Why Does Organized Dentistry Hate DSOs?


What do state dental boards and state dental associations have against dental support organizations?  The answer is pretty clear.  Just about everything.

Let’s explore why organized dentistry is anti-DSO:

  • COMPETITION. State dental boards and dental associations are almost exclusively run by solo owner dentists.  Many of these dentists view DSOs and dental groups as competition.
  • TRADITION.  These solo owner dentists who reside on the boards and associations do not want to see their traditional model of dentistry and the standard formula challenged.  They do not want the way they practice dentistry and run their businesses disrupted.
  • LIFESTYLE. Solo owner dentists still typically operate according to traditional ‘banker’s hours’.  However banks don’t even have banker’s hours anymore.  Solo owner dentists have enjoyed flexible weekday schedules, with a long-standing tradition of taking Wednesday and/or Friday off.  Many DSOs are open seven days a week.
  • ECONOMICS. Solo owner dentists, up until the advent of DSOs and dental group practices, have not really had to focus on the business side of dentistry.  They could run a fairly inefficient practice and still make a great living.  Now DSOs, with streamlined practices, have increased competition supplying patients with more choices.
  • CONVENIENCE.  Solo owned practices have traditionally only offered general dental services under one roof.  If a patient requires oral surgery, complex periodontal work, orthodontics, or another dental service which that solo practitioner does not offer, the patient will be sent to another dentist, perhaps in another part of town. DSOs typically offer multi-specialty practioners under the same roof.

This anti-DSO / anti-competition mentality is cloaked in various ways.  Anti-DSO proponents shroud their protectionism under the guise of clinical freedom and patient safety.  What most of these anti-DSO supporters don’t care to understand is that a true DSO structure can and does clearly separate clinicians and their treatment choices from the business side of dentistry.  It also frees clinicians up to focus on dentistry, while not being distracted by traditional business owner obligations.  Yes, there have been cases of questionable patient care and misconduct at several dental group practices.  However, there are just as many, if not more, cases of solo dental practices with questionable clinical treatment of patients.

It is easy to get carried away with the anti-DSO rhetoric.  It is rare that you even hear the words “dental support organization” mentioned when DSOs are attacked.  ‘Corporate dentistry’, ‘dental mills’ and ‘dental chains’ do a much better job at painting the picture of an evil corporate entity ready to take over the dental industry.

One thing is clear, the business model for dental providers is changing and the old guard is going to try to resist that change. Fear of change is driving many in organized dentistry to try and limit or eliminate the dental support model. Here are just a couple of examples of attempts at regulating dental service organizations in particular states:

  • Wisconsin – Read more HERE
  • Washington – Read more HERE
  • North Carolina – Read more HERE

Stay tuned for an upcoming supplement to this opinion piece where we will try and determine where the American Dental Association stands on dental support organizations.

Beth Miller, Contributing Editor, GDN