More job openings, greater efficiency and improved patient experience are three impacts dental professionals have seen as a result of consolidation.
Here, dentists and executives answered the question: What impact has consolidation had on the dental industry?
Editor's note: Responses have been lightly edited for clarity and length.
Chris Anderson. Chief Compliance Officer of Rock Dental Brands (Little Rock, Ark.): Good on the overall market. My estimation that dental lags behind in the medical industry, meaning what was good for the physician market is now true for the dentist market. A lot of individual dentists are going to feel tighter pressures from payers, both federal and commercial.
Deborah Brown, DMD. CEO of My Community Dental Centers (Petoskey, Mich.): Consolidation has led to larger dental practices with more dentists working together. This trend works well in areas where there are high rates of dentists, but in rural areas it can cause an access to care issue. When private practices close and the owner joins a group practice outside of the area, that leaves a gap in care. Consolidation will create more purchasing power for supplies and a greater ability to hire dentists by offering enhanced benefits packages and the latest technology. There are definitely pros and cons to consolidation, but it appears this trend is likely to continue into the future of dentistry.
Kevin Cumbus. President of TUSK Partners (Charlotte, N.C.): I think consolidation has made the job market much better for graduates of dental school. Ten years ago, if you wanted a job, you had to find a dentist looking for an associate. Those opportunities are still available, but every DSO in the nation is hiring as well.
Baroui Deirmenjian, DDS. Smiles West (Mission Hills, Calif.): Consolidation is good for the dental industry. We will always have the boutique private office out there for people, but the consolidation is also good for doctors to be part of a larger group and being able to take advantage of the benefits of the economies of scale.
Scott Dudley, DMD. CEO and Founder of Branin Partners (Denver): Consolidation has resulted in fewer doctors who have ever owned or run businesses. Doctors who are employees and only working via contract are less likely to be around next week, next month and next year. Doctor churn is more likely to result in unstable office cultures, higher staff turnover and therefore less patient loyalty. This will put pressure on marketing and advertising campaigns, and their relative budgets, to attract and rely on a consistent supply of new patients.
Martin Dymek. CEO of Navigate Surgical Technologies (Vancouver, British Columbia): In the past, new technology and innovations had to be introduced one practice or dentist at a time, a very slow, time consuming and inefficient process. Now, with the proliferation of DSO networks, the delivery of dental care at hundreds if not thousands of dental practices can be influenced through a single point of contact, allowing a more rapid adoption of innovative clinical solutions that benefit the patient, the individual dentist and the entire DSO network. The value of proprietary digital and AI-driven solutions and workflows is not lost on the large dental companies, DSOs and private equity firms with a vested interest in dental. They will increasingly strive to consolidate smaller tech companies to "own" end to end digital solutions that accelerate the growth of their core business.
Elliott Feldman. President of Empower DDS (Oakwood Village, Ohio): Some doctors we have worked with enjoyed making the jump to a DSO. Other doctors complain about losing freedom and the DSO not doing things "the right way." Much like everything else, there are good and bad companies. Finding a DSO that shares your beliefs regarding patient care and team management goes a long way.
Steve Gill. Owner and President of Chapman Gill International (New York City): There have been many impacts, including the transformation of the dental ecosystem landscape, increased competition between companies, operational efficiency increases and expanded access to capital.
Mick Janness. CEO of Oakpoint (Raleigh, N.C.): The consolidation trend positively impacts the patient, provider and team members. The patient will experience enhanced patient care by the platform reducing administrative burden for the doctor. When done correctly, patient outcomes and the overall patient experience will be pronounced at every step of the lifecycle. The doctor receives the benefit of reduced administrative burden and an opportunity to collaborate with like-minded professionals in a collegial environment. Team members who seek professional advancement have the opportunity to do so as the platform scales. The delivery model is efficient and harmonious when a clinical team is aligned with the support team.
Patrick Jarvis. President and CEO of Dentistry on Purpose (Birmingham, Ala.): Leadership is key to a successful DSO. And leadership starts by recognizing the need for the right team with the right skill sets. Many leaders want to cultivate the right team, but this process is slower and the investment is greater than expected. Many emerging DSOs with between four and nine clinics are challenged to get to that next level, mainly because the team needed to maintain a five-office group is much different than to lead a 15- or 30-office group. Many emerging groups are at the cusp of overloading their current team and not having the resources to map out and to implement an M&A strategy for external growth.
Scott Kalniz, DDS. Founder of Kalniz DSO Advisory Group (Sylvania, Ohio): The impact of dental practice consolidation on the industry has been significant and positive. One is increased efficiency, as dental practice consolidation can help to streamline operations and reduce costs through economies of scale. This can make it easier for practices to invest in new technology and equipment and to offer a wider range of services. Second, consolidated dental practices often have more resources to invest in patient amenities and experience, such as better waiting rooms, state-of-the-art equipment, and more specialized staff, improving patient experience. Third, consolidated practices can often secure financing more easily than smaller independent practices, which can enable them to invest in new facilities, technology and services. Finally, consolidated practices often have established protocols and guidelines for patient care, which can lead to more consistent treatment outcomes.
Abe Kasbo. CEO of Verasoni (Parsippany, N.J.): Consolidation in dental, like in other sectors, is sometimes fraught with pitfalls and risk that can be mitigated or minimized along the way. We spend a lot of time talking to patients and what's important to them is quality of care and relationships with their doctors. Sometimes during the process of consolidation patient communications suffers. We find practices or entities who are acquirers who engage in early, clear and appropriate patient communications tend to have a smoother transition than those who are doing it to check a box. Those enterprises who have and can implement a patient transition communications plan tend to experience much lower patient turnover than those who don't. The same for staffing. We find staff transition to be an issue during consolidation, where some staff jump ship because they fear the buying entity. Patient and staff disruption continue to be a key challenge for dental consolidation and will continue to be for the foreseeable future.
Robert Klaus. President of Unique Dental Scheduling (Jefferson, Ind.): I think mostly what we look for and pay attention to are operational standardization trends in DSOs. There is a constant tug of war that plays out between the center in a DSO and the offices and how they operate. The more standardization, the easier for the DSO to take advantage of scale. With the challenges of staffing that the entire industry has faced, that has weighted more operational latitude to the office side and away from the corporate center.
Dustin Netral. President and CEO of Vista Verde Dental Partners (Carmel, Ind.): As I look at the consolidation of the industry, I believe that it's good for the patient and increases access to care. Consolidation creates an environment whereas everyone must improve their processes and efficacy to be competitive within the market. I find it interesting to see what types of consolidations are driving improvements for not only the patients, but for the other stakeholders within our industry.
Melissa Turner. Chief Hygiene Officer of Cellerant Consulting (Washington, D.C.): The impact of DSO/MSO/multisite consolidation on the dental industry is complex and, as with any significant change, will have positive outcomes as well as drawbacks. For example, private equity firms have shown increased interest, which will help shift traditional and ineffective mindsets. Also, large organizations typically must rely on their institution-wide systems and processes, which will help provide more accountability, direction and growth paths otherwise not offered in small-businesses. Consolidation of dental practices will also improve bargaining power with third-party payers, thus lowering cost for the patients. And finally, consolidation may also tangentially improve employee culture and increase the number of employee wellness programs, something that small-business independent dental practices often struggle to implement.
David Williams. CEO of QualDent (Mount Laurel, N.J.): To be blunt, the large DSOs are not far from IPOs. I suspect the industry will soon have some DSOs publicly traded, so as with other public companies, consolidation will have multiple financial benefits.