The biggest challenges DSOs are up against

Recruitment, competition and maintaining consistency of patient experience are some of the hurdles DSOs must navigate as their popularity surges.

Seven dental leaders weighed in to answer: "What is the biggest challenge DSOs are up against?"

Editor's note: These responses were edited lightly for clarity and brevity.

Scott Asnis, DDS. CEO of Dental365: The perception that DSOs don't care about achieving excellent clinical outcomes. As a dentist-led company, we are always striving to achieve great outcomes. We have a saying at D365: dentistry is hard, doing great dentistry is even harder.

John Button. CEO of CollectiveCare Dental: Providing outstanding oral healthcare to every patient is what we strive for each day. The lingering effects of the pandemic have impacted DSOs with a shortage of highly qualified people looking for work as well as significant cost increases in both materials and labor. This comes at a time when insurance reimbursement from some large plans has been decreasing. This provides both challenges and opportunities for DSOs, as their size and scope of services provides better "staying power" to find resolution than smaller practices might have.

Paul Madsen. CEO of Prime Dental Partners: There are many challenges ahead for a DSO of any size. If I had to focus on just one, it would be the importance of creating and maintaining a positive work environment for all our staff. It seems the larger we grow, the more critical it is to have a healthy work environment where every team member has a role and responsibility to serve our patients. We strive to ensure we always live up to our mission, vision and values.

Tom Marler. President and CEO of Sage Dental: One of the most challenging aspects of managing a successful DSO is ensuring consistency of brand and patient experience across all office locations. At Sage Dental, for example, we've worked hard to make sure that no matter which of our 82 offices a patient walks into, they will experience the same high-caliber care, cutting-edge technology, and streamlined scheduling and billing experience. This includes ensuring all our offices are outfitted with teledentistry and tele-orthodonture capabilities, online patient portals for appointment scheduling and bill pay, and other dental service innovations like intraoral scanning, digital X-rays and more. We also employ [artificial intelligence]-aided diagnostic technology from Pearl called Practice Intelligence, which helps ensure patients receive consistent diagnoses, no matter which Sage office or provider they receive care from. These offerings not only keep patients coming back, they also ensure patient trust in their provider and help our dentists and hygienists establish long-term, meaningful relationships.

Trevor Maurer. CEO of OMS360: DSOs are growing rapidly, faster than most other healthcare sectors and we are all competing for the same talent. Finding the very best leadership, doctors and team is increasingly difficult. Move that challenge up the ladder one rung, hiring recruiters to lead those searchers is now even more difficult. The right talent is a competitive advantage, but so is the right recruiter helping you to find that talent.

Norton Travis. CEO of Prohealth Dental: The recruitment of clinical staff remains a challenge throughout the industry. However, the significant impact of inflation may actually send more dental staff candidates back to work in the same way that it is causing many dentists and other healthcare professionals to defer retirement. However, we must assume that inflation and the reduction in disposable income may cause consumers to defer elective procedures (and other discretionary expenses), as can already be seen by the increased number of appointment cancellations. Unlike smaller practices, DSOs have greater economies of scale to weather the current impact of inflation. Despite these challenges, I remain confident that Prohealth Dental's model of affiliating with large medical groups and hospital systems that promote the importance of oral health to their patients will continue to give us a market edge in attracting and retaining new and existing patients.

Stephen Thorne. Founder and CEO of Pacific Dental Services: The increased competition for team members. The growth in group practices, DSOs and new private equity-backed groups has caused some of the most intense competition for dentists, hygienists, operations managers and others that I have experienced in my 34 years. Some of the things I have seen are undisciplined approaches to supporting successful dental practices and could ultimately have a negative effect on our industry that we've all worked so hard to create.

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