The most common misconceptions about DSOs, per 1 exec

One of the most common misconceptions about DSOs is that dentists don't have clinical autonomy, according to Barry Lyon, DDS. 

Dr. Lyon is a chief dental officer for the division of orthodontics and pediatric dentistry at Sarasota, Fla.-based DSO Dental Care Alliance. He recently spoke with Becker's about the benefits of joining a DSO and what dentists should consider before affiliating with one.

Editor's note: This Q&A is part of a weekly series featuring Dr. Lyon focused on topics in the dental industry and DSO field. Responses were lightly edited for clarity and length.

Question: What are the benefits of joining a DSO?

Dr. Barry Lyon: Among the benefits of joining a DSO, obtaining a positive work-life balance is almost always at the top. Dentists joining a DSO are focused on patient care while leaving the business support to the DSO.

In addition to a work-life balance, many dentists, especially recent graduates, enjoy the mentorship provided by more experienced doctors in the office or by the DSO’s clinical directors. This leads to another benefit: professional growth.

While many privately-owned dental practices may have limited budgets and resources, DSOs are able to provide new technology and a robust marketing plan that enhances practice development.

Q: What are some common misconceptions in the dental industry about DSOs?

BL: One of the most common misconceptions about DSOs is there are quotas for production. DSO-supported dentists have clinical autonomy. The dentist examines and creates treatment plans based on the patient’s needs, not the practice’s needs. Following this, there’s the misconception that the dental care provided by a DSO is substandard. While most privately-owned practices have no or little clinical oversight, dentists supported by DSOs are subject to clinical quality audits. DSOs are keenly aware that to succeed as an industry, clinical care must be beyond reproach.

Another misconception is that low-quality materials are used. Using inferior materials leads to treatment failures, which is something no DSO wants.

It’s often said that having DSO-supported dentists on state dental boards leads to laws being enacted that favor DSOs. This is false. The regulations and statutes dental boards enforce are passed by state legislatures and not the dental board itself.

Q: Why might a dental practice owner be leery of affiliating with a DSO?

BL: Dentists considering affiliating with a DSO may fear the character of their practices and their clinical autonomy would be altered by the supporting DSO. For a DSO, doing this would be counterproductive. When a DSO affiliates with a successful practice, tinkering with what has brought success for years makes no business sense. Along these same lines, dentists may also fear a DSO would come in and make wholesale changes to the office staff. Again, this is something a DSO would not do, especially in today’s business climate when finding skilled staff members is challenging. Besides, why break up a successful team? DSOs want the transition from private practice to supported practice to be as transparent as possible.

Q: What should a dental practice owner consider when deciding whether to join a DSO? 

BL: Dentists considering affiliating with a DSO need to do their homework. They need to learn precisely what a DSO does and does not do. The dentist needs to speak with dentists who have sold to a DSO, just as they would obtain a reference before hiring an employee.

Looking deeper, the dentist should investigate if there are other supported practices in the general area that have affiliated with the DSO. This is an important factor as it relates to successful operational support from the DSO.

If it is a specialty practice, the owner dentist should research how many other practices of the same specialty the DSO supports and how long they’ve been supporting that specialty. There are significant differences in how a general practice is supported versus a specialty practice. If the DSO has little experience with that specialty, then the practice owner should look elsewhere.

There is much more to consider beyond the selling price. Alignment with the DSO's philosophy and core values leads to successful affiliations.

Q: How has the dental industry changed since the emergence of DSOs?

BL: There have been notable and measurable changes in dentistry since the growth of the DSO model. 

According to the American Dental Association, in 1999, two out of every three dentists were in solo practice. By 2019, that decreased to one out of two dentists. For dentists under age 35, only one out of four dentists were in solo practice. 

In 2005, 85 percent of dentists owned their practices. By 2019, that dropped to 76 percent. For dentists under age 35, ownership dropped from 49 percent to 31 percent.

Today, approximately 18-20 percent of dental practices are affiliated with DSOs, while some trade experts predict that percentage will grow to 50-65 percent by 2025.

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