DSOs have had a significant impact on the dental space, both positive and negative. While organizations have helped dentists in ways such as expanding access to capital, they can also sometimes limit dentists' autonomy.
The leaders featured in this article are all speaking at Becker's 2024 dental conferences. This includes our Spring Future of Dentistry Roundtable, which is set for June 19-21 at the Swissotel in Chicago, and the Fall Future of Dentistry Roundtable, which is set for Oct. 30 to Nov. 1 at the Hyatt Regency in Chicago.
If you work at a DSO or dental practice and would like to be considered as a speaker, please contact Randi Haseman at rhaseman@beckershealthcare.com.
Note: Responses were lightly edited for clarity and length.
Question: What impact have DSOs had on the dental industry, and how will they affect the dental space going forward?
Sara Mahmood, DDS. Founder and owner of Brush365 (Dallas): DSOs have driven the industry to value efficiency, which has had both positive and negative ramifications. I'm grateful for the DSO model inspiring me to have a more discerning eye on how time and materials are used in my offices. However, we never want profits to come before people, and there's a fine line when the industry has become fixated on margins and EBITDA.
Ronald Perry, DDS. Associate Dentist at Dentistry by Design (Boston): DSOs have had a significant impact on the dental industry, both positive and negative. Positive impacts include improving efficiency and standardization, bringing additional access to capital for dental practices, offering professional support to free up dentists to focus on patient care, and pricing more career opportunities for dentists. On the negative side of things, some dentists feel that joining a DSOs means sacrificing clinical autonomy and decision-making authority, added financial pressures to meet productivity targets and adhere to corporate protocols, the continued market consolidation, reducing competition in local markets and potentially prioritizing profit over patient care. Going forward, the impact of DSOs on the dental industry will depend on numerous factors, including regulatory changes, market dynamics, and consumer preferences. Regulatory scrutiny: Regulatory bodies may increase oversight of DSOs to ensure quality of care, patient safety and fair competition within the dental industry. Overall, the future impact of DSOs on the dental industry will be shaped by ongoing developments in healthcare policy, consumer preferences and technological advancements, with potential opportunities and challenges for both patients and dental professionals.
Scott Pope, DDS. Co-owner of Coliseum Dental Walnut Creek (Calif.): The impact of DSOs on the dental industry can be significant and can vary depending on various factors: increased efficiency and standardization, which can result in improved patient care and experience; access to capital and resources, providing practices the capital for expansion, modernization and investments in technology; and professional development opportunities and training programs for dentists and staff members, helping them stay updated with the latest advancements. The rise of DSOs has led to market consolidation, with smaller independent practices being acquired or joining larger DSO networks. Some critics argue that DSOs may prioritize profit over patient care, leading to concerns about the standardization of care and potential conflicts of interest. However, proponents of DSOs argue that they can maintain high standards of care while improving operational efficiency. Joining a DSO network may involve relinquishing some degree of autonomy for individual practitioners. While this can lead to more standardized business practices, it may also limit the ability of dentists to make independent decisions about patient care and practice management. The growing influence of DSOs has attracted regulatory scrutiny in some jurisdictions, particularly regarding issues such as corporate practice of dentistry, patient privacy and billing practices. DSOs must navigate regulatory requirements and compliance standards in multiple jurisdictions where they operate. Overall, the impact of DSOs on the dental industry is complex and multifaceted, with both benefits and challenges associated with their growth and influence.
Robert Trager, DDS. Dentist at JFK Airport (New York City): My outlook on how DSOs affect dentistry now and in the future is that of a perspective of a solo practitioner, which I am. The DSOs will survive and proliferate as long as there is available private equity funding and anticipated decrease in the interest rates. The DSOs are a lifeline to the graduating dentists who have a large debt due to student loans. The DSOs will provide a stress-free future for the recent graduate by having a place of employment for them and paying for their health and malpractice insurance. The DSOs are actively buying out independent practitioners and more so adding on specialties such as oral surgeons, endodontists and orthodontists. What I envision in the future is that many of these DSOs, in order to alleviate the staff shortages, should open up their own dental assistants and dental hygiene schools in their own facilities or nearby. The outlook for the young providers is that if they ever want to open up their own practice or to associate, they will have no or little skills in practice management, financing, marketing and devising their own treatment plans. They will also lack the skill of hiring and firing and which dental labs to use and where to get the best deals in ordering supplies and which dental plans to accept or not to accept. They will not possibly know where to open their own office or to associate with another office. There will be a generation of skilled practitioners who have relied on AI and treatment plans that have been provided for them without their input. They will need to learn all of this in order to survive.