he did not wait to take the initiative to use his knowledge and skills to grow his reputation in the community which, in turn, made him a very valuable asset for the optometry practice to lock in as a partner.

Maintain Professional Line Between Doctor and Staff

As an owner I see this happen whether it is new staff or a new doctor. Many employees want to have an in-road to management, and if they can get close to one of the doctors they feel their opinions will carry more weight. Not all staff are like this, but be leery of being one of the staff instead of one of the doctors.

In any situation where there is a questionable relationship, I always recommend that the associate communicate early and clearly their concern. Define the behavior and then state what the result of the behavior is and why it makes the associate uncomfortable. For example, if the associate has been made uncomfortable by a technician telling him intimate details of her personal life, he would take her aside, and in a respectful way, let her know that the information she is sharing is her personal business, and that it would be best if she kept it to herself in the workplace.

Be Humble; Avoid Being the Know-It-All

Check your pride at the door because it is not wanted here. We are all constantly learning and making mistakes. The inability to acknowledge those mistakes and learn from them is a mark of an arrogant doctor. Nobody wants to work with or for an arrogant doctor. If you can’t get over yourself then please start your own practice because any partner willing to take you on is asking for trouble.

Teach-ability is the character trait that separates the mediocre associate from the great ones. An associate must first be open to admitting that they can, will and do make mistakes. Vulnerability leads to humility and humility leads to optometric teamwork that pushes the upper limits of excellence in patient care. Primary care optometry is not always 1+1=2, as many times patient cases are not like the textbook and require research and asking good questions of your colleagues. With humility, optometrists can learn and grow from each other.

I have heard and seen numerous cases of new associates in their first one to three years of practice who have not asked questions about what they can’t figure out, thus appearing like they know it all. This usually leads to greater malpractice risks and an internal fear of working independently with patients.

For example, an associate once came to ask me about a patient with a condition that baffled him. I came into the room to take a look and knew what it was immediately. This is not because I am any smarter than him; it was only because I had experienced it in practice whereas the new associate had never seen it in a textbook or clinical rounds at school. It was a great teachable moment and began a very healthy relationship in which we both ask each other “dumb questions.” It’s better to ask a dumb question, then be the dumb doctor who couldn’t resolve the patient’s eye problem.

Go Beyond Your Associate Agreement Mandates

Think of your associate agreement as the bare minimum of expectations. Ask the doctor who may be your potential partner for detailed job expectations and an overview of what he or she expects from you to be successful. If you want to be partner, this communicates that you are interested in being the best and are working hard to continue to improve yourself.

There are many ways to go beyond the requirements of your associate agreement. For example, during the second year of your associateship you will be in the clinic seeing patients five days each week with the option to schedule patients on Tuesday when another doctor is out of the office. You would probably also have a variety of other responsibilities within the practice as it pertains to staff management and training, systems implementation, executive team responsibilities, peer chart reviews, case presentations and other daily operations of the practice.

Meet with Employing Doctor Regularly

Proactively ask the potential partner doctor to meet with you to go over everything from clinical care to staff management. Be prepared to communicate with the doctor about clinical cases and if he or she would manage them differently. Be prepared to walk through your job expectations and discuss how your growth has been since you first started. Do not be afraid to communicate that you are interested in a partnership and you want to earn the respect of the owners and prove you are the right person for the position.

It is about asking the owner-doctor the right questions: Where have I exceeded expectations? In what areas do I need the most improvement? What can I do to make the practice better?

Related ROB Articles

Salary Negotiations: Make it Mutually Beneficial for Owner and Associate

Adding an Associate: Compare Doctor & Associate Expectations

Associate Acumen: Prepare Well When Adding a Doctor

Chad Fleming, OD, FAAO, is the Business & Career Coach for AOAExcel and also a partner with Wichita Optometry, P.A. in Wichita, Kan. He assists optometrists in the buying and selling of optometry practices, coaches ODs through the transition process from associate to partner, and speaks on business strategies for practice growth. To contact:

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