Why Visibility is the Next Frontier for DSO Growth

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For the last decade, growth in the dental industry has been all about scale. Roll up more practices, expand into more markets, and let the economies of scale take care of the rest. And that model worked well, until we started poking holes and asking questions around holistic success.

Today’s DSOs are under pressure to prove not just how many locations they manage, but how well those locations perform. And yet, many are still flying blind.

How is this possible in 2025? Often, it’s because the tools they’ve relied on to grow—often added piecemeal at the practice level—have created a fractured ecosystem that obscures the very metrics that matter most.

Tech Stack Sprawl: The Hidden Cost of Fast Growth

Talk to any DSO operator and you’ll hear a version of this story:

One office uses one platform for phones. Another uses a different one for their PMS. A third prefers a custom call solution.
Some track new patient conversions in Google Sheets. Others rely on staff memory.
Everyone defines “booked” differently.

A study of DSO operators and multi-location practices found that:

74% reported using more than five separate front-office tools across locations
61% said they lacked a consistent way to measure call outcomes
Only 18% tracked voicemail follow-up across locations
And yet, practices that responded to missed calls or voicemails within 1 hour saw 32% higher booking rates compared to those who responded later or not at all

This is the gap between knowing and guessing, between growth and value. As DSOs scale, what started as smart, localized decisions begin to create confusion at the enterprise level.

The result? No shared visibility. No consistent benchmarks. No easy way to answer basic questions like:

Which locations are actually converting the most calls into appointments?
How many new patients are we losing to voicemail each month?
Where are our top-performing staff, and what are they doing differently?

Consolidation Demands Clarity

It’s no longer enough to grow headcount or location count. Investors want to see enterprise value, and that means having a clear understanding of what’s happening across your entire portfolio.

In other words, integration isn’t just about merging practices or standardizing systems. It’s about centralizing insights.

The best operators don’t just look at individual office performance. They zoom out and compare:

Answer rates across locations
Missed call volume by time of day
Voicemail frequency and impact on scheduling
Conversion rates by front office team
Revenue per appointment type

When you can see that clearly—and tie it back to specific actions—you stop guessing. You start scaling what works.

The Problem with Practice-by-Practice Metrics

One of the biggest challenges DSOs face is data that lives in silos. Each office may have visibility into its own numbers, but there’s no reliable way to compare them apples to apples.

Worse, most of the data that matters—call logs, voicemail recordings, booking follow-up—is either buried, manually tracked, or lost entirely.

Without unified analytics, it’s hard to identify what’s a one-off problem and what’s a pattern worth solving. It’s even harder to develop training, improve processes, or measure the impact of new initiatives.

Integration Is About Insights

DSOs don’t need more software. They need better visibility.

That means working with tools (and partners) that:

Normalize data across locations
Layer in both aggregate and location-level reporting
Show patterns in real time
Include voicemail and missed call data—not just answered calls
Make insights actionable at the operator, region, and office level

With the right approach, analytics stop being something you review at the end of the quarter. They become your daily operating tool, one that guides decisions, tracks improvements, and surfaces issues before they become problems.

What the Next Era of DSO Growth Looks Like

As private equity expectations rise, DSOs are facing a new kind of mandate: prove performance at scale.

That doesn’t mean more tools or dashboards. It means a single source of truth for what’s happening on the phones, in the schedules, and at the front office, at every location.

The fastest-growing DSOs of the past decade won by expanding quickly. The most valuable DSOs of the next decade will win by operating smarter.

The determining factor between those DSOs starts with a simple question: Can we see what’s going on across all of our locations?

Headed to Dykema 2025?

Peerlogic is partnering with Bill Neumann of Group Dentistry Now to offer 20-minute 1:1 expert consults – no pitch, just value – to help DSOs like yours uncover revenue opportunities, improve integration, and maximize same-location value. Reserve your spot: ➡️Review your Portfolio

Written by Josh Wagner. Josh is a go-to-market and partnerships expert who helps growth-stage companies scale faster with fewer resources. He’s currently Co-Founder and Partner at In Revenue Capital, where he brings hands-on GTM operator experience to startups, focusing on ecosystem-led growth.

He also sits on the advisory board at CRE OneSource, building and evolving their GTM strategy, and hosts the Love Selling Hate Sales podcast, now with over 100 episodes exploring modern sales tactics.

Previously, Josh led enterprise sales at LeadMD, helping drive $100M+ in services revenue through strategic partnerships, contributing to the company’s acquisition in 2021.