The Great Consolidation | Dental economy

We are in a period of consolidation. Entrepreneur dentists combine several practices under their own management. Dental service organizations continue to grow through the creation of new practices and through acquisitions. While the vast majority of dental practices in the United States are still independently owned and operated,1 we would be naive not to notice the opposite trend.

First of all, I have to say that I don’t think this trend should worry independent practitioners. For many of us, consolidating practice ownership conjures up images of a bleak future with no choice but to work as an employee for a big corporation. We turn to our healthcare cousins ​​in medicine or optometry who have little freedom to practice on their own. The good news for my fellow Independent Owners is that our business model is alive and well. As long as we are proactive in maintaining and growing our practices, we will enjoy our independence for the foreseeable future. In their article, Bart Walker, JD, and Diana Castro, JD, write about the driving forces behind consolidation, but also the bottlenecks they believe will slow the growth of DSO (page 16).

And for the enterprising dentists among us who dream of trading chair time for leadership roles, it’s an incredible time to be in business. We have experts and resources like never before to help us grow from one successful practice to many more. In this issue, Brady Frank, DDS, shows us the benefits of additional passive income when we have multiple practices (page 40). Jacob Puhl, CEO of the Dentist Entrepreneur Organization, tells us that developing a healthy culture is perhaps more important than healthy KPIs (page 32). If we are looking to grow by acquisition, Tarek Aly, BDS, wants to remind us of the checklist of considerations we need to make before going too far in the buyout process (page 36). Brian Colao and Victoria Bahrami, JD, of the Dykema Dental Service Organization Industry Group, offer alternatives to traditional DSO legal structures that can help us preserve more autonomy (page 26).

As we increase the number of our practices, quality control becomes an increasingly difficult dilemma. Marty Jablow, DMD, shows us how we can leverage technology to ensure our practices deliver care while maintaining standards (page 58). Tim McNeely writes about how to structure the sale of your small empire to maximize your financial gain (page 22).

If and when you reach the level where you consider your collection of practices a DSO, you would do well to follow the advice of Aspen CEO Bob Fontana (page 12). Like Jacob Puhl, he is a firm believer in creating a successful culture to stay competitive in a competitive landscape.

We have been following the consolidation trend in dentistry for several years and there is no shortage of interest. DSOs want to learn how to take better care of their patients and the dentists they employ. Entrepreneur dentists are excited about the possibilities of running multiple practices and creating great wealth along the way. As this issue cannot contain all the lessons that our colleagues can teach us, we have decided to create a new e-newsletter: Group practice and DSO Digest. If you want to follow the content we develop, subscribe and stay informed.

The Great Consolidation is not about dentists losing their independence; it’s quite the opposite ! Individual practices can continue to thrive while the business leaders among us can take advantage of new opportunities to indirectly serve many more patients.


Chris Salierno, DDS

[email protected]


  1. Guay A, Wall T. Considering the practices of large groups as a vector of consolidation in dentistry. Health Policy Institute research paper. American Dental Association. Published in April 2016.

To note: Want to stay on top of DSO trends and strategies to develop multiple practices? Look for our latest e-newsletter, Group practice and DSO Digest, which is expected to debut soon. (Subscribers of our Practice Management Principles e-newsletter will automatically receive a copy. Not a subscriber ? Visit today.)

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