Balancing Growth: The People-First Approach to Sustainable Growth

Growth is often seen as the primary indicator of business success, particularly for Dental Service Organizations (DSOs). Driven by the goal to rapidly increase revenues and expand practice locations, reflecting a broader business culture where scaling up is equated with success. However, this relentless pursuit of growth can sometimes lead to unsustainable practices, fraught with challenges that may compromise the foundations of these organizations.

I remember sitting down with a few DSO CEOs last year, asking them, “What is your #1 focus this year?”  They all stated – Grow, Grow, Grow.  While this was an expected answer, their growth focused on how many locations they planned to add that year.  As usual, this has become part of what we have come to learn. Grow as fast as you can, and sometimes Grow at all costs.

The conversation around growth in private equity-backed DSOs often centers on meeting investor expectations and the perceived necessity for quick expansion – Grow as fast as you can. This raises the question of whether such rapid growth is feasible and sustainable.

The drive for growth and rapid acquisition of new practices presents the challenge of smoothly integrating these new practices while ensuring consistent quality of care across the network. Managing this expansion effectively requires robust systems for communication, training, compliance, and leadership to guarantee seamless integration and maintain the standard of care.  It’s more than just “adding a location”.

Look, there is nothing wrong with growth, even rapid growth as long as DSOs can scale in a responsible way. The benefits of profitable growth are clear, offering advantages like shareholder satisfaction, job creation, improved wages, and overall financial stability. However, you don’t want growth to kill the company.  Growth must be pursued strategically, carefully considering that it does not undermine the organization’s core values, operational integrity and the core of the company – the people.  Rushing to expand can weaken a company’s identity and diminish the qualities that initially drove its success.

The reality is that sustained, rapid growth is uncommon. I have seen many DSOs stretch their resources too thin, leading to staffing shortages, supply issues, compliance, inconsistent quality of care, overlooking and mismanaging their existing practices and difficulties in integrating new ones, all of which can be complex to resolve.

So, the question is: How do you sustain growth? Sustainable growth can be elusive. A critical factor in achieving sustainable growth is through your human capital.  Dentistry is a people-focused business. For DSOs to realize sustainable growth, a comprehensive approach incorporating employees’ well-being and development as the core growth strategy is crucial. The concept of “human sustainability” is becoming increasingly important, emphasizing the value of enhancing employees’ lives in mental and physical well-being, providing training and development, mentoring, and guiding an overall purpose. Focusing on human sustainability has been proven to improve organizational performance significantly.

With the #1 concern of DSOs being workforce challenges, we are starting to truly understand the impact on the business. We have DSOs experiencing high turnover rates, employee burnout, and a lack of commitment to their workplace. According to a survey completed by, 57% of associate dentists are planning to look for a new job in 2024, citing their motivation as higher pay, better work environment and more appreciation.  With this amount of turnover, how can a DSO sustain their growth?

As DSOs chart their growth paths, it’s critical to integrate workforce considerations into their strategic planning. Looking within and understanding the needs of your people is important for sustainability. The success of any organization hinges on its people. There is a well-established link between employee well-being and organizational performance. Employees who are healthy and engaged are more productive, build stronger relationships, and are more driven to effect change. “Human sustainability” is about adding value to employees’ lives and improving their well-being, skills, and sense of purpose, which benefits them personally and positively impacts the entire organization. Doing so can help prevent turnover, employee disengagement, burnout, and a lack of commitment.

Before launching the next growth initiative, DSO leaders should prioritize their people to ensure that growth efforts do not compromise employee well-being or the company’s overall health. Viewing staff as more than just numbers, acknowledging them as crucial assets, and investing in their growth is essential. Creating a diverse and inclusive team, supporting employees individually, and assessing initiatives beyond financial gains are vital to fostering a sustainable and prosperous DSO environment. This people-first growth strategy ensures that decisions benefit all stakeholders, aligning with individual and organizational objectives for a successful future.

Written by Heidi Arndt, RDH. Heidi is the Founder and Host of the Evolving Group Dentistry Conference. Her journey in the Dental Service Organization (DSO) industry spans more than two decades, starting as a dental hygienist, consultant, and eventually leading as the CEO of a mid-sized DSO. Heidi’s passion lies in working with people and guiding teams through significant changes to achieve operational effectiveness while fostering excellence in clinical practice and leadership development.

Take advantage of the opportunity to dive deeper into sustainable growth strategies at the upcoming Evolving Group Dentistry Conference, May 9-11 at the Fairmont Princess Resort in Scottsdale, Arizona. Use Code EGD100_GDN to save $100. Explore comprehensive solutions and innovative approaches tailored to the unique challenges faced by Dental Service Organizations. This event is your chance to connect with industry experts, gain valuable insights, and learn practical strategies to ensure your DSO’s profitable and sustainable growth. Be part of the conversation on creating a successful, people-centered growth strategy for your organization.