Dear Reader,

So, you’ve inked the deal. You’ve sold your practice—or at least part of it—to a Dental Service Organization (DSO). Maybe you’ve got a hefty check sitting in your bank account, or you’re holding onto some promising equity. Congratulations. But as you sip that celebratory glass of champagne, a question might creep up: “Now what?” Well, let’s talk about what post-transition life really looks like. No fluff, just the real-world changes you can expect.

Day-to-Day Operations: What’s Staying, What’s Changing?
First things first—don’t expect to walk into the same exact practice the morning after the deal closes. Sure, your name might still be on the door, and familiar faces will greet you. But change is coming. How much change? That depends on your deal. Here’s what I’ve seen time and again:

Dear Reader,

You’ve probably noticed the rumblings by now. Conversations at conferences, articles in the industry journals, whispers from colleagues who’ve “made the leap.” Dental Service Organizations—DSOs—are no longer just a growing trend; they’re transforming the entire industry. And if you’re a private practice dentist, this isn’t something you can afford to ignore. But what does it really mean for you and your practice?

Let’s get clear on the facts. Today, roughly 20% of dental practices in the U.S. are affiliated with DSOs. That number is projected to grow to 50-65% in just a couple of years. This shift isn’t about hype; it’s driven by cold, hard economics and industry realities. Wall Street has taken notice, with investors seeing DSOs as a steady, profitable bet. And here’s the kicker: new dentists, saddled with astronomical student loans, are opting for salaried positions over ownership. The result? More DSOs, fewer solo practices.

Dear Reader,

Let’s talk about a topic that often gets brushed under the rug in the excitement of signing a lucrative DSO deal: the pitfalls. Believe me, I’ve seen it all. From the dentist who thought a handshake was enough to guarantee post-sale autonomy, to the staff blindsided by new policies and patients jumping ship. These horror stories are avoidable—if you know what to look out for.

Case Study #1: The “Handshake Agreement” Nightmare
Dr. Smith (not his real name) ran a highly profitable practice. When a DSO came knocking with a juicy offer, he jumped. The deal was rushed. “Don’t worry,” they said. “Your terms will stay the same.” Spoiler alert: they didn’t. Dr. Smith lost decision-making power, struggled with rigid policies, and eventually left disillusioned.

Dear Reader,

Let’s put aside the shiny brochures and slick presentations for a minute and get down to brass tacks. Joining a Dental Service Organization (DSO) is a financial decision that will ripple through every aspect of your life—personal and professional. I’m here to make sure you walk into this with your eyes wide open. We’re talking taxes, buyouts, and financial structures that can either set you up for a golden retirement or leave you wondering what happened. So, buckle up.

Dear Reader,

Let’s cut through the noise, shall we? When it comes to partnering with a Dental Service Organization (DSO), most of the chatter focuses on dollar signs, buyout structures, and EBITDA multiples. And while money matters—let’s be honest, it matters a lot—there’s another element that can make or break your transition: cultural fit.

If you think culture is just a “feel-good” buzzword, think again. I’ve seen what happens when dentists ignore it. They walk into lucrative deals only to find themselves miserable, frustrated, and trapped in a partnership that doesn’t reflect their values, their approach to patient care, or their legacy. I’m here to help you avoid that fate.

Dear Reader,

Let’s have a heart-to-heart about your future. You’ve likely spent decades building a practice. You’ve put in the long hours, managed every curveball that came your way, and served countless patients. But now, the idea of retirement is creeping up—maybe sooner than you think. The question is: Will your practice be a bridge to the retirement you’ve dreamed of or a missed opportunity? Enter the role of Dental Service Organizations (DSOs) in your exit strategy.

Here’s the truth: planning your exit isn’t just about selling a practice for a lump sum and riding off into the sunset. It’s about long-term financial security, preserving your legacy, and maximizing what you’ve spent a lifetime building. Done right, a DSO transition can be the key to a prosperous, worry-free retirement. Done wrong, it can leave you feeling shortchanged. Let’s dig into how to make sure you get it right.

Dear Reader,

Let’s be honest: the thought of negotiating a deal with a DSO can make even the most seasoned clinician sweat. You’ve built a successful practice, maybe over decades. And now, you’re considering selling part—or all—of what you’ve created. The stakes couldn’t be higher. The good news? With the right strategy, you can secure a deal that doesn’t just fill your bank account but aligns with your personal and professional goals. Let’s walk through how to do it right.

Dear Reader,

A DSO, or Dental Service Organization, is like a powerhouse behind the scenes of a dental practice. It’s a business model where the DSO handles the non-clinical parts of running a practice—everything from marketing and billing to HR, compliance, and even securing the best deals on equipment and supplies. In other words, they take over the operational side of things that frankly, let’s be honest, is often a huge hassle for dentists.

So, if you’re tired of spending your valuable time on paperwork, hiring staff, chasing insurance companies, or balancing the books, a DSO partnership could be what you need. Imagine focusing entirely on patient care, enjoying the clinical side of your practice without the constant distractions.

Dear Reader,

You’ve built a great practice. You’ve put in the years of hard work, and now, you’re enjoying the fruits of your labor. The income is good, your patients love you, and dentistry still brings you joy. So why on earth should you even consider joining a Dental Service Organization (DSO)?

Here’s the thing—joining a DSO doesn’t mean you don’t have a great practice. It doesn’t mean you’re giving up control or walking away from what you love. In fact, for many dentists like you, it’s the exact opposite. It’s about securing your future, enhancing your freedom, and getting more out of what you’ve built without sacrificing what makes your practice great.

Let’s break it down.

Dear Reader,

In a traditional doctor-to-doctor sale, the ultimate driver of the transaction is simple: how much a bank is willing to loan to the buyer. And here’s where the problem lies: banks are conservative. They’re not looking at the future potential of your practice or its true profitability. Instead, they’re looking at risk—how much risk they’ll have to take on when financing the sale.

What does this mean for you? It means that when you sell your practice to another dentist, the value is typically undervalued. The buyer has to rely on a loan, which is based on the current revenue and assets of the practice, with little to no consideration of its long-term growth potential or profitability. Banks simply don’t take those things into account—they care about protecting themselves, not maximizing the value of your practice.