Are the DSOs really taking over?

May 8, 2017

There's been a lot of doom and gloom about the end of private practice-but is the future really so bleak?

Recent Dental Practice Management articles have identified a significant number of potential problems that dental private practice appears to have with the apparent takeover by DSOs.

They are better funded, organized, and staffed, while wielding buying power that we could never imagine in a solo practice. The growth of DSOs seems to be at a pace which would scare any dentist into thinking that the end of practice as we know it, is in its death knell. But is it really as bad as it appears to be? Can dentists find happiness in our profession without being part of a large dental conglomerate? Let’s take a look at the issues and see if it is all doom and gloom.

First, DSOs are all corporations and have all their employees follow rules, regulations and procedures ultimately structured for the corporation rather than the worker. I see ads all the time which promise high earning potential and benefits that seem a little inflated to someone already in practice. So how do they do it?

After talking with some recent grads that have lived the DSO model, the feeling they conveyed to me was that it was OK, but they would rather be in practice for themselves and were planning to get out of corporate dentistry as soon as the situation allows it. Their employer dictated the schedule, determined the dentist workload and strongly encouraged them to present services and procedures that may or may be in the best interest of the patient. Trying new materials and technology only happened when the powers that be decided it was good for the bottom line. In short, they were already burning out and felt somewhat disillusioned by the experience.

Second, dentistry is unique in that we are physicians, contractors and artists at the same time. We engineer and build things, alter appearances and make changes to the human body. It’s built into our genes that we will create and do it our way. This kind of fierce independence won’t stop any time soon and it could be the reason that there is a fairly high turnover of dentists in DSOs. Many of us still want autonomy and the ability to just do it our own way. That’s not corporate.

Third, private practice is a respite, for a significant number of people, from the new order we see in medicine which is turning more and more depersonalized. Patients tell me all the time they would never ever go to a DSO office and will always be a part of an independent practice where they are treated well and don’t feel like a number. DSOs are here to stay and will continue to grow over the coming years but the warning that they will take over dentistry as we know it just doesn’t fit in with I see.

Next installment: So how do we fight back?