How 1 oral surgery practice's 'leap of faith' fueled its growth

Austin (Texas) Oral Surgery was the founding practice of Irving, Texas-based U.S. Oral Surgery Management, launching the first oral surgery-focused management services organization in the U.S. in 2017.

Thomas Weil, DDS, MD, of Austin Oral Surgery, recently spoke with Becker's about the practice's partnership with USOSM and the benefits of affiliating with an MSO.

Editor's note: Responses were lightly edited for clarity and length.

Question: Why were you looking to join an MSO?

Dr. Thomas Weil: We were already a very big group. I was managing the group probably worse than I thought I was. We just kind of realized we needed better people, better managers, we needed a better operations person and we just couldn't afford it. We had 15 positions at the time, and you can't hire a Stanford MBA and run that cost across 15 doctors and make it work. We knew to get better management, to improve customer service and referral service and our back-office operations, we needed to get bigger. We just didn't have the capital to do that on our own, so we partnered with a private equity firm and set about getting bigger. Now I think we're at 200 or so providers.

Q: What did the MSO and DSO landscape look like when you joined USOSM?

TW: There were no specialty MSOs or DSOs. There were DSOs for generalists, some with better reputations than others, but there really were no specialty DSOs. We were the first. We had some background knowledge on DSOs and a pretty good idea of what the good and bad things might be, but as for specialty DSOs, we kind of created our own path. 

How has your practice evolved since joining USOSM?

TW: We got to offload a lot of our high friction back-office stuff to our services organization. Our bookers, insurance people, accounts receivable and HR functions, all those are centralized now so it's not something we have to deal with. Hiring and managing has been a huge relief where we can just concentrate on taking care of patients and making sure everything is running okay. 

This is kind of counterintuitive because most MSOs or DSOs take a little bit of your income to take over all those functions, but just through better practices we've achieved greater practice revenue and greater take-home compensation than before we partnered. So it has really cost us nothing to do that. You can ask every one of our surgeons and they'll all tell you this is the best thing we've ever done. 

Q: Were you nervous to be one of the first partners of USOSM since there were no other oral surgery-focused MSOs at the time?

TW: Hugely nervous. It was really a leap of faith to do the deal, but we had enough faith to do it and our executive team is so sensitive to the needs of the doctors that it's just really been everything we hoped for.

Q: What advice do you have for other practice owners who are considering affiliating with an MSO or DSO?

TW: I would say don't focus entirely on the transactional money details, but focus on a partner who is going to put the doctors and patients first. Try to find somebody who is at least substantially if not majority-owned by the doctors. We're 54 percent doctor-owned and when you have a lot of equity owned by the doctors, there tends to be a more sympathetic perspective on what the doctors need and want.

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