The DSO landscape in 2021 and beyond: 3 experts weigh in

As dental practices adapt to changes brought by the COVID-19 pandemic and plan for the future, industry leaders must capitalize on key trends and upcoming opportunities.

Practices created in response to the pandemic may last years after the public health crisis ends. During an Oct. 20 session at Becker's Dental + DSO Review Virtual Event, a panel of experts discussed what dentistry will look like in 2021 and beyond.

Panelists included:

  • David Pegg, chief development officer at Sarasota, Fla.-based Dental Care Alliance
  • Daniel Burke, chief enterprise strategy officer at Irvine, Calif.-based Pacific Dental Services
  • Cotton Hawes, CEO at Leawood, Kan.-based Bright Tiger Dental

Here is an excerpt from the conversation, lightly edited for clarity. To view the full session on demand, click here.

Question: DSOs were gaining traction before the pandemic — what will the DSO landscape look like moving forward?

Mr. Hawes: There's a shift in how dentistry is being organized. More than $2 of every $5 spent in dentistry come directly out of the consumer's pocket, so that's a major driver in the industry. Funding sources for dentistry organizations used to typically be a bank or private equity — that's shifting. As the landscape becomes more consumer oriented, new funding sources are emerging. We're starting to see a number of new entrants into dentistry that are already affecting the industry. Consumers already have changing expectations. For example, consumers can go into a strip mall location and see better hours and accessibility and now expect that from the traditional dental office as well.

Mr. Pegg: Right now, we're starting to see vertically integrated delivery healthcare models that include dentistry, such as Walmart Health. The patient wants to be treated in totality, not have his or her issues compartmentalized. Over the last seven months the DSO landscape has begun to shift — the overall competitive landscape and discussions with prospective partners no longer focus solely on valuation. I look at the covenant that a DSO makes with its practices, including its doctors, their teams, the patients, and it's not exclusive to the times of stability and prosperity, but extends to times filled with adversity, such as the one we're operating in today. Moving forward, operational excellence steeped in experience and an unwavering commitment to the covenant DSOs make to practices is going to determine how dentists select their partner.

Mr. Burke: The pandemic has been one giant commercial for DSOs. It gives an example of the tangible value a DSO can bring. At PDS, more than 700 of our practices stayed open and I don't mean "if you call, we'll come in." I mean open. That took a massive amount of work — we had to change everything. We stood up tele-dental in four days and literally combed the globe for personal protective equipment. We loaded all the PPE onto a plane, flew it to the middle of the U.S. and PDS employees drove overnight, loaded up their cars and drove out to our practices. Then we had to let patients and emergency departments know we were open. We had calls with our dentists every day and were available for compliance calls because guidelines were changing so quickly. We had to be there to support our dentists so they could practice with confidence. It's the thing I'm most proud of in my professional career. There are fantastic, independent dentists out there, we all know that, but how could an independent dentist possibly do that?

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