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Top 5 Reasons DSOs Exist (And How Best to Compete)

By June 9, 2016Insights


Historically dentistry was great for doctors who wanted autonomy and freedom. Increasingly, it’s hard for dentists to be independent and successful.

In past decades, a dentist would graduate from school, became an associate and buy out a practice as a partner. Today, the rise of the Dental Support Organization (DSO)[1] has more and more dentists electing to join existing DSO-supported practices.


  1. History repeats itself. Dental industry trends follow the healthcare industry with about a 10- to 15-year lag. America witnessed the consolidation of healthcare providers at the turn of the 21st Century, and dentistry is following suit.
  2. Dental schools are expanding. According to the U.S. National Institutes of Health’s National Library of Medicine, there were 42 dental schools in 1950.[2] Today, there are closer to 65. This means that the marketplace is flooded with new dentists looking for work.
  3. Debt is climbing. The average dentist is $280,000 in debt. A bank is not apt to loan the average new dentist $750,000 to open their own practice. Therefore, new dentists are more likely to seek out a career with a DSO than go into solo practice.
  4. Guaranteed pay. DSOs offer a guaranteed salary, which has more and more dentists going this route.
  5. Business support. Dentists working in a DSO have all of the accounting, marketing and other business strategies handled for them. They just show up and do dentistry.

The last one is the best place for independent dentists to compete. Independent dentistry can indeed still be a profitable business, if the dentist gets help on the business side.

As dentists, we hear this all the time. But where to start?

First, understand what “business side” means. Simply, put, the business side is comprised of these functions:

  • Human Resources
  • Practice Management
  • Payroll
  • Marketing and Branding
  • Accounting and Tax Strategies
  • Recruiting
  • Risk Management
  • Information Technology

Next, nix altogether the do-it-yourself approach to these functions. The point is that you spend more time with patients, not more time working in the business or reading books and manuals on these areas of expertise.

It’s important to use experts in each field. It’s like medicine – you don’t go to a cardiologist for your foot.

Avoid the idea that “none of this really applies to me.” Policies, procedures, risk management, human resources… it’s enough to make someone glaze over. You don’t know what you don’t know; get out there and explore the possibilities for truly safeguarding your practice.

Don’t wait until it hurts. An employee lawsuit, cash flow slippage that costs the practice tens of thousands of dollars over the years, attracting new patients only to have them leave the practice before their next recall appointment – all of these things are 100% preventable, but can kill a practice if left “untreated.”

As in dentistry, an ounce of prevention is worth a pound of cure.

Written based upon an interview with Quinn Dufurrena, DDS, JD, the President/CEO of Avitus Dental Management Solutions.

[1] May also be referred to as Dental Practice Management Company (DPMC), Dental Management Service Organization (DMSO), Group Dental Organization (GDO), or Group Practice Organization (GPO).

[2] What’s Going on in Dental Education?