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What is an IDSO?
There are over 1000 IDSOs in the U.S. with tens of thousands of doctor partners, both GP and all specialties. Some IDSOs are over 30 years old, and many have 200+ practice partners!
IDSOs become a doctor’s silent partner by purchasing 51% to 80% of a practice for cash up front. Doctors continue to lead their practice as owners for years or decades with their brand, team, strategy and full autonomy, not just clinical autonomy.
Values in an IDSO partnership are often 2x+ the value of a doctor-to-doctor practice sale or associate buy in. LPS completed multiple IDSO partnerships in 2024 with initial practice values at over 300% of collections and over 10x EBITDA.
Practice values in IDSO partnerships set records in 2024 in part due to the $8.0 billion of new capital provided to IDSOs in 2024 alone. IDSO investors are not just Private Equity! They include traditional asset managers like BlackRock, Sovereign Wealth Funds and billionaire family offices globally.
Consolidation is accelerating. If your practice has at least $1.8 million in collections, you may be able to partner with an IDSO at a high value. Smart doctors will join an IDSO or prepare to compete with many in their community. It is only a matter of time.
Of the $1.0+ billion in IDSO partnerships engineered by LPS for clients in the last 24 months, over $150 million were for doctors in their 30’s.
IDSO partnership is not a short-term exit strategy, but rather a generational wealth building opportunity, if you choose the right IDSO partner. Some IDSOs have increased their doctor partner’s retained ownership value by 10x+ in less than ten years, and others will fail.
IDSOs come in all shapes and sizes. There are now 17 IDSOs focusing on OMS, 14 are ortho only and there are a dozen Dental Trifecta IDSOs eager for pedo, ortho and OMS in the same communities. Some IDSOs are seeking perio, endo and implant/All on X focused practices. And hundreds of GP and multispecialty IDSOs are contacting larger practices every month!
The Key to IDSO Partnership Value and Success: Choose Wisely!
Of the 1000+ IDSOs in the U.S., LPS considers less than 100 of them qualified to bid on our clients. The balance are on the LPS “Blacklist” which changes regularly.
The key to success in IDSO partnership is to choose the right IDSO partner. Many will deliver on their promises of creating generational wealth and some will fail.
Specific IDSO Benefits for Practice Owners, If You Choose Wisely!
- Full Autonomy, no micromanagement
- Millions in cash up front to diversify doctor investment portfolios
- Significant long term ownership value increase
- Supply cost reductions of 30%
- Insurance reimbursement rate increases
- Some IDSO recruiting and marketing teams have dozens of people helping partners
- IDSOs take over banking, accounting, tax, legal, compliance, credentialing
- No PMS Software change required
- Only positive impact on team members (better benefits, lower cost)
- Risk free capital for growth
- AAA Credit Tenant for Your Practice Real Estate (increases property value)
The Fears of IDSO Partnership if You Choose Poorly
- Loss of autonomy
- Micromanagement/change
- Failure of the IDSO partner
Why NOW, Not Later?
- Age Matters: The younger the doctor, the higher the value
- Record values today: But is the market near a peak or a trough?
- Covid Earn Outs: Pay Doctors Additional Consideration on Future Growth
- LPS Clients in 2025: Typically have five or more qualified bidders
- Long Term Equity Gains: Newer IDSOs with fresh capital have high value creation potential
- Reduce Risk: Most practices are one doctor’s heartbeat away from value destruction
Confidentially Learn the Value of Your Practice in an IDSO Partnership Without Cost or Obligation
LPS is the largest advisor in the U.S. to dentists of all specialties eager to monetize a part of their life’s work and benefit from the resources of a larger partner. The little advisors who are paid by both the doctor and the IDSO have conflicts of interest and cannot deliver the number of qualified IDSO bidders for which LPS is famous.
LPS is paid nothing unless a transaction is completed and only by our clients, not the IDSOs. High value partnerships for dentists is all we do; no vet, medspa, optometry or anything else; just dental.
Doctors should understand the IDSO option as they will ultimately join one or compete with many. Doctors with at least $1.8 million in collections are invited to schedule a call with LPS CoFounder, Chip Fichtner to learn more about IDSOs and their specific practice value today.
Chip Fichtner, CoFounder of Large Practice Sales has completed over $1.0 billion in IDSO partnerships in the last 24 months with dozens of IDSOs nationally. He has built, bought and sold companies in a variety of industries and has been featured in numerous media outlets. His tolerant wife of 34 years allows him to live on his airplanes visiting clients every week. Learn more at largepracticesales.com
Read Chip’s other article: Hundreds of Invisible Dental Support Organizations Now Partnering with Larger Practices at Record Values.
Listen to Chip on the Group Dentistry Now podcast: The Group Dentistry Now Show: The Voice of the DSO Industry – Episode 129
