Growing a dental practice, while providing a wide range of services in different dental specialties, is the aim of every single dentist in the world; but how about business management and marketing?

The concept of dental service organizations (DSOs) has evolved recently to answer the above query. As dentists may struggle with managing their own practices, while still wishing to grow their dental business, becoming part of a larger DSO can be a more efficient option to gain more popularity and, in turn, widen the scope of provided dental services. It is clearly understood now that a DSO comprises of a number of dental practices in several locations within the so-called franchising dentistry or corporate dentistry.

The typical image of DSO workflow is as follows. DSO purchases the non-clinical side of the practice from the dentist(s) and takes control over managerial issues such as the property, equipment and rental, while the dentist(s) still controls the clinical aspects including sterilization protocols and safety measures. This agreement allows small dental practices to purchase modern dental technology and to provide high-quality care. That is, an average percentage of 8% of US dentists are currently converting to the DSO workflow.

This more or less resembles working under one brand name in different locations. The model seemingly suits for young/active dentists, mid-career dentists and end-career dentists who might be more interested in part-time work. It also appears as one of the best options for dentists who want only to focus on the clinical work and need to give up the management work.

On the other side, working with a DSO can be less interesting for dentists who don’t like working under supervision or reporting to other staff members as part of their daily or weekly tasks. Dentists would also raise concerns regarding how will they be paid (salary or percentage), the ownership and employment agreements as well as the working hours. Non-clinical managers could have some recommendations regarding clinical consumables, materials and supplies from financial view, and dentists should now agree as employees with no longer decision making. Another concern for many dentists is the inter-personal issues, that is, DSO manages patients as numbers or money while dentists might had used to treat their patients in personalized manner regardless of numbers and finances.

The key value of DSO is BRANDING. Dental practices, operated by 1 GP, 1 orthodontist and 1 periodontist, can coalesce and merge in 1 brand under a DSO, with similar gains of corporations or large organizations. However, similarly to the above-addressed concerns, not many dentists welcome getting involved with partners. Theoretically speaking, dentist mergers should have higher potential for expansion easily and readily because of the more specialties covered with different marketing approaches, and with less administrative hassle.

DSOs are currently capitalized on large private equity firms with end-career dentists who need to retire while keeping their businesses running. This approach was attractive not only to practices’ owners in large, multiple geographic areas but also to dental companies that seek for raise the purchasing power of their technology and products. The biggest challenges for DSO are marketing and operational costs. DSO should also maintain high quality of all its subsequent practices and, thus, need to upgrade dental offices in terms of equipment, website, scheduling systems, etc. In addition, running DSO requires a team including medico-legal lawyers, health-care workers as well as recruitment and financial specialists. It is worth mentioning that a typical DSO won’t be working only with dental practices but also with dental laboratories. DSO can have one central lab in each geographical area, to serve its subsequent practices in this area, or could additionally have the capacity to launch smaller dental lab inside each practice. The revolution of digital dentistry where most of lab work is done on computers, transmitted online and stored in data clouds enhances fully digital workflow between labs and practices.

A dentist before selling his/her practice to a DSO must seek for cultural fit and needs to determine how satisfactory a new dental regime with more profit motivation can be. In addition, a dentist must seek for recommendations from medical and legal advisory who can better identify the challenges in advance.