What Should be in a Dentist Leaving the Practice Letter? | Dental Practice

Hi, I’m attorney Renee Osipov with Chelle Law in Scottsdale, Arizona. We draft employment agreements, policies, and patient letters for dentists within their practice. If you’re watching this video, there are probably multiple dentists in your practice in which one of them has decided to either retire or leave the geographical area. The best way to communicate this information to your patients is via letter. The letter should at least give the patients 30 days prior notice to the change. 

Practice Letter of a Dental Doctor to Their Patient

The letter should also notify them of the change with the dentist leaving the dental practice and then reassure them of quality care within your group. It’s also important to let them know that they have the option of obtaining their dental records, should they choose to leave your clinic, and they can go elsewhere. You can provide them with a dental health record release form as well. And then, depending on the situation, you may want to give them the contact information for the dentist leaving the practice. Still, that’s optional, depending on the reason for their departure. 

And then lastly, you’ll want to add an apology for any inconvenience and reassure them that the continuity of care will continue. Each situation is unique, and here at Chelle Law, we help draft those letters for dentists within their practice. You can check out our website. It’s Chelle Law, C H E L L E law.com. On our website, you’ll also find information on contacting us. We’re happy to set up a consultation where we can discuss your unique needs within your dental practice. Thank you.

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• What Should a Dentist Put in a Termination Letter?
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What You Need to Know about a Dental Associate Employment Agreement 

Dental associate employment agreements are important legal documents for both the dental professional and the employer. Signing such a contract means you understand what is expected of you and your employer moving forward. 

If you’re a dental associate about to join employment, you may be wondering what to look out for in your employment contract. What benefits should the employer provide? Can you cancel your contract at any time? And are there drawbacks to signing such a contract? Here’s everything you need to know about the dental associate employment agreement. 

What is a Dental Associate Employment Agreement? 

A dental associate employment agreement is a contract between the dentist employer (practice owner) and an employee (dental associate) that sets out the terms and conditions of employment.  

The agreement specifies the services to be provided, the duration of employment, and other relevant details that should guide both the dental associate and the dental practice owner on how to work together.  

It is vital to have a dental contract lawyer review your employment agreement before signing it. This way, you can be sure that the contract is as fair and reasonable to you as it is to your employer. 

What To Look Out For in a Dental Associate Employment Agreement | Contracts

When signing a dental associate employment agreement, it’s important to ensure the following terms are present and well explained: 

Term Length 

The contract should specify the start and end dates of the employment so as to determine the length of the term. It also should outline any conditions that need to be fulfilled before the start date, such as acquiring a license in the practicing state. 

Expiration 

The contract expiration date should be included, after which the terms of employment will need to be renewed either automatically or manually.  

Alternatively, the agreement may state that the contract will continue until either party terminates it. So be sure to check which applies to your situation and have it stated clearly in the contract to avoid issues such as having to wait for a certain period to be able to renew your contract.  

Duties and Responsibilities 

What exactly are you being employed to do? Your contract should outline your daily duties and responsibilities in detail. It should also specify the working hours, days, and location. 

It should also clearly state if the required hours will be counted for your clinical duties or will you also include other administrative and marketing duties you may be required to do.

Understanding your duties and responsibilities ensures there’s no confusion about what’s expected of you, and you can’t be held accountable for something that wasn’t part of your job description. 

Benefits 

The contract should also specify the benefits that the employer will provide, such as paid time off, health insurance, continuing education reimbursement, and retirement savings plans. 

Benefits play a big role in your overall compensation; therefore, if you’re not happy with what’s being offered, be sure to bring it up and negotiate for a better benefits package. 

Non-competes 

Some employers may include a clause in the contract that prohibits you from working for a competitor during and after your employment for a specific geographical area and time period.  

If such a clause is included in your contract, ensure you’re comfortable with it, as it can hinder you from finding a job if you leave the practice. If you’ll be working in a densely populated area, a radius of 2-15 miles is fair and reasonable. 

Dispute Resolution 

The contract should state how disputes between you and your employer will be resolved. This may include arbitration or mediation, which are alternatives to going to court. It is important to have this part in the contract so that you know what to expect if a disagreement arises. 

Contract Termination 

Who can terminate the contract? How much notice should be given? Are there repercussions thereafter? Your contract should address these questions as well as specify the conditions under which the agreement can be terminated, for example, due to breach of contract. If the provisions are not specific, for instance, such as “the associates disobey the employer” or “the employer is not happy with the work,” then the contract may be terminated for any reason. 

Note that there’s a difference between the termination of employment and the termination of a contract. Unless the agreement is terminated, you may be entitled to some provisions even after your employment is terminated. So, check the wording. Also, make certain that you are not signing an independent contractor agreement, as this is a different employment relationship.

Payment Terms 

How and when will you be paid? What is the salary or hourly rate? Are you eligible for overtime pay, and how will it be calculated? Which compensation model will be used? These are the questions that your contract should be able to answer. It should clearly lay out the payment models and all the terms involved. This part of the agreement is very important to you, and you should therefore pay close attention to it. After all, you’re working to make a living. 

What If a Patient Sues You for Malpractice?

Every dental associate should have liability insurance. Such insurance is meant to financially protect you in the event that a patient sues you for malpractice. Some employers will require you to get your own policy, while some will include it in the contract. If the employer is including it in the contract, make sure you understand what is and isn’t covered. You don’t want to be caught up in surprise later on. 

About to Sign a Dental Employment Contract? 

Dental associate employment agreements are important documents that specify the terms of your employment. Be sure to read them carefully and understand all the clauses before signing. And if you’re not happy with the terms of the contract, don’t be afraid to negotiate. After all, it’s your career. You want to make sure you’re protected. The best way to ensure you get the best outcome is by involving a knowledgeable dental contract lawyer to review your agreement. Our attorneys are available to do so. We have the experience and skills needed to help you. Reach out to us today. 

How to Negotiate a Dental Associate Contract? 

I will give some tips and tricks to get a better contract. Negotiating a contract with somebody just out of training is different than with someone already established in a community. You have more leverage if you are in any community and either a corporate practice or another group is bringing out your practice and wants you to join them, and you have an established patient base. Let’s first talk about those coming out of training. What do you need to do to put yourself in the best position to negotiate a contract? Well, you need to know what’s important.

For most dental doctors, the most important things are compensation, is it a base salary? Is it a daily rate? Is it a net collection? How do you terminate the contract? Can you get out of it with a certain amount of notice or the benefits? Do they pay for your license, DEA registration, credentialing, and continuing education, and are they signing bonuses and relocation assistance?

Do you have to pay them back if you leave within a particular time? And then probably the two highest priorities are who pays for dental malpractice insurance. Who must pay for tail insurance after the contract terminates if it’s a claims-made policy and the non-compete? This is some people’s absolute, most important thing in the contract. If they’re tied to a community, kids in school, or family, they absolutely can’t leave, then you need a reasonable non-compete that’s not going to make your move entirely out of the area.

Find the Ongoing Rate in Dental Practice Competition

Those are the most important things to dental associates. Now, you’re coming to training. You have a job offer, and they’re giving you a certain amount. How do you know what’s reasonable and what’s not? Well, talking to your classmates is the best way to find that information. What are the offers they’re getting? How much are they getting, and how are they structured? Where are the job offers coming from? That’s the best and most, I would say, accurate means of finding out what the going rate is at that time. The compensation is going to vary wildly. Is it a base salary or a daily rate? Is there some kind of net collection involved, or is it a hybrid? Could it be half base, half net-collections?

Often, compensation for a job may look great, but then the benefits are bad, they’re not paying for your tail insurance, or the non-compete is terrible. So, you can’t just take compensation as the number one factor in determining what a good opportunity is, but it certainly is important. Knowing whether a non-compete is fair or not is something you probably must talk to a professional about.

For the most part, anywhere between one to two years, and then maybe 5 to 15 miles from your primary practice location would be considered reasonable. If you’re in a non-compete that’s more than two years, or it knocks out like multiple counties, or maybe they’ve attached the non-compete radius to, let’s say, it’s a corporate practice in a big city, and they have 10 locations. And they’re saying, well, you can’t work within 10 miles of every location we own. That’s not a reasonable non-compete.

Compensation, Benefits, and Restrictive Practices

The actual negotiation will depend on two things. One, do they give you an offer letter, or do they just give you the employment agreement? If they give you an offer letter, they expect that those terms will be negotiated in advance and then incorporated into the employment agreement. And then, they’re going to give you the employment agreement. I find it difficult to come to terms with the main parts of an offer letter without seeing the full employment agreement. If I had a perfect scenario, there would be no offer letter. They would just give the employment agreement. Then you’d have a full understanding of what the job entails and the expectations for both parties.

You could agree to a salary, you could agree to the length of the term, that there is a non-compete, that the things they’ll pay for, but when you see the specific language in the contract, it could greatly change the way you look at the value of the contract. Just because you’ve signed an offer letter doesn’t mean you can’t renegotiate those terms if you provide proper context to the employer.

Alright, I was okay with making $110,000 a year and base salary, not knowing that the non-compete effectively knocks me out of the entire state. If you want me to sign this contract with that non-compete, I need 130,000. There are many ways of going back and forth. Some employers will simply say, this is a take-it or leave-it. I would be wary of signing a contract with an organization unwilling to make any changes in the contract.

Red Flags in the Dental Practice

It usually means they’re difficult to work with down the road or in a very rigid and unprofessional environment. If you find that someone says, take it or leave it, I would leave it and move on and find a better opportunity. If they take the mindset that they’re not going to change anything in the contract, like nothing at all, no change at signing bonus, relocation assistance, benefits, anything like that. It is a bad sign moving forward. And then one more thing to think about and absolutely should be top of mind when you’re signing a contract or negotiating the terms of an agreement: every employment contract should have without-cause termination. Either party should be able to terminate the agreement at any time with a certain amount of notice to the other party.

Usually, it’s somewhere between 30 to 90 days. If your contract does not have without-cause termination, meaning, you must fulfill the entire initial term of the agreement somewhere between one to three years, normally, it’s an enormous red flag. You absolutely shouldn’t sign that contract for this reason. Suppose they have excluded without-cause termination, which is essentially standard across all healthcare professions. In that case, it usually means they’ve had a ton of turnover. Or they’ve had some very dissatisfied dental doctors that have wanted to leave.

So, they’ve removed that ability and made sure that they must stay there for a three-year or a two-year period or whatever. If it’s not in the contract, that’s why it’s normally not in there because they’ve had a ton of turnover, and the turnover is normally due to bad management. It’s either it’s a toxic work environment, or the compensation is not worth the amount of time or effort you’ve, you’ve had to put into it.

The Need for No-Cause Termination Agreements

It makes sense there’s always without-cause termination and the employment agreement. Don’t feel bad about asking for things. If you’re negotiating the terms of employment, most smart employers expect there will be some back and forth. Ask for a little more salary, a little more bonus, and a little less non-compete radius. The incremental things you can get changed in the agreement can significantly change the value of an opportunity. So, don’t feel bad. Now, if they’re offering a hundred and you ask for 300 or some crazy amount, they will think that you have no idea what’s going on.

They’ll probably move on. When you ask for something, it needs to be reasonable. How do you find out what’s reasonable or not? Once again, talk to your classmates, any mentors, or attorneys who understand what they’re doing. And deal with these contracts every day. That’s where you need to get in. But if you go in and ask for these ridiculous changes to an agreement, most places will pull the offer to say, no, we’re not doing any of that. So, that’s how you negotiate a dental associate contract.

Dentist Non-Compete Restricted Offices Explained

How many locations should a dental non-compete apply to? Before we get into this specific question, let’s back up and talk about what is a non-compete clause. Non-compete clauses are standard in just about any dental employment agreement. Even if you’re with private practice or a big corporate practice, there’s usually always a non-compete. Now, they might go by a couple of different names. It might specifically say a non-compete clause. However, it may say restrictive covenant, a promise not to do something. And then it will list the language that employment agreements typically include a non-compete clause. And sometimes, they don’t go by any name. They sneak them in there. So, you want to ensure that you read over your employment agreement very carefully, because this could affect your career after your employment ends with whatever practice you are signing this agreement with.

Can Management Restrict an Employee Dentist?

Let’s talk about what is in a typical non-compete clause. Normally, there are two components to a non-compete clause. One is the period that you’re restricted from the competition. Now, this can typically be anywhere from six months to two years. It rarely goes over two. And I would say most of the time I see is around two years. Sometimes, I can get negotiated down to one year, but again, usually, I would say the average is anywhere from six months to two years. Now, we have our timeframe. This is how long the non-compete restricts you from competing after terminating your employment. You might terminate it, or the dental practice might, but your employment has ended. And this is when the non-compete clause would then become valid.

Okay, so we’ve got the time for how long. The other component of it is where the restrictive covenant applies. Again, this depends on where you are in the country. If you’re in New York, you’re not going to use miles. Typically, New York city’s non-compete clause will stay in city blocks because if you even go one mile, you’re going to knock out most of the city. So, that’s not reasonable. If you’re in a rural area, a tiny town, sometimes the non-compete clause can go anywhere from 10 to 20 miles. And then, if you’re in just a regular city setting, such as Phoenix, the mileage typically goes a little less.

When it is an Unreasonable Restriction

It can be anywhere from 3, 5, or 10. I would say anything over 10 would likely be unreasonable. That would be something that you would want to negotiate down. So, we have our timeframe, you must know how long you’re restricted, and then you need to know where you’re restricted from. And this is where we’re talking about the specific questions today. How many locations should that restricted area apply to? This is easy. If it’s a private practice, and they only have one location you’re restricted from, let’s say three miles from the practice, which we’ll use as an example, that’s great. You know that you cannot practice dentistry within three miles of that location. That’s easy. But likely they get a little bit more complicated than that. Let’s say it’s a private practice or a small corporation, and they have multiple locations.

Sometimes, the language they’ll use in the non-compete is that you’re restricted to that mileage. So, three miles from any location that you provide services for practice ABC. The complicated part is when it uses the word “any location you provide services for”. If you cover a dental doctor who’s on vacation, so you work a couple of days, maybe a week at another location for the practice, well, that three-mile restriction now applies to that second location. 

Red Flags in Dental Business Practices

So, you want to be careful when you’re reading your employment agreement. If you see anything that says any location that you provide services at, that should kind of be a red flag for you to really think about it. So, we talked about the language where they say any location you provide services for. A green flag will be if you see where they say you’re only restricted by the three-mile restriction from your primary place where you provide services, which is a little bit clearer. Suppose you only typically work at one location. In that case, you provide 90% of your services at one location, that’s your primary location, and therefore, you’re only restricted to three miles from one location. That’s great. It’s easy to follow, it won’t change in the future, and you’ll know if you violate it. 

Another sort of red flag that you want to be aware of is whether it is a practice with multiple locations or a corporation with many locations. Sometimes, employment agreements will have a language that states you’re restricted from any location that a corporation ABC owns. So, this gets a little tricky. Again, let me restate this. If it says any location from a corporation or dental practice ABC, this gets tricky. You could be restricted. That three-mile restriction could attach to hundreds of locations you’ve never even been to.

New Practice Restrictions: Patient Relation

This isn’t easy because this can knock out a huge region. Let’s use Phoenix as an example. It could knock out the whole city if they have multiple locations around the city, even if you’re not providing services for them. You want to make sure you’re reading the contract very carefully. And if the dental practice is expanding in the future, they could add 5, 10 locations, and you’ll have that three-mile radius attached to any of those locations too.

So, to be more concise, you want to know where you will provide services. That’s very important. Your employment agreement should outline it. Then the non-compete clause should only attach to your primary location. You should advocate for this because if it’s from any location you provide services for, you need to remember that in the future if you cover for a dentist who’s on vacation, your non-compete clause now attaches to that office that you only worked for for a week.

And it’s going to knock out that area. The other thing is if it says any location that the corporation or dental practice owns. That’s a big red flag, too, because you don’t know if they’re expanding in the future. How many locations, it’s hard to tell. When you sign the agreement, you don’t see what you’re restricted from.

In conclusion, how many locations? In my opinion, it should be only from your primary location where you are providing services, where you have built up a patient base, and relationships with your patients. You just want to be stopped from going across the street and those patients going there that they would consider competing.

Dental Associate Non-Compete Length

And then two other things you need to consider regarding the non-compete. First, the location is listed. As you know, big conglomerates are gobbling up these dentist-owned practices. And so, you could be in a city with eight locations for your employer. You want to ensure that it explicitly says your location or maybe the two locations where you spend most of your time. You don’t want to sign a non-compete stating that it attaches to every employer-owned location, even if you never worked in those locations. This is especially true for dentistry.

If you’re in private practice, dentist-owned, and they only have one location, then it’s simple. It’s just going to be that location and nowhere else. But, if you’re in a big city and they own a bunch of locations, you want to make sure it explicitly states your location, not all the locations. And then also, if you’re in a specialty, you don’t want to get stuck from being unable to do any dentistry. You want it to say specifically what you’re doing for that employer. That way, if you can do other things for the period, like let’s say you can’t move because of kids or family reasons, you could have an alternative for a year. That might not be ideal, but you could do that for a year and then return to your normal specialty.