DSO Blog

The Playbook for Maximizing Your Practice’s Value (And Avoiding the Fire-Sale Trap That’s Costing Dentists Millions)

Written by Everything DSO | Sep 25, 2025 1:00:02 PM


Most dentists think their practice is worth more than it is.

They convince themselves:

  • “I’ve worked too hard for this not to pay off big.”
  • “We do $2–3 million in collections, so I’ll get top dollar.”
  • “Any DSO will line up to buy me.”

And then the offers come in.

That $10 million payday you pictured? It’s $6. That $5 million you counted on? It’s $3.

Why? Because you walked into the negotiation unprepared. You didn’t know the rules of the game. And when you don’t know the rules, you don’t just lose—you get slaughtered.

The Fire-Sale Trap

Here’s the harsh truth: DSOs and private equity buyers don’t pay for sweat equity. They don’t care how long you’ve been in practice, or how much you sacrificed to get here.

They pay for profitability, scalability, and systems.

If your financials are sloppy, if your hygiene department is underperforming, if your associate contracts are weak—you’re not worth what you think you are.

That’s how dentists who should be walking away with life-changing money end up settling for half of what they deserve.

It isn’t because the DSO is “evil.” It’s because you didn’t maximize your value before you sold.

The Playbook: How to Build Maximum Value Into Your Practice

If you want to cash out at the highest multiple, you need to think like a buyer. Here’s the checklist:

  1. Clean Up Your Books

Buyers pay for clarity. Messy QuickBooks files and “creative” accounting slash your value. Get your financials cleaned up, audited if possible, and make sure every dollar of EBITDA is easy to see.

  1. Lock In Associates

DSOs want stability. If your associates are on handshake deals or ready to bolt, your value tanks. Formalize contracts with non-competes and retention bonuses.

  1. Supercharge Hygiene

A weak hygiene department is a red flag. Buyers see it as untapped potential they won’t pay you for. Boost recall systems, expand hygiene production, and prove your systems work.

  1. Cut the Fat

Excess overhead doesn’t just eat your profits—it kills your multiple. Streamline expenses, renegotiate vendor contracts, and show that your practice runs lean and profitable.

  1. Build Systems, Not Personality

If your practice only runs because you run it, you’re not selling a business—you’re selling yourself. DSOs won’t pay top dollar for that. Build documented systems for scheduling, billing, marketing, and patient flow that don’t depend on you.

  1. Nail Down Real Estate

If you own your building, get it appraised and decide if you’ll sell or lease. If you rent, negotiate favorable terms with options to extend. Buyers hate uncertainty in real estate.

  1. Document Patient Loyalty

High patient retention and recurring revenue streams (like memberships or wellness plans) boost value. Show the data. Prove patients stick.

The Brutal Bottom Line

A dental practice is either a gold mine or a fixer-upper. DSOs pay gold mine prices for turnkey, profitable, systemized practices. They pay fixer-upper prices for chaos.

If you don’t do the work to maximize your value before you sell, you’re volunteering for the fire-sale trap.

And once the deal is done, there’s no going back.

What This Means for You

The biggest check of your career isn’t earned in the sale—it’s earned in the years leading up to it.

Clean up your books. Lock down your associates. Build systems that run without you. Do the hard work now so you can walk away with the payday you deserve later.

Because when the time comes, you’ll either be celebrating—or wondering why you just left millions on the table.

To your unstoppable success,
Your Team at Everything DSO