Dentistry is under pressure from nearly every direction. Reimbursement continues to trail inflation, staffing remains a constant challenge, AI tools are reshaping operations and the DSO deal market has entered a more disciplined era.
But at Becker’s 5th Annual Future of Dentistry Roundtable in Chicago, a consistent message emerged: The organizations best positioned for what’s next are the ones getting the fundamentals right. That means investing in their people, fixing broken processes before automating them and knowing when to walk away from a deal.
Here are a few of the standout quotes from the roundtable’s sessions.
Editor’s note: Responses have been lightly edited for clarity and length.
Culture and the team
Tarun Agarwal, DDS. Founder and Dentist of Raleigh (N.C.) Dental Arts: One of the things I try to stress to young dentists is your customer isn’t the patient. Your customer is the hygienist and the assistant and the front office team member. Ninety percent of all the dentistry that a young associate does comes from the innate trust that a hygienist or an assistant or a front office person has for you. So when you teach them to make the team the customer, the patient will naturally follow.
Sherry Hassler. COO and EOS Integrator of Today’s Dental Nebraska (Omaha): As a culture, we have an understanding with all of our team that we do not make policy decisions off of a one-time thing. Yes, the AI program made a mistake, but so did Sally at one point. We didn’t take Sally out behind the woodshed and shoot her, so we’re not going to shoot our AI receptionist. It’s a culture of failing forward.
Jason Lockwood. President and CEO of Flagship Specialty Partners (Charlotte, N.C.): I made a big mistake once. We bought a practice, and I was in front of all the employees, who found out the day after the deal closed. I thought it was going to be soothing to them, saying, “Hey, nothing’s really going to change.” Worst words I ever could have uttered, because I never got to live those down.
Sami Webb, DDS. CEO of Epic4 Specialty Partners (Scottsbluff, Neb.): We can open new offices. We can buy new equipment, but we can’t just manufacture an orthodontist or pediatric dentist. So for us, this is a provider problem, and it’s really about finding those quality doctors that we can make long-term partners, make owners and then retain.
Patients and practice operations
Jaleh Pourhamidi, DMD. COO of Today’s Dental Network (Tampa, Fla.): Revenue cycle management is a big one. That’s one of my top things that I lose money on, because you’ve done the work. You just haven’t collected the money. That is the worst business model I’ve ever heard of. It’s almost like we’re embarrassed to collect the money from the patient, and to me, that’s insanity. You don’t go to a dermatologist and walk out without paying, and the dermatologist isn’t embarrassed to ask you to pay that day.
Dan Romary. COO of Certify Health (Washington, D.C.): The DSO that I work for, we keep the local branding of all those practices. We don’t brand them as a large DSO corporate name. We let them preserve their local place in the community, because I don’t go to the dentist; I go to Dr. Smith. My family goes to them, and I trust that doctor. That part of the culture is so important to preserve, because that’s where we get the value.
Robert Rubino. CEO of Qualitas Dental Partners (Sharon, Mass.): If you’re spending $60,000, $100,000 or $150,000 a year in marketing your practice, and you’ve got two years of unscheduled treatment, then you’re spending your time in the wrong place.
Stefanie Salerno. Director of Revenue Cycle Management at Aligned Dental Partners (Sarasota, Fla.): One thing I really want to stress is you don’t want to automate a broken system. You want to make sure that you have a good process first. Otherwise, you’re going to throw technology at something that’s already not working properly, and you’re not going to see those returns. You’re going to have frustrated doctors. You’re going to have frustrated patients.
Strategy and the business of dentistry
Manu Chaudhry, DDS. President of Capitol Dental Care (Salem, Ore.): Regardless of whether we’re talking about Medicaid or any type of insured, there’s just less money in the healthcare system. It took me a good six months of reflecting after the signing of H.R. 1 to come down to that bite-sized nugget. It’s not that people don’t want to give us more money to do what we do. It’s just that there’s not enough money to hand out to do the stuff that we do. So we need to think about how we do dentistry differently.
Joe Feldsien. President of PDS Health Medical (Henderson, Nev.): The dental industry, by and large, is undervalued. There’s an incredible opportunity for all of us to create additional value, and it’s not that hard. It’s one or two additional things. But create that additional value, and we will have more demand than we have capacity to fill. And frankly, we will have a far greater impact on outcomes than we ever imagined.
Matt Hendrick. Co-founder of Elevate Dental Partners (Denver): I came from the investing side originally, and one of the first things I was doing was looking at DSOs. The analysis was literally: Is your EBITDA post-corporate greater than the sum of all the practices that you’ve acquired? If it is, that means ideally you are benefiting from the corporate scale or centralization that you’re putting in place. That was the litmus test we had: Is this working? So we always keep that lens in mind whenever we’re looking at whether this was a productive use of centralization or not.
Ellen Polsky, DDS. CEO of DashCare Group (Seattle): Anybody in our organization, from the dental assistant to the admin team, knows that the data needs to come into that system clean, because it took us three years to clean out our database to get AI ready. So everybody has to have buy-in internally. Otherwise, it’s not going to work, and the resistance will be there. Nobody likes change.
Mike Rice. CEO of Phase 1 Equity (Chicago): Just like with acquisitions, you have to have the ability to walk away. If you don’t walk away, you’re not going to be doing good acquisitions all the time. And I think the same thing goes for markets and your playbook. You have to be able to say, “We put a lot of time and energy here, but I don’t think the benefits are going to outweigh the risks here, and it’s time for us to pick up our bags and try something else.”
