Introduction
You can be the best producer in your practice and still be the biggest thing holding it back.
That’s the uncomfortable idea Dr. Blake Hamblin and Gary Bird unpack when they talk about hiring an associate.
A dentist producing $1.5 million or $2 million a year alone sounds like a huge success. And it is.
But there’s a point where doing more dentistry stops being the answer.
You become the bottleneck.
There are more patients coming through the door. More treatment needs to be diagnosed. More opportunities are sitting in hygiene. And you’re trying to handle all of it yourself.
The result isn’t necessarily more growth.
It can be missed treatment, less time with patients, less time leading the team, and a dentist who finishes eight hours of dentistry and then has to switch immediately into CEO mode.
Blake lived this himself.
His perspective changed when he realized hiring an associate wasn’t simply an additional expense. It could create the capacity that allowed the entire practice to grow.
“You’re redlined as it is.”
The question isn’t simply, “Can I afford an associate?”
A better question is:
“What is it costing me to keep doing everything myself?”
3. The Real Problem: You’re the Bottleneck
A high-producing dentist can create a strange problem.
The better you become clinically, the more treatment you can handle.
The more treatment you handle, the more valuable your time becomes.
Eventually, there’s only one of you.
That’s where the ceiling appears.
Blake describes seeing solo doctors producing between $1.5 million and $2 million annually while also handling roughly 200 to 250 exams a month.
On paper, that sounds impressive.
Operationally, it can be a warning sign.
Look at your exam count
Blake’s benchmark is straightforward:
- Around 140 periodic exams per month for a single doctor is a major signal.
- More than 30 comprehensive exams can also indicate that it’s time to consider an associate.
- If you’re pushing well beyond those numbers, you may not be able to give each patient the attention they deserve.
The issue isn’t that you can’t physically perform the exams.
You can.
The issue is what happens to the quality of the conversations when you’re constantly moving from one room to another.
You start running two columns.
You check multiple hygiene columns.
You jump from patient to patient.
And somewhere in that pace, opportunities get missed.
Not necessarily because your team is bad.
Because you’re overloaded.
Capacity Check
Are you producing more because you’re growing, or because you’re personally absorbing all the demand? If new patients continue increasing but every exam, diagnosis, and treatment decision still depends on one doctor, the practice may have outgrown the owner’s capacity. Look at exam volume before deciding that the answer is simply to work harder.
4. More Exams Don’t Always Mean More Production
This is one of the biggest mindset shifts in the conversation.
A dentist may think:
“If I do more exams, I can find more dentistry.”
So they keep adding exams.
But eventually, the opposite happens.
You don’t have enough time to actually have the conversations those exams require.
Gary describes the problem as running on a treadmill.
You’re moving constantly, but you don’t have the space to step back and solve anything.
That’s when the owner can become frustrated with the team.
You finish a full day of dentistry.
Then you walk into a team meeting and discover that new patients are down by two.
Now you’re angry.
But the real problem may have started hours earlier.
You simply didn’t have enough capacity to lead.
“When you’re just running on a treadmill… you can’t have those conversations effectively.”
Hiring an associate creates something more valuable than another set of hands.
It creates space.
Read: The 6 CEO Focus Areas That Create Dental Practice Momentum
5. Before You Hire, Prove Your Marketing Can Create Demand
There is another side to the equation.
You don’t want to hire an associate and then discover there aren’t enough patients.
Gary’s solution is deliberately simple.
If you’re unsure whether your marketing is working, test it.
One option is to cut your marketing.
The other is to increase it significantly.
Gary’s preferred test is to double the marketing budget and see what happens.
If you’re spending $5,000 to $7,000 per month, increase it and watch the result.
If new patients increase, you have evidence that the marketing is generating demand.
If they don’t, you have another problem to investigate.
Maybe marketing isn’t working.
Maybe the phones aren’t being answered.
Maybe the practice can’t convert the demand it already has.
Maybe something operational is broken.
That’s why growth isn’t just a marketing question.
It’s a marketing and operations question.
Run the simplest test
Ask:
- Are we generating enough new patients?
- If we generated significantly more, could we handle them?
- If we can’t handle them, where is the bottleneck?
- Is the bottleneck the dentist?
If the answer to that last question is yes, an associate becomes much more logical.
Quick Tip
Test your marketing before you blame the market. If you’re unsure whether more marketing would actually create more patients, change the input and watch the result. A significant increase in marketing should produce a noticeable change if the marketing is working. If it doesn’t, investigate marketing, phones, conversion, or operations before adding capacity.
6. An Associate Doesn’t Have to Match Your Production
One fear keeps coming up:
“What if I hire an associate and they don’t produce what I produce?”
They probably won’t.
At least not immediately.
Blake isn’t suggesting that a new associate needs to walk into the practice and perform at the owner’s level.
The associate can start with simpler dentistry.
Blake specifically talks about moving procedures such as Class I and Class V restorations to the associate.
That doesn’t mean the owner isn’t capable of doing them.
It means the owner’s time has become more valuable.
If another doctor can handle the bread-and-butter dentistry, the owner gets capacity to do more valuable work.
That might mean:
- Complex procedures
- Leadership
- Training
- Treatment planning
- Business development
- Team development
- Strategic growth
The associate doesn’t have to replace the owner.
The associate helps remove the owner as the ceiling.
“Your time needs to become more valuable. And by doing that, your business becomes more valuable.”
Owner Mistake
Don’t judge an associate only by whether they produce what you produce. A new associate doesn’t need to walk in at the owner’s level. Their value may be freeing the owner from bread-and-butter dentistry, creating additional patient capacity, and allowing the owner to focus on more complex clinical work or leadership.
7. The First Three Months Are About Development
Blake’s practice does use a minimum for new associates.
But there’s an important reason.
The first three months are an onboarding period.
The practice needs to make sure the associate understands:
- The systems
- The protocols
- How the practice operates
- How patients are handled
- The expectations
- The clinical approach
That means the owner has responsibility too.
You can’t bring someone into a broken system, provide no training, and then complain that the associate isn’t producing.
The first three months should be about giving the associate the tools to succeed.
After that, Blake expects the associate to take what they’ve learned and apply it.
If they can’t, there may be a fit problem.
That distinction matters.
A minimum shouldn’t become a permanent hiding place for poor performance.
8. Build the Practice You Would Want to Join
Here’s a better way to think about recruiting.
Don’t ask:
“How do I convince an associate to work here?”
Ask:
“Why would a great associate want to work here?”
Blake’s answer includes several things:
- A strong flow of new patients
- A team that knows how to collect
- Systems that work
- Training and mentorship
- A culture people want to join
- Significant treatment opportunity
- The ability to earn based on performance
If you walked into your own practice as an associate, would you want the job?
That’s the test.
“You have to build the job you would want to take.”
If the answer is no, the problem isn’t necessarily the labor market.
It may be the practice.
And that is something you can change.
Leadership Insight
Build the practice you would want to join. Great associates have options. If your practice offers patient volume, mentorship, functioning systems, a strong culture, and meaningful production upside, recruiting becomes much easier. If you wouldn’t want the associate position yourself, fix the job before blaming the candidate pool.
Read: Want to Grow? Fix Your Hiring First
9. Stop Optimizing for the Minimum
There is a common argument against associates:
“You have to pay them a minimum.”
Blake’s response is that the type of associate he wants isn’t looking for a permanent minimum.
They’re looking for upside.
That’s an important distinction.
A strong associate wants:
More patients → more opportunities → more production → more income.
Gary compares it to a commission-based sales position.
If someone has a high volume of opportunities and significant upside with little of the overhead and risk of ownership, that’s an attractive position.
So if you’re only attracting people who want guaranteed minimums forever, ask yourself why.
It could be that your practice isn’t giving them enough opportunity.
It could be that your compensation structure isn’t attractive.
Or it could be that the wrong people are being hired.
Don’t solve the wrong problem.
10. Redundancy Is a Growth Strategy
Blake makes a powerful observation toward the end of the conversation:
Redundancy is one of the biggest advantages you can create in a business.
He originally thought about redundancy in terms of equipment.
Multiple scanners.
Multiple autoclaves.
Backups for the things that could stop the practice.
Now he thinks about redundancy in people.
More than one hygienist.
More than one associate.
More than one assistant.
More people capable of keeping the practice moving.
Why?
Because one person should not be able to shut down the entire operation.
Run the next-level calculation
If you have five people today, don’t automatically hire five more tomorrow.
But calculate it.
Ask:
“What would ten people allow us to do?”
Then ask:
“What would that freedom be worth?”
That’s a different way to look at payroll.
You’re not only buying labor.
You’re buying capacity.
You’re buying flexibility.
You’re buying resilience.
And, eventually, you’re buying back your own time.
Watch: Why Most Dentists Are Trapped in a 24/7 Job (And How to Fix It)
11. Hiring an Associate Can Give You More Freedom
There’s another benefit that doesn’t show up on a P&L immediately.
Flexibility.
If you’re the only doctor in the practice, taking time away can be difficult.
A vacation means fewer production days.
An illness can disrupt the schedule.
Retirement eventually means selling.
But if you have another provider who can serve your patients, the practice becomes less dependent on you.
You can take time away.
You can work on the business.
You can eventually reduce your clinical schedule.
Or you can keep practicing because you genuinely enjoy it.
The important part is that you have a choice.
Blake calls this redundancy in people.
And Gary connects it to a broader idea:
You’re buying back your time.
That could mean paying someone to mow your lawn.
Or paying another dentist to do dentistry you don’t need to be doing.
The principle is the same.
Your time is limited.
Use it where it creates the most value.
Read: Why Some Dentists Take Home More Without Working More
12. The Mindset Shift Owners Need
The biggest obstacle to hiring an associate may not be the associate.
It may be your own belief about what an associate means.
Blake admits he had the same limiting beliefs.
He worried that bringing on another doctor would reduce his own production and take money away from him.
His perspective eventually changed.
An associate doesn’t necessarily mean:
“I’m stepping away from dentistry.”
It can mean:
“I’m stepping into the work only I can do.”
That might be clinical.
It might be leadership.
It might be business development.
It might be mentoring.
It might be building the next practice.
The goal isn’t to remove dentistry from your life.
The goal is to remove the requirement that you personally have to do everything.
“It’s not about you stepping away from the chair. It’s about you stepping into something that’s uniquely yours.”
The Associate Decision Framework
Before you decide whether to hire, walk through these five questions.
1. Is demand already there?
Look at your new-patient numbers and marketing performance.
If you increased demand, could your practice absorb it?
2. Are you at your production ceiling?
Look at your exam volume.
If you’re consistently above roughly 140 periodic exams a month as a solo doctor, take a serious look at your capacity.
3. What are you currently doing that someone else could do?
Identify the bread-and-butter procedures that don’t require the owner.
Those may be the first procedures to transition.
4. Would a great associate want your job?
Look at your patient volume, culture, mentorship, systems, compensation, and growth opportunity.
Build the position you’d want yourself.
5. What would the additional capacity give you?
Don’t stop at “more production.”
Think about:
- More time
- More leadership
- More complex dentistry
- More flexibility
- More patients served
- More resilience
- More options for the future
That’s the real return.
Read: How to Scale Without Burnout: Dr. Blake’s Strategy for Sustainable Growth
Key Takeaways
- A dentist producing $1.5M to $2M alone may already be at a capacity ceiling.
- Around 140 periodic exams per month is a strong signal that a solo doctor should evaluate adding an associate.
- More exams do not automatically create more production if the doctor is too overloaded to have effective patient conversations.
- Test your marketing before assuming you don’t have enough demand.
- An associate doesn’t need to match the owner’s production immediately.
- Use the first few months to train, mentor, and establish expectations.
- Build a practice where talented associates actually want to work.
- Redundancy in people creates capacity, flexibility, and freedom.
- Hiring an associate isn’t necessarily about stepping away from the chair. It can be about stepping into the work only the owner can do.
Conclusion
Hiring an associate can look like an expense when you only look at the payroll line.
Look at the entire practice instead.
What happens when the owner can stop doing every bread-and-butter procedure?
What happens when 200 exams no longer have to flow through one doctor?
What happens when another provider can serve patients while the owner works on the business?
What happens when the practice isn’t dependent on one person?
That’s where the economics change.
The associate isn’t simply another expense.
The associate can create the capacity that allows everything else to grow.
Blake’s biggest challenge to dentists is simple:
Explore your reason for not hiring one.
Maybe you genuinely aren’t ready.
Maybe you don’t have the demand.
Maybe your systems aren’t prepared.
But maybe you’ve simply convinced yourself that the practice can’t grow without you doing more dentistry.
That’s the belief worth challenging.
Because sometimes the thing you think is protecting your income is actually limiting it.
And sometimes the next step in growing your practice isn’t doing more.
It’s finally getting someone else in the chair.
Listen to the Full Episode
Want to hear Dr. Blake Hamblin and Gary Bird go deeper into the economics, capacity, production, and mindset behind hiring an associate?
Listen to Episode 53 of My Dental Playbook: “The Hidden Cost of NOT Hiring an Associate: Your Practice Is Quietly Dying.”
