By Dr. Tyler Scott, WCI Columnist

As part of my application to dental school, I was required to submit a signed paper showing that I had completed 100 hours of shadowing in dental offices as a way of demonstrating my commitment to the field and providing some real-world context for what I was attempting to sign up for.

I completed some of those hours with a younger dentist who was about eight years out of school in the major metropolitan area of Salt Lake City, some with various specialists along the Wasatch Front, and just a handful with an older dentist in the quiet and cold Cache Valley of northern Utah. While my time in the busy offices of the specialists and the younger doctor made me more excited to be a dentist compared to the relative inaction of my time up north, it is the sage words of that rural doctor, wizened by nearly 40 years of practice, that left the biggest impact on me as I started my dental journey.

On my way out of his office in the late fall of 2007, signed paper in tow, he put his hand on my shoulder and, with a tone of compassion and concern, he delivered a prescient warning:

“You are a fine young man, and I have no doubt you will succeed in this vocation that has been so good to me. But I can’t let you leave without telling you the winds of change are building for dentistry. By the time you are my age, I fear there will be precious few old men like me owning and operating their own practice and doing it on their own terms. The fiery corporate engine that built this modern world and whose flame consumes those that impede it is approaching on the horizon. They have already absorbed many of our medical brethren, and I believe it is inevitable they will likewise consume us in due time. This doesn’t mean dentistry can’t and won’t be a wonderful path for you. Just don’t think it will look the same tomorrow as it did yesterday and keep a good head about you when the heat starts to build.”

I had absolutely no idea what he was talking about or what to make of this foreboding tale offered up out of nowhere by Dr. Gandalf The Gray, DDS.

Well . . .  now I know, and all dentists know, exactly what the sagacious doctor was talking about. He was forecasting the precipitous rise of private equity into the dental landscape, a phenomenon with which our friends practicing medicine are already familiar. He was talking about the rise of the DSO.

Before we get into the nuts and bolts of the DSO world, let me be clear about my intentions for this column. This is not intended to be a comprehensive or complete analysis of the complex world of DSOs or the myriad variables any given dentist would consider when it comes to doing business with them. I am confident that most of you practicing dentists know much more about this than I do, and I defer to your knowledge and experience. Further, I welcome your participation in educating me and our peers based on those learnings and lived observations.

In short, I want to frame this conversation from a place of DSO neutrality. Despite Doc Gandalf’s warning, my goal is to neither advocate for nor dissuade from the consideration of partnering with or selling to a DSO.

 

What Is a Dental Service Organization (DSO)?

According to the American Dental Association, a DSO (Dental Service Organization) is an “entity that dental practice owners contract with to manage the administrative, marketing, and/or business sides of that dental practice.” In other words, a DSO is a company that says to a dentist: “Hey, we know you would rather do a root canal and a crown that you are really good at instead of dealing with HR, payroll, marketing, billing, and all the business stuff that you aren’t so good at or just hate. Let us buy into your practice, and we will handle all that stuff for you so you can just focus on being a great clinician.”

That is the right pitch to the right person.

It is an open secret that, by and large, dentists don’t enjoy and are not particularly good at the business side of dentistry. And who can blame us? Dental school provides zero meaningful business education despite saddling new graduates with monstrous student loan debt which alone requires a high financial IQ to navigate. Generally speaking, the predatory nature of the financial world with its legions of commission-based salespeople masquerading as financial advisors are all too happy to prey on this demographic of uninformed and unprepared business owners.

It can be scary out there in the business world for new and old dentists alike. It is no wonder that DSOs are on the rise with their very pragmatic value offering of removing the day-to-day administrative burden from dentists should they prefer to just focus on the oral health of their patients—an area that they know and understand and in which they excel.

More information here:

Why More and More Dentists Are Going ‘Out of Network’ — And Why That’s Actually Good News

A Dental Career Reimagined — I Thought I’d Be Rich But I Found Wealth in Another Way

 

How Does a DSO Work?

med school scholarship sponsor

When I say a DSO is a company, let’s refine that understanding. A DSO is really a private equity venture. Unburdened by the rigor and constraints of traditional lending from a bank (the historical norm in dentistry is a new dentist buys a practice from an old dentist by borrowing money from a bank), the investors in the DSO can simply buy equity in existing practices and implement their own business practices immediately.

The owner dentist gets a big chunk of money and relief from business-related stresses, and they get to keep practicing as an employee in a familiar setting. The dentist’s new employee salary is usually “market rate” based on local/regional averages, but there are often some strings attached to the timing or amount of the initial payout and/or the ongoing salary based on a contractual expectation that the practice maintains—or even increases—their production for a period of time after the sale. Most DSO contracts require the dentist to continue working in the practice for at least three years.

The DSO gets an equity share in an established cash flow-positive business and obtains varying levels of control over how the business is run going forward (every DSO and DSO contract is different). The equity position of the DSO is a majority share in most cases. Some states mandate that a licensed dentist be the majority owner, which occasionally requires the original owner to retain a 51% holding, but most DSOs work around this by having a licensed dentist as a shareholder and thus, speciously claiming that a dentist is the majority owner.

You can see why this is so appealing to the private equity world. You get ownership in and control over a historically inelastic industry without having to train, build, or borrow to get there. It is a plug-and-play investment that has both tangible property (real estate and equipment) and goodwill (the established patient base).

You can also see why it is so appealing to the dentist. They get a large infusion of cash, they get to drop a huge source of their professional headaches, and they get an (allegedly) guaranteed paycheck just workin’ the 9-5.

 

How Fast Are DSOs Growing?

Depending on where you look and who you ask, somewhere between 13%–23% of all dentists are currently working for or are affiliated with a DSO, giving them a current market size of ~$139 billion. Five years ago, the market share was ~5%-10% less than it is now.

The largest DSOs have been growing 13%-14% annually, and the overall growth rate is expected to be 17%-18% compounded annually each year between 2024-2030. The market share is expected to be over 30%-40% by 2030 with a market size of $454 billion-$761 billion.

There are somewhere between 100-200 DSOs backed by private equity right now. The largest controls more than 1,000 practices with the smallest owning only a few. You have probably seen or been treated at some of the big ones: Aspen Dental, Heartland Dental, Pacific Dental Services, Western Dental, Smile Brands, MB2 Dental, Affordable Care, or Dental Care Alliance.

While some of these, like Aspen Dental, are obvious to the public because they operate under the DSO-branded name, most patients being seen by a DSO don’t know it. You may say, “Oh not me, I’ve been seeing Dr. Anderson for years, and she owns and operates her own practice.” Well, that could be true. Or perhaps it just used to be true, and in fact, Dr. Anderson sold to a DSO a few years ago and continues to operate under the same practice name.

The point is that they are already everywhere, and they are growing fast.

More information here:

Is Dentistry Worth It? Comparing It to Being a Pediatrician, a Planner, and a Plumber

 

Why Are DSOs Growing So Rapidly?

To understand where this rapid growth is coming from, it’s important to acknowledge the economic forces that have been affecting dentistry recently.

  • Increasing overhead costs associated with staffing, infection control, and the technologies and materials that patients have increasingly come to expect.
  • Overall decreases in the patient utilization of dentistry. (It is true that 2021 and into 2022 was a good period with pent-up demand and patients having extra cash from COVID. But overall, patient visits are down compared to before the pandemic.)
  • Increasing cost of undergraduate and dental education (which is largely unnecessary and indefensible for dental schools).
  • Rising interest rates to borrow money for education, practices, equipment, and technology.
  • Reimbursements from insurance that haven’t gone up in years (or even decreased) despite significant inflation. (On a related aside, a future column will examine the profound financial value of being a dentist compared to most other medical providers due to the theoretical ability to raise fees at the rate of inflation, a luxury most physicians don’t have or can’t control resulting in less and less “real” income each year.)
  • Burnout and emotional exhaustion that lead to fewer patient hours and lower productivity.

These economic conditions affect dentists at different stages of their careers in different ways, but all conspire to fuel the growing DSO fire.

 

Why Do DSOs Appeal to Late-Career Dentists?

DSO private equity

As dentists get toward the end of their careers, there are typically two things happening at the same time.

First, they are looking to simplify their professional life. They want to keep doing the procedures they enjoy with patients they have come to know over many years, but they want to do them without the ever-increasing burdens of EMRs, HIPPA compliance, employment law, sterilization testing, recertifying radiographic equipment, website management, etc.

Second, they want to get as much for their practice sale as possible, as this often represents a meaningful portion of their retirement nest egg. Increasing profitability and finding a well-qualified buyer starts taking up more and more bandwidth in their minds.

A DSO can help with both of these concerns. We have already covered how a DSO lifts an administrative burden from the dentist, but let’s look at the two ways a DSO can help maximize the sale of the practice.

The first way is that the DSO purports to increase profitability by reducing overhead, implementing more efficient processes, and increasing marketing. This can all raise the metrics used to evaluate a practice at the time of the sale and put more money in the retiring dentist's pocket.

The next way is that DSOs can often pay more than a traditional new dentist buyer for the practice, because the DSO doesn’t have to rely on a bank for financing in the way a “regular” buyer does. The private equity firm already has the cash on hand. This is very appealing to a selling dentist in the same way a homebuyer is more likely to sell to someone with a cash offer, especially if that cash offer is a higher price than the person relying on lending would pay even if they got the loan.

 

Why Do DSOs Appeal to Mid-Career Dentists? 

The primary appeal to the owner dentist who is in the middle of their career is the immediate liquidation of locked-up equity and the promise of fewer admin headaches.

Many dentists in their late 30s to early 50s have several areas of their financial lives that would benefit from a large infusion of cash. They may have debt they are anxious to resolve in the form of student loans, practice debt, equipment loans, or building loans. They have kids who are about to go to college, and they have undersaved for their college funding goals. Many are looking to upgrade from their starter homes or make considerable renovations to their existing home. Others have woken up to how their delayed retirement planning has put them in a mathematical bind, and they now understand how a large lump sum investment into the market would aid in shoring up their retirement projections.

Many dentists in this group didn’t really understand the multitude of stressors awaiting them when they became small business owners over the last 10 years, and they have grown weary from the grind of spending increasing time “running and managing the business.”

Both of these motivators were evident when I informally polled my old OHSU classmates at our dental school reunion in the summer of 2023. In a room full of 40+ dentists mostly in their mid-30s to mid-40s I heard a lot of:

  • “I am so sick of handling staffing. The teeth stuff is fine; it’s the people that are killing me.”
  • “The practice is doing OK, but man, the rest of my life is so much more expensive than I expected. I’m just a lot more stressed about money than I thought I would be at this point.”
  • “If I have to rerun another denied insurance claim for a procedure I did four months ago but still haven’t been paid for, I’m going to completely lose it.”
  • “I swear, something is always broken. The autoclave, the website, the breakroom toilet, the air conditioner, the waiting room iPad, my hygienist’s pinky finger. It’s always something, man. There is no peace.”

The DSO offering to relieve some short-term financial stress and alleviate ongoing business tasks can be very appealing to this group of mid-career providers.

There is also a tax-planning strategy that can motivate practice owners to set up a DSO to support just their own practice. Many dentists do not benefit from the Qualified Business Income (QBI) deduction, aka the section 199A deduction, which is available to owners of “pass-through entities (i.e., sole proprietorships, LLCs, S Corps) because their taxable income is too high for the deduction and/or because dentistry is considered a “specified service trade or business” (SSTOB) and not a “qualified trade or business” (QTOB). Experienced readers will recall that only a QTOB qualifies for the QBI deduction when taxable income exceeds the limits ($191,950 for singles and $383,900 for joint filers in 2024).

Even though the clinical practice of dentistry is considered a SSTOB, the administrative services provided by a DSO (owned by the dentist) are not. A DSO is a QTOB, or at least it can be argued to be such.

Thus, the owner of a fairly large/successful practice may consider “carving out” the non-clinical portion of their practice and setting up a DSO as a pass-through entity (i.e. LLC). The practice would then contract with the new DSO and pay them as high a fee as is reasonably justifiable to perform administrative duties for the clinical practice.

Given that the QBI deduction is the lesser of either 20% of the DSO’s income or 50% of the W-2 wages, the DSO will need to pay its employees W-2 income. Any employee of the dental practice not providing clinical services is hired by and paid by the DSO on a W-2.

This gets very complicated very quickly, so if you are considering this, work closely with your tax professional. My point is that the QBI deduction (set to go away by the end of 2025) has been a motivating factor for some to give birth to their own DSO.

 

Why Do DSOs Appeal to Early-Career Dentists? 

Young dentists can be drawn to working with DSOs for reasons that are both practical and generational. According to the ADEA, 18% of graduating dentists intend to work for a DSO as their first job as a new dentist.

Pragmatically, young dentists are the most indebted of any professional demographic in America. The average dental student loan debt will surpass $300,000 for the 2024 graduating class. That’s an average, so for everyone getting out with $150,000-$200,000, there is someone else with $400,000-$450,000 in loans at ~7% with no option to refinance for much less at today’s rates.

They are then buying into one of the worst housing markets of all time with the silent pressure to buy a home “suitable for a doctor and their family.” That’s another $700,000-$1.2 million, often with 0% down on a doctor mortgage with a 6%-8% interest rate.

It’s not uncommon for me to encounter young dentists online, in social dental circles, or as clients that have between $1 million-$2 million in debt, and that’s BEFORE they have bought into a practice. It’s not hard to imagine why this hypothetical 28-year-old with a new baby and unproven real-world clinical skills may be reticent to buy a practice the “old school” way which can easily be another $600,000-$1 million, depending on the practice and its location. Some also have the chance to buy the building for another similar amount.

Enter the DSO offering a steady paycheck, benefits, and sometimes even the option to buy into the larger DSO conglomerate with its promise of 15%-25% returns in the years ahead. That can be a very appealing point of entry or a long-term career plan for a new provider who has already taken on seven figures of debt at 7% just for the opportunity to work and to have an overpriced roof over their head.

Furthering the pragmatic appeal is the common refrain from new graduates that, “DSOs are really my only option. It doesn’t seem like private practices are really hiring many associates, and if they are, I don’t know where to find them. But the DSOs do a lunch-and-learn every month and make it easy to apply.”

DSOs also tend to offer significantly more CE benefits than private practice. If a DSO is offering a new dentist $15,000+ of covered CE a year, that is understandably a tough benefit for a private practice to match and is a very appealing value add for a new provider who knows dental school was just the beginning of learning real-world dentistry. Now, often this CE is the DSO's own “in-house” CE, which may have all sorts of problematic considerations. But the allure is still strong.

Young doctors are also commonly heard saying, “The opportunity for leadership at the DSO is really exciting.” Many DSOs have a so-called “lead dentist” at each location, and from there, dentists can grow into different regional positions that pay more and require less time working in the mouth. Critics paint this as a glorified dental MLM, as lead dentists hire more associate dentists and get to keep a portion of the associates’ collections. But new grads can find the idea of moving up the dental corporate ladder to be very appealing.

In short, it’s not uncommon to hear something like this from current and former DSO-affiliated dentists talking to the next generation at a dental convention happy hour: “If you can find the right one, they can be a great place to get a lot of CE while you figure out where to go next.” This begs the question: how do you find the right one? It's a question I’m hoping you can collectively answer.

There is also a generational component at play for young providers. Most of the Gen Z dentists I talk to are not looking to work full-time until they are 70 (yes, the average retirement age for dentists has crept up from 65 in 2001 to 69 in 2018). They have seen their peers take six-figure jobs working from home, flexible work schedules, and great benefits. They have seen the toll that burnout has taken on the Gen X and Millennial dentists ahead of them, and they have a stated desire to achieve a more thoughtful work-life balance.

In short, they are much more inclined to “work for the man” than previous generations. I’m sure that concerns and/or irritates the older generation of dentists reading this. I’m not endorsing it; I’m just reporting the trend.

If you feel inclined to offer up a multi-paragraph soliloquy in the comments about how you put your nose to the grindstone and boot-strapped your way to $1 million of collections in your fee-for-service practice, and, thus, you view dentistry as an unassailable path to wealth and a sustainable work-life balance for anyone that will just work as hard as you did with as much business acumen as you obtained . . . feel free to do so. It will likely be impressive and inspiring to many. I just fear that those anecdotal stories, inspiring as they may be, are not representative of the vast experiences of most dental graduates over the last 10 years, and it's not what awaits most new graduates. Instead, these stories can often serve to distract from the difficult decisions this current generation is facing as they enter this profession we can be so passionate about and so defensive of.

More information here:

Leaving Dentistry and Finding Happiness

 

What Are the Different Kinds of DSO Deal Structures?

DSOs are not all the same; several types of DSO-structured agreements suit different goals for the owning dentist.

 

100% Affiliation

This is simply where the dentist sells 100% of the practice to the DSO. The dentist may stick around and work in the practice focusing only on the clinical side for a few years or just step into retirement.

 

Joint Ventures

In a joint venture model, the dentist sells 60%-90% of the equity in the practice to the DSO. Typically, the dentist receives 70% of the sale price upfront (see the cons section below for more on how the sale price is established), and the remaining 30% is paid out over three years at 10% each year if predetermined profitability targets are achieved. If not, the dentist will get a prorated amount of that last 30% or not get it at all based on the terms of the contract (which most dentists do not read carefully or understand). In this model, the dentist typically retains clinical control over the practice. However, note that the dentist has given operational control over to the DSO but is still responsible for profitability targets to receive the remaining portion of the sale price over the next three years (more about this in the cons section below).

The DSO and dentist then proportionally share in the profits of the practice going forward. Sometimes, the dentist leaves after the mandatory three-year work-back period, and sometimes the relationship goes forward indefinitely.

 

Equity Roll

This arrangement is not a partnership; it is a group affiliation. The idea is that the owner dentist sells 100% of the practice equity and then “rolls” a portion of the proceeds to purchase equity in the broader DSO as an investment.

 

Sub-DSO

This structure can be thought of as a joint venture and equity roll blend. The practicing dentist who owns the business gets paid a large upfront payment, exits the transaction without debt, and maintains 40% ownership and profit-sharing from the broader sub-DSO portfolio.

 

Non-Captive DSO

In this arrangement, the dentist doesn’t sell equity at all. Rather they contract with the DSO for certain non-clinical support in exchange for 3%-6% of gross revenue.

 

Direct Investment with Private Equity

This is where the dentist doesn’t mess around with an existing DSO but rather becomes a founding member of a new one. The dentist who typically would have a fairly large/successful practice purchases ownership within an operating company. This direct investment can be a buyout with controlling interest transferred to the investor or it can be a minority growth investment.

 

Pros of DSOs

We have covered the appeal and potential advantages of a DSO as we have moved through the basic orientation already covered. To recap:

  • DSOs provide the dentist the ability to focus on clinical dentistry and reduce/eliminate the administrative burden of running a small business.
  • DSOs give dentists a chance to recognize partial or full liquidity of the equity in their practice. This can sometimes be at a higher price than they would have otherwise received, sooner than they anticipated receiving it, and/or receiving it with less hassle compared to more traditional buy-sell agreements.
  • DSOs can represent an investment opportunity for the selling dentist as they become shareholders in the broader private equity venture.

 

Cons of DSOs

Anecdotally, I hear a lot more stories filled with regret, frustration, or outright rage when it comes to DSOs than I hear stories centering on relief, excitement, and gratitude. Internet forums; podcasts; clients; and my dental colleagues, classmates, and friends have left me with a wary eye toward this growing trend.

That may be simply because people are more likely to tell or remember a negative story than a positive or neutral one (the one-star review section of Google, Amazon, or Yelp will reveal how strongly and loudly people are willing to share a bad experience compared to the three-star review section where most people don’t take the time to share a “meh” experience). My hope is that dentists who have had DSO interactions will share those experiences in the comment section below: the good, the bad, and the in-between, so we can all get a better sense of how this is going for folks out there.

Whether my personal observations are reflective of the broader dental field’s interactions with DSOs, it’s worthwhile to take a minute to review some of the chief complaints that are shared and documented across the dentalverse.

 

Decreased Quality

Remember that higher profitability the DSO offered with more efficient processes? Well, one of those more efficient processes can be that the DSO gets to buy dental materials and equipment at a discount because it is buying in bulk for all of its practices. This can mean that if you have a filling material, dental lab, or brand of instruments you like, you may not get to keep using that stuff, and you may feel your clinical quality suffers as a result.

 

Decreased Customer Service

Many patients have started to notice and complain about how challenging it is to get ahold of their dental office. The overall trend of businesses hiding or eliminating their phone number to cut costs related to the expensive act of 1:1 communication with customers is finding its way into dentistry as corporate “efficiency practices” are implemented by DSOs. Patients looking for a phone number to call on the practice website are increasingly being routed to AI chatbots, centralized chat teams not located at the specific office the patient visits, or sent a page where they are “asked” (forced?) to email their question.

Where phone options do exist, patients are encountering ever-maddening phone trees that in no way resemble having “Becky-the-nice-front-desk-lady” pick up the phone to which they are accustomed. Even dentists trying to do a “doc-to-doc” consult can spend 5-10 minutes navigating an automated phone system which continually pushes them away from the dentist and back to the front desk or “trunk” of the phone tree where they are given the office hours, address, fax number, and option to “conveniently pay an existing balance by using your touch-tone keypad.”

 

Change in Benefits

Remember how you didn’t want to handle HR, payroll, and benefits anymore? Turning that over to a DSO often means you and your staff are getting a new benefits package. Maybe this represents an improvement, or maybe your staff wants to burn the building down because they just saw their medical premiums jump 30% and they lost their favorite doctors.

Also, if you were an owner with a profit-sharing 401(k) and you had become accustomed to maxing out your contributions at the 415(c) limit each year ($66,000 in 2023 and $69,000 in 2024), having that limit drop to $23,000 in 2024 as a “regular” W-2 employee could represent a major change to your retirement planning and certainly to your tax bill. Similarly, your access to an HSA may go away, as could your staff’s access to fringe benefits like free or reduced treatment in the office.

 

Trading Admin for Clinic Time May Result in More Clinic Time Than You Realize

Remember that three-year workback period where the dentist is responsible for the profits of the practice? You got 70% of the sale price upfront, but the DSO is holding back that 30% and may be asking you to carry the note. What if there is a recession, what if you get sick/disabled, what if there is a pandemic? How is your profitability going to look in those scenarios? What if changes to staff pay and benefits result in an exodus? How will your profits look using new filling materials, new labs, new dental assistants, and new hygienists?

Also, the DSO often adds a 5%-15% management fee for its implemented admin services that reduces your net income. You must “maintain” your presale profitability, but with the added management fee, you actually have to increase your production to keep pace and make sure you get that full 30% for which you were planning.

 

Sales Price Can Be Difficult to Understand

Often dentists are pretty excited when they see the price being offered for the equity in their practice. I have heard things like, “They are offering above market price,” or, “I’m going to get over 100% of last year’s collections.” Maybe that’s true; maybe you didn’t read and understand the fine print.

It’s not unusual for DSOs to make an offer based on a popular pricing method in the private equity world known as EBITDA (Earnings Before Interest, Tax, Depreciation, and Amortization). EBITDA is not always calculated the same, and it can be manipulated by the DSO in ways that don’t exactly favor the dentist. Remember, while you were in your first year of dental school learning the Krebs cycle for the 33rd time and finding eosinophils in a microscope, these people were working on Wall Street in hedge funds and corporate law offices. It’s important to keep that in mind in these moments. Some dentists believe they sold their practice for 4-6x of EBITDA, but in reality, the DSO manipulated the math based on the note the dentist will be carrying and the management fee. Thus, the actual sale price is nowhere near what the dentist was led to believe.

 

Loss of Autonomy

This is implied in everything we are talking about, but it’s worth saying out loud. You didn’t want to be a business owner making all the decisions, and that’s exactly what you will get. You are now an employee with limited or no decision-making authority. That reality cuts both ways: less deciding and less control. It is not uncommon to hear about dentists who just bail on the last 30% of the sale agreement because the lived reality of working for someone else wasn’t the greener grass they dreamt it would be.

More information here:

Freedom from Student Loan Debt: A Dentist’s Story

 

The Bottom Line

My primary motivation for writing this column was to create a page to aggregate some basic information about DSOs and, more importantly, create a forum for discussion. I wanted there to be a useful search result when a future dentist types DSO into the search bar on this website where they can learn from what you have to offer.

While I am certainly skeptical of some of the business practices I have read about and observed, the truth is that I am agnostic on DSOs. Perhaps more accurately, I feel pragmatic about them.

This is a thing. It’s going to be a bigger and bigger thing every year, so we have to wrap our heads around how they work and start talking as a group about what the impacts and implications will be.

For example, do you know any pediatricians who are finishing residency, hanging a shingle, and running a fee-for-service individual practice? How about any solo pharmacists running their own pharmacy? Yeah, me neither, but I do see a lot of CVS and Walgreens around, and when I take my kids to the doctor, I notice it’s operated by an enormous regional medical conglomerate, not by ole Dr. Fred.

We don’t have to imagine what this will probably look like for dentistry 20-40 years from now; the history of modern medicine sheds a great deal of light on what some of the outcomes are likely to be.

It’s still early in the DSO era, but as Doc Gandalf once told me, the winds of change are blowing harder every day and the corporate flame is cresting on the horizon. Dentistry certainly won’t look the same tomorrow as it did yesterday, and it’s time to keep a good head about us as the heat builds ever warmer.

Do you have experience with a DSO or other private equity? Is this good or bad for the future of dentistry and medicine? Comment below!