DSOs and Hockey: Building a 5-Year Winning Team and the Business Lessons Behind It

Written by Joel Idelson, CEO, Image Specialty Partners

Here’s a stat that doesn’t sound real: I’ve coached a high school summer hockey team that hasn’t lost a game in five years and counting.

We didn’t do that with the same roster. This is a high school team. Players age out, move on, and graduate. We’ve kept winning because the strategy stays consistent, the standards never drop, and the leadership culture doesn’t change.

And no, it’s not because we’ve cornered the market on teenage Wayne Gretzkys. We win because the system stays consistent, the standards never drop, and the leadership culture doesn’t change just because the names on the back of the jerseys do.

We don’t win because we’re the most skilled team on the ice. We win because we have the right people in the right roles, a clear game plan, the ability to adapt mid-play, we have fun, and above all… trust.

We allow mistakes, we learn from them, and we play for the guy next to us. And honestly? That’s the same formula I use to build a winning DSO.

Talent is Overrated – It’s Placement That Wins

Too many DSOs think success comes from hoarding “top 1%” doctors. Um yeah, and if you buy enough caviar, you’ll become a Michelin-starred chef.

It’s not just about doctors. It’s about the office teams, corporate talent, ops, finance, marketing, RCM, HR, IT… every single function that moves the platform forward. If one of those gears strips, the machine starts smoking.

In hockey, you don’t always win with a bunch of superstar players. You win with a structure that lets everyone do their job at a high level, and a culture that holds everyone accountable to something bigger than themselves.

The same goes for a DSO.

Right people.
Right roles.
Real clarity.
And leadership that doesn’t flinch when things get hard.

The Stuff That Doesn’t Show Up on the Score Sheet

In hockey, not every contribution shows up in the stats. The guy who blocks shots doesn’t get a parade. The one battling in the corner doesn’t get trending highlights on ESPN. But without them? You’re done.

Same in a DSO.

It’s the office manager who keeps the team calm when the schedule explodes at 9:15 a.m. on a Monday.

The corporate finance lead who finds $10K in savings nobody saw coming.

The marketing director who quietly protects the brand while keeping performance metrics in the green.

The RCM analyst who spots a problem before it becomes a collections nightmare.

The Regional Manager who doesn’t just vomit KPIs at you, but actually develops people.

If you only reward what’s on the “official” report, don’t be surprised when the people doing the real work stop caring. You can’t just measure the flash; you have to value the grind.

Mistakes Are Part of the Game – Punishment Isn’t

We don’t play scared. We make mistakes. We own them. We fix them. Then we get back on the ice.

If your front desk, ops managers, or corporate team are afraid to try something new because they’ll get hammered for failing… congratulations, you’ve built a culture of hesitation. And hesitation in hockey is the same as hesitation in business: you get hurt.

Winning teams don’t hesitate. They move. They adapt. They trust that if they trip, someone will help them up instead of sending them to the penalty box.

Trust: The Competitive Edge You Can’t Fake

In my locker room, players go all out for each other. Not because they’re all best friends, but because they know everyone’s got everyone’s back.

In business, the best people protect the team even when no one’s looking.

OMs back their doctors.
Corporate backs the field.
Doctors feel heard.
Everyone knows someone’s in their corner.

Trust builds speed. Speed builds wins. And you don’t get that with more dashboards or fancier charts. You get that with leadership that treats trust like currency.

People Don’t Leave Jobs, They Leave Broken Systems

If your top doctors, managers, or corporate staff are heading for the exits, it’s not because they “weren’t a fit.” That’s corporate speak for “We failed them.”

At Image, we strive for the following:

Doctors get a real path to partnership.
OMs run their offices like they own them.
Corporate leaders drive strategy, not just play corporate Whac-A-Mole.
The culture feels like a locker room, not a cult.

That’s how you win. That’s how you retain. That’s how you grow.

Dealing With the Inevitable Loss

Yeah, one day we’ll lose a game. Probably sooner than I want. And that’s fine. Losing is inevitable, in sports and in business.

The question is: What do you do when it happens?

Do you point fingers? Collapse? Or do you break it down, learn, adjust, and come back stronger?

In hockey, we study the tape. In a DSO, we look at the metrics, talk to the people, and figure out what actually happened instead of inventing some narrative that makes us feel better.

A bad quarter. A bad hire. A bad call. It’s not fatal. It’s feedback.

Hockey Taught Me This

You don’t win because of one brilliant play. You win because you do a thousand little things right, over and over again.

In business:

Clear systems that scale without suffocating.
Autonomy with accountability.
Data that leads to decisions, not just pretty decks.
A culture that rewards consistency, effort, and initiative.
People in every role – from ops to execs – who know why they matter.

Leadership Is the Coach You Deserve

The hockey coach who only screams from the bench? Yeah, we’ve all had that boss. Fear works short-term. It also kills creativity, loyalty, and initiative faster than you can say “We’re restructuring.”

The good coach and the good leader know when to yell, when to stay silent, when to change the lines, and when to let players solve it themselves. The trick is knowing your people so well that you can coach each one differently while still holding the same standard for the team.

That’s how you get the best out of a quiet introvert in finance and the loud extrovert in marketing. You coach to the individual while managing to the mission.

The Long Game

Here’s the secret: you’re not just trying to win this game. You’re trying to build something that wins over and over again, long after you’re gone.

If my hockey team falls apart the second I stop coaching, I’ve failed. If a DSO collapses when one exec leaves, it wasn’t a platform; it was a personality cult with a payroll.

Sustainable winning is about systems, not superheroes.

I’m proud of the streak we’re in the middle of… now five years without a loss. But I’m more proud of how we’re doing it. With changing rosters. New faces. Same mission.

Fast. Focused. Adaptable. And always for each other.

Oh…and…anyone can win one game. Even a bad team gets lucky once in a while. But building something that wins long after you’re gone? That’s the real scoreboard…and you don’t need a jumbotron to see it.

Joel Idelson is the Chief Executive Officer of Image Specialty Partners, headquartered in California, ISP is a specialty dental platform backed by ONCAP (Onex). Known for his ability to lead through complexity, Joel specializes in building and scaling multi-site healthcare platforms, particularly in fast-paced, private equity-backed environments where the stakes are high and the path isn’t always clear.

Joel thrives in moments that require operational clarity, cultural reset, and bold decision-making. He simplifies the complex, resolves tough challenges, and drives performance without compromising culture. His philosophy is rooted in empowerment: give teams the tools to focus on care, equip office staff to lead with confidence, and build smart systems that support both without getting in the way.

At Image Specialty Partners, Joel is focused on delivering measurable impact, tightening operations, improving clinical, financial, and business performance, and creating environments where great talent sticks around because they feel heard, supported, and proud of the work they do.

Before ISP, Joel served as CEO of Advanced Dental Brands, leading the company through a period of rapid expansion and ultimately a successful private equity exit. He also founded and scaled Flossed, a high-growth, on-site dental brand. Earlier in his career, Joel held executive roles at several leading consulting firms.

Read Joel’s other article, The ‘S’ In DSO Stands for Support – Not Suffocation.