This DSO doesn't want to buy your practice

A key component of Smilebliss Orthodontics' operational model is something not commonly seen in the dental industry. 

Metairie, La.-based Smilebliss Orthodontics was founded in 2021 as an alternative model to support orthodontists. The organization provides orthodontists with marketing, operational and equipment support without having them give up a portion of ownership. 

Smilebliss Orthodontics recently expanded its network to 30 offices in 14 states.

Angela Weber, president of Smilebliss Orthodontics, recently spoke with Becker's to discuss the organization's goals for this year, how the organization stands out from competitors and the top stressors facing DSOs today.

Editor's note: Responses were lightly edited for clarity and length.

Question: How would you describe Smilebliss' growth since its launch?

Angela Weber: Smilebliss's growth has been very measured and thoughtful on our end. A big part of our model is making sure we have the right doctors. Smilebliss is very different from a traditional DSO in that we don't own the practices. It's more like a franchise concept than a DSO, but we're providing similar support services.

The growth also reflects the industry's search for something different. A DSO provides many advantages, like mentorship, camaraderie and support. Post-COVID, independent orthodontists felt stressed from the difficulty of hiring and retaining good employees and bringing in a steady flow of new patients. So, Smilebliss' market launch really struck at a good time when the market was prime for support like this. 

We've had doctors reach out to us a year or two years into owning their practice because they are starting to realize how tough it is now. They were doing okay for a startup, seeing patients enter their doors because of pent-up patient demand from COVID shutdowns. Now, they realize the market is different from what they assumed it would be. Smilebliss is the answer for stability and getting their quality of life back. We help with hiring and training. We're doing the marketing. We're driving new leads into the practice. We put operational efficiencies into the office, benefiting the doctor. It's the concept of being in practice for yourself but not by yourself and retaining full ownership.

Q: Is that type of operational model common in the DSO field?

AW: No, it's not. Smilebliss is different because we don't own practices. It's a three-year contract and a 5% fee, so we have skin in the game to help a practice grow, and we know how to do that. Our operational model and brand are consistent so that we can provide a well-worn path to success. Growth predictors are off if every practice a DSO acquires is doing things differently. Smilebliss has a more predictable model for growth.

Q: What else does the company have planned for 2024?

AW: Some locations are starting to hit the two-year mark. Our current owners are excited about opening second locations because they've seen success. Our startup locations are hitting 600 starts in year one. So when you have the confidence and that level of growth, it doesn't take long to start thinking about the next location. What will also be interesting in our industry is that doctors who sold their practice to DSOs about five years ago are starting to hit that mark where they want to reenter the market. Smilebliss is going to be an option for those doctors who want to get back into ownership even if they don't want to work in the practice day-to-day. We are getting a lot of calls from doctors who have been through that journey and are excited about the next step and some independence.

Q: What are some of the top stressors for DSOs today?

AW: I think DSOs were focused on the next acquisition. Now, what we're seeing is DSOs are tightening their belts. They've slowed their acquisitions and are trying to streamline their existing portfolio for efficiency. They may realize, "Okay, I've got 200 locations, but I've got 200 locations doing things 200 different ways." So they're starting to shore up their own house and determine what services they will provide. [We've been] hearing a lot of doctors saying, "I have the same problems now that I had prior to selling, but now I don't have as much control to solve them. I'm kind of just sitting around waiting for somebody else to solve them." There's now this realization that maybe a DSO doesn't solve all of the problems. We're all going to have the same challenges: bringing on talented people, training them, dealing with the turnover and getting new patients in the door. That's where we spent much time and energy building our model, the marketing, consulting and operational playbook so any Smilebliss employee understands and believes in the mission. "Smilebliss" says it all. That's what we want. Smilebliss inherently brings a strong foundation for a doctor to build a team and positive culture. Our consultants help practice owners have the right people in the right roles so they are ready for growth because growth will come.

Q: What does Smilebliss look for in a partner?

AW: An open-minded doctor who enjoys the craft, doesn't necessarily want to do the business side of things, and is open to expanding beyond what's traditionally been done in the industry. 

There's a significant population that could benefit from treatment yet isn't seeking it. SmileDirectClub had many flaws in its model, but one thing you couldn't argue with is that it did tap into this consumer. Orthodontists incorrectly assumed that meant people wanted aligner treatment, but that's not necessarily the case. One of the foundations of the model is making it easy and convenient for consumers to come in. We're not the practice that has the coffee bar, but it is a professional, fun environment that really caters to patients who wouldn't have otherwise received treatment. The fees are transparent, it's affordable and we really streamline the entire patient process.

Q  What other trends are you following right now?

AW: Everyone's talking about artificial intelligence and how that can be applied. Our marketing generates a lot of leads. It's a good problem to have when you're driving hundreds of leads a month for each individual office; how can we help streamline that lead process? So [we're] working on potential AI ad concierge [services] for after-hours to schedule appointments.

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