How to Find a Dental Associate Placement that Leads to Ownership

You're two years out of dental school, working as an associate at a four-chair practice somewhere outside Marietta, and the owner just dropped a casual line about "slowing down in a few years." You want to say something back. But you also don't want to come off like you're already planning your takeover.

If you're an associate dentist looking for a path to ownership, situations like that one are exactly where the path opens or closes. The associates who end up owning the practice they work in usually aren't smarter or better clinicians than the ones who don't. They're just the ones who started building a real plan early, in writing, with the right practice.

This article walks through how to find an associate position with a genuine ownership track, what to look for in the practice and the contract, where the strongest opportunities sit in the Southeast right now, and the mistakes that most often derail the deal. I'm Ryan LaPrad, a principal broker at DDSMatch South, and I've watched this transition play out across Georgia, Tennessee, Alabama, and the Florida Panhandle for nearly two decades.

Why Has the Path From Associate to Owner Become So Much Slower?

The path is slower because more graduates start in DSOs or large group practices instead of private offices, and because private owners are increasingly selling to DSOs rather than to an associate. The result is fewer natural owner-to-associate transitions than there were 15 years ago.

The numbers back this up. According to research from the ADA Health Policy Institute, only 21 percent of dentists who graduated between 2016 and 2020 owned a practice within 5 to 9 years of finishing dental school. For dentists who graduated between 2011 and 2015, that number was 33 percent. For graduates before 2010, it was over 60 percent.

ADA HPI describes this trend as primarily an early-career phenomenon. By the time dentists are 15 to 19 years out of school, ownership rates catch up across generations. So ownership isn't disappearing. It's just happening later, and the route is less obvious than it was for the prior generation of dentists.

Three things are driving the change. More new graduates start at a DSO-affiliated office where ownership isn't a built-in option. As of 2024, 16 percent of all U.S. dentists are affiliated with a dental support organization (DSO), and that number rises to roughly 27 percent for dentists less than 10 years out of school. Student debt loads have shifted what feels financially possible in the first few years. And many practice owners who once would have groomed an associate to buy them out are now selling to DSOs at higher cash multiples instead.

At DDSMatch South, we still see plenty of associates step into ownership across our service area. But the matches don't happen by accident. They happen because the associate set up the path on purpose.

What Does a Real Ownership-Track Associate Position Actually Look Like?

A real ownership-track position has a written buy-in or buy-out option in the employment contract, a defined timeline of 1 to 5 years, a stated method for setting the future purchase price, and an owner who actively wants to transition the practice. Verbal promises don't count.

There's a meaningful gap between an associate position where ownership is "possible someday" and one where it's actually built into the deal. The first kind is common. The second is much rarer and worth searching specifically for.

A real ownership track usually includes a written option to buy in or buy out the practice within a defined window. It includes a stated valuation method, not a hand-wave about "fair market value at the time," so both sides know roughly what the price will look like. It typically includes a first right of refusal, which means the owner can't sell the practice to a DSO or third-party buyer without offering it to you first.

If the position offers a buy-in instead of a full buy-out, it should specify what percentage of equity becomes available and on what timeline. A buy-in path that says "we'll figure it out as we go" almost always means the owner hasn't actually committed to selling yet.

Restrictive covenants matter too. A 10-mile non-compete with a 2-year duration is normal in most Southeast markets. A 25-mile non-compete with a 5-year duration on an associate who might leave because the ownership conversation never materialized is a different beast. The contract should account for what happens if the buy-in doesn't close.

How Do You Spot a Practice Where Ownership Is Actually Realistic?

Look for owners within 5 to 10 years of retirement age who don't have a family successor, practices that haven't taken serious DSO meetings, financial transparency from day one, and an owner who treats you like a future colleague instead of a hired clinician.

The clearest signal is age and intent. An owner in their late 50s or early 60s who has explicitly said they want to transition to another dentist (not a DSO) is the strongest starting point. An owner in their mid-40s with no exit plan in mind is a long bet, even if they say the right things.

Watch how the practice handles you. Owners who are serious about an internal succession plan tend to introduce you to long-term patients early, give you access to production reports, and start including you in business decisions within the first year. Owners who keep you at arm's length on the business side are usually not planning to sell to you, even if they say otherwise.

Practices that have already taken DSO meetings deserve a candid question: have you decided not to sell to a DSO? If the owner is still weighing both options, the associate path is fragile. DSO offers, especially in fast-growing Southeast markets like Nashville, Atlanta, and Birmingham, can pull owners away from internal succession plans late in the process.

"The associates I've seen succeed on this path aren't the ones with the strongest production numbers. They're the ones who started learning the business side of the practice on day one. The owners noticed, and the contract conversation got a lot easier when it came." — Ryan LaPrad, Principal Broker at DDSMatch South

What Should Be in the Employment Contract from Day One?

If ownership is your goal, the employment contract should include a written buy-in or purchase option, a defined valuation method, a first right of refusal, a transition timeline tied to specific milestones, and clear language about what happens to the non-compete if the ownership path falls through.

Most standard associate agreements don't include any of this. They're written for the owner's protection, not for an associate planning to buy the practice. You need to ask for these provisions explicitly, and you need a dental-focused attorney to review the final version. A general business attorney will miss things specific to dental transitions.

Here's a baseline checklist of provisions to look for or request:

• A buy-in or full purchase option with a defined window, commonly 2 to 5 years
• A valuation method spelled out in writing, such as an EBITDA multiple, a percentage of average collections, or a stated formula
• First right of refusal if the owner receives an outside offer
• A pre-set timeline for when the parties will start the valuation process
• A non-compete that either softens or expires if the ownership path doesn't close through no fault of yours
• Clear treatment of patient lists and goodwill if the path ends
• Defined production expectations during the lead-up period

It's also worth understanding what type of compensation arrangement you'll have during the associate period. Most owners pay associates as W-2 employees or 1099 independent contractors based on collections, with rates typically running 28 to 35 percent of collections in the Southeast. The structure of associate compensation itself can affect how a future buy-in is calculated, so it pays to think about both at the same time.

Solo Buy-Out vs. Partnership Buy-In: Which Path Fits Better?

A solo buy-out makes sense when the owner wants to fully exit within 2 to 3 years and you're ready to take on full ownership debt. A partnership buy-in works better when the owner wants to stay clinical for 5 or more years and you'd rather share decision-making and financial risk during the early years.

Both paths can lead to full ownership. The right choice depends mostly on the owner's timeline, your financial situation, and how you want to spend your first years as an owner. Dental Economics describes the typical buy-in pattern as a multi-stage process that often runs 3 to 5 years, starting with a honeymoon period before any equity changes hands.

The biggest mistake associates make here is locking into a partnership buy-in when what they really wanted was a solo buy-out, or vice versa. Owners and associates often have different default preferences. Talking about which structure makes sense should happen early, ideally before the first employment contract is signed.

How Do You Bring Up Ownership Without Making the Owner Defensive?

Bring it up directly during the interview, frame it as a question about the owner's long-term plans rather than a demand for a buy-in, and ask what the path has looked like for any previous associates who worked there.

Owners get understandably nervous when an associate brings up ownership for the first time three months into the job. It can come across as an exit threat or a sign of dissatisfaction. The cleaner approach is to address it during the hiring conversation, before either side has any sunk cost.

A natural way to bring it up: "I'm looking at this position long term. Can you tell me what your plans look like for the next 5 to 10 years, and whether ownership is something we'd structure into the agreement?"

That phrasing does three things. It signals you're serious. It gives the owner room to answer honestly about their plans (some will say "I'm not selling anytime soon" and that's useful information). And it opens the door to talking about the agreement structure without putting the owner on the defensive.

For associates who are already working in a practice without an ownership conversation having happened, the same approach still works. Frame it as: "I've been thinking about my long-term goals, and I wanted to talk through whether ownership at this practice is something we could explore." Don't ambush the owner with paperwork or specific terms in the first conversation.

Where Are the Best Southeast Markets for Associate-to-Owner Opportunities?

Mid-size Southeast markets like Chattanooga, Augusta, Huntsville, Pensacola, and Macon tend to have more associate-to-owner opportunities than fast-growing metros, because DSO competition for those practices is lower and owners are more likely to want a doctor-to-doctor transition.

Big-city practices in Atlanta, Nashville, and Birmingham often draw aggressive DSO interest. When a practice is doing $1.5 million or more in collections in a growth market, the owner usually has a stack of DSO offers and can sell for a higher multiple than an associate can finance. That doesn't mean associate-to-owner deals don't happen in those markets. They do. But they're more competitive.

Practices in mid-size Southeast markets often see different dynamics. A solid two-doctor practice doing $1.2 million in collections in Chattanooga or Augusta isn't on every DSO's target list. The owner is more likely to want a successor who'll keep the practice intact and serve the same patient base. These are the practices where the associate-to-owner path still works the way it used to.

Rural and smaller-town practices across the Southeast, including towns in north Georgia, west Tennessee, south Alabama, and the Florida Panhandle, are an underrated category. Buyer competition is lower, real estate is often included at attractive terms, and many of these owners are specifically looking for a doctor who'll commit to the community long term. The trade-off is lifestyle fit, which only the associate can evaluate.

With over 80 years of combined dental industry experience across our team, DDSMatch South has worked with hundreds of practice owners in these mid-size and smaller Southeast markets through our doctor-to-doctor transitions service. The associates who land these positions usually do so by getting connected to the practice before it ever hits the open market.

What Are the Most Common Mistakes Associates Make on the Ownership Track?

The most common mistakes are taking verbal ownership promises at face value, picking a practice based on commute or pay rather than ownership fit, not understanding the practice's financials early enough, and waiting too long to bring in their own advisor team.

Verbal promises about ownership are worth almost nothing in dental practice transitions. We've seen associates spend four years in a practice based on "we'll figure out the buy-in when you're ready," only to watch the owner sell to a DSO for cash. Get it in writing or treat it as if it doesn't exist.

Picking a practice based on lifestyle factors alone is another common one. An hour-long commute and a slightly lower pay rate at a practice with a real ownership path will produce a better outcome over 10 years than a higher-paying job in a practice that has no plan to sell to you.

Financial blindness is the third trap. If you're planning to buy the practice, you need to see real production and collection data, overhead percentages, and patient retention numbers within the first 6 to 12 months. Owners who refuse to share this information aren't planning to sell to you. They're keeping their options open.

The last mistake is building your own advisor team too late. By the time you're sitting at a closing table, you should already have a dental-focused attorney, a dental CPA, and a transition advisor who has handled these deals before. Building those relationships during your first year as an associate is much cheaper than scrambling for them when an LOI is on the table. DDSMatch South can plug into that process early through our associateships program, connecting associates to practice owners who are specifically looking for an internal successor.

About the Author

Ryan LaPrad is a Principal Broker at DDSMatch South with more than two decades of practice transition, real estate, banking, and finance experience. Over the past 18 years, Ryan has worked with hundreds of dental professionals across Tennessee, Georgia, Alabama, and the Florida Panhandle on practice acquisitions, transitions, and associate placements. He is a Certified Business Intermediary through the International Business Brokers Association and holds real estate broker licenses in both Tennessee and Alabama. Reach Ryan directly at rlaprad@ddsmatch.com or through the DDSMatch South team page.