Although the number of dentists affiliated with DSOs has increased over the years due to the benefits these partnerships provide, many dentists still see the advantages of remaining in private practice.
Three dentists recently spoke with Becker’s to discuss the competitive edge private practices have over DSOs in today’s industry.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: In what areas do private practices still have a competitive edge over DSOs?
John Lucia, DDS. Lucia Family Dentistry (Rochester, N.Y.): I believe that private practices are built upon long-term relationships with their patients, often spanning multiple generations of families. The trust that is built has been established over years, and sometimes, even decades. There is no business model that can compete with the good will of a private practice. You can talk about metrics all you want, and conversion rates of case acceptance, but there is nothing that can replace a trusting dentist-patient relationship. When this is the case, treatment recommendations are followed through; there is no need to upsell. It is truly healthcare, not healthcare disguised as revenue generation. This is how private practices have a competitive advantage.
Sonalika Rungta, DMD. Dentist at Thompson Smiles (North Grosvenor Dale, Conn.):
1. Better patient relationships
- Patients often see the same dentist for years.
- Higher trust leads to stronger retention and referrals.
- Treatment acceptance is often higher because of continuity of care.
2. Clinical autonomy
- You decide treatment plans, materials, labs and scheduling.
- No pressure to meet corporate production metrics or standardized protocols.
3. Flexibility
- You can quickly adopt new technology, adjust fees, change office hours or add services without corporate approval.
- Faster decision-making can create a competitive advantage.
4. Higher long-term wealth creation
- Practice ownership builds equity that can be sold.
- A profitable practice can appreciate significantly over time, especially with strong EBITDA and collections.
- Owners also benefit from profits after expenses, not just clinical compensation.
5. Team culture
- Smaller teams often have lower turnover when leadership is strong.
- Staff may feel more connected to the practice’s mission.
6. Local reputation
- Independent practices become part of the community.
- Community involvement and word-of-mouth can be difficult for larger organizations to replicate.
7. Greater income potential
- A productive owner-dentist frequently earns more than an associate dentist because they receive both clinical income and business profits.
- Efficient practices with good systems can achieve excellent margins.
Joshua Sun, DMD. Albuquerque (N.M.) Periodontal & Implant Specialists: I worked for a DSO for five years. They accepted all PPO insurances, but some insurance reimbursement rates were extremely low, and [I] had to work harder. The company cared more about production than the quality of services. Doctors had to follow the rules of the front desk persons, [and there was] no team culture.
I have been in private practice for the last seven years. Fee-for-service, [I do not] have to work harder for that production, 100% autonomy, front desk persons help doctors, and it is a team.
At the Becker's 5th Annual Future of Dentistry Roundtable, taking place September 14-15 in Chicago, dental leaders and executives will gain insights into emerging technologies, practice growth strategies and the evolving landscape of dental care delivery, with a focus on innovation, patient experience and operational excellence. Apply for complimentary registration now.
