Just Say No To The DSO

Bob Speil and Nate Williams open with the starfish principle—one doctor who doesn’t sell is worth the whole podcast—then analogize DSO dealmaking to Big Tobacco: a fortune in getting people hooked, almost nothing in talking them out of it. They take a highlighter to Chip Fichtner’s LPS 2025 scorecard and “just reconnect” emails, knocking the 6.75–11x EBITDA headlines down to work-backs, minority equity, and a commission machine now waving BlackRock, yachts, recruiting teams, and AI as reasons to hand over the name on the door. The closer is the real question under the sales copy: when private equity and family offices own the cash flow, who still owns the patient’s care—and why the honest answer still starts with just saying no.

In this episode, Dr. Whitney Weiner shares her journey from private practice to joining ICON Dental Partners, discussing the motivations, challenges, and industry insights related to group dentistry and private equity involvement. We explore the nuances of practice ownership, valuation, and the impact of DSO models on dentists and the profession.

This is a special Just Say No episode with a dentist who entered into a DSO and realized it was the wrong way forward for himself as his patients. Dr. Brad Langley recounts his tale of not only saying yes to a DSO but finally breaking free and finding new freedom after getting out. Here is a great quote from today's episode: "After spending years in a DSO, I realized the corporate grind was squeezing out the personal touch. I started feeling disconnected, especially when it came to valuing my team. The constant push for profit often overshadowed patient care and staff well-being."

In this episode, Dr. Stephanie Klasner shares her journey through the dental industry, her experiences with DSO models, and her insights on ethical practice and ownership. Discover how she navigated challenges and found success by prioritizing relationships and integrity.

In this episode, Dr. Michael Davis discusses the pitfalls of DSO affiliations, legal settlements, and the importance of ethical practice in dentistry. He highlights recent cases like Aspen Dental's legal issues and offers advice for dentists considering partnerships.

This episode features Dr. Mike Davis discussing the complex financial restructuring of major DSOs like Dental Care Alliance and Affordable Care, revealing the risks for dentists and the industry. We explore the implications of private equity ownership, debt-for-equity swaps, and the future of dental practice investments.

As a dental professional, you may wonder about the implications of selling your practice to a DSO versus a private buyer. In this episode it's case study time as we delve into crucial insights on this topic, including tax considerations, the time value of money, and what it means for your practice.

We've looked at serveral dentists deep into their careers and gone over how a DSO doesn't really make sense...what about the doctor with all of the promise in the world on the very front of his career...does a DSO make sense there? In this episode, Brendan Gallagher, an oral surgeon and podcaster, shares insights on the impact of DSOs on dentistry, the importance of practice ownership, and strategies for young dentists to maximize their careers and income potential.

This episode exposes the realities behind DSO equity and why selling to a DSO often results in less financial benefit than expected. There is a magic trick all DSOs are trying to pull...the magically disappearing equity. Nate and Bob dissect the myths, true principles, and risks associated with DSO deals, empowering dentists to make informed decisions about their practice futures.

Starting a dental practice can be daunting, but with the right insights and support, it can also be incredibly rewarding. Mike and Christy Crockett, who have navigated the complex world of dentistry together, share their journey—from Mike’s schooling to their eventual ownership of a successful dental practice. In this post, you'll discover key lessons on building a practice, the importance of relationships in business, and how to make informed decisions like when to Say No to a DSO, this is the awesome conclusion to a great interview with Nate and Dr. Mike Crockett and his great wife Christy.

Starting a dental practice can be daunting, but with the right insights and support, it can also be incredibly rewarding. Mike and Christy Crockett, who have navigated the complex world of dentistry together, share their journey—from Mike’s schooling to their eventual ownership of a successful dental practice. In this post, you'll discover key lessons on building a practice, the importance of relationships in business, and how to make informed decisions including when to Say No to a DSO. Enjoy meeting the Crocketts with Nate in this awesome 2 part series.

This episode exposes the hidden truths behind DSO deals in dentistry, revealing how dentists are often financially fleeced through complex deal structures. Bob and Nate bring you their expert analysis to break down the mechanics of these deals, showing why saying no to DSOs is crucial for dentists' financial health.

In this in-depth interview, a blue blooded Tar Heel, Dr. Travis Nixon shares his insights on the rise of DSOs, legislative challenges, and how dentists can protect their profession through education and advocacy. Not only does Dr Nixon have great insight into the current dentistry pipeline of practitioners, he also shares incredible insights into the business and structural changes of medicine and draws parallels to dentistry. You are going to love this episode with Dr Nixon

This episode explores the six fundamental principles that reveal why DSO deals are detrimental to dental practitioners. Hosts Bob and Nate dissect the realities of private equity models, emphasizing the importance of maintaining control, understanding the true value of your practice, and making informed decisions to protect your wealth and profession.

summary In this episode, Dr. Michael W. Davis shares critical insights into the private equity influence on dentistry, the risks of DSOs, and how dentists can protect their practices and patients. A must-listen for dental professionals concerned about industry integrity and patient care.

Nate sits down with the Orthodontic Pearls podcast in order to give his take on owning your own practice and why to stay away from selling out to PE and DSO groups. It's a full panel lineup with Drs. Chris Teeters, Andy Sarpotdar, and Brian Anderson.

This episode features a candid discussion on the realities of DSOs in dentistry, highlighting industry failures, ethical concerns, and the importance of dentists making informed decisions about their practices. Hosts Bob Nate share insights, stories, and call for transparency and honesty among dental professionals. Bottom line...DSOs suck

In this conversation, Nate and Dr. Joe Feller discuss the complexities and challenges faced by orthodontists when considering selling their practices to DSOs. Dr. Feller shares his personal journey in orthodontics, his experiences with DSOs, and the reasons he ultimately decided against selling his practice. The discussion highlights the emotional and financial stakes involved in such decisions, the misleading nature of DSO promises, and the consequences faced by colleagues who chose to sell. The conversation serves as a cautionary tale for practitioners contemplating similar paths. In this conversation, Nate and Dr Feller discuss the implications of private equity in dental practices, particularly focusing on the challenges and stressors faced by orthodontists who sell their practices to DSOs. They explore the false promises of wealth and ease, the reality of corporate meddling, and the importance of maintaining ownership and control over one's practice. Dr. Feller shares insights on the emotional toll of selling a practice and the value of community and support among private practitioners. The discussion culminates in a call to prioritize patient care and ethical practices over financial gain.

In a conversation between two of the most soothing voices on the internet, Bob Spiel interviews Jonathan Martin, a CPA with extensive experience in dental transitions. They discuss the complexities of selling dental practices, the myths surrounding DSOs, and the importance of financial planning for dentists. Jonathan emphasizes that many dentists are not adequately prepared for retirement and often make significant financial decisions without proper representation. The discussion highlights the need for careful planning and consideration of all options before deciding to sell a practice, particularly to a DSO.

In this conversation, Bob Affleck shares his extensive experience in the dental industry, discussing the implications of selling dental practices to DSOs. He highlights the challenges and regrets many dentists face after selling, particularly regarding autonomy and financial expectations. The discussion also covers the importance of leadership and business acumen for young dentists preparing them for practice ownership. Overall, the conversation provides valuable insights into the current state of the dental industry and the future of practice ownership.