profile

Get Clear Insights Straight to Your Inbox

What I learned meeting with a 100+ location DSO CEO

Published 21 days ago • 4 min read

I recently met with the CEO of a DSO with over 100 locations.

And I walked away with a few realizations that most dentists don’t think about.

Not every DSO is bad. But every DSO is different.

Dentists love to generalize.

“DSOs are corporate.” “DSOs don’t care about doctors.” “DSOs only care about numbers.”

Some do.

Some don’t.

The real issue isn’t whether DSOs are good or bad.

It’s whether you’ve done the work to understand how a specific one operates.

If you’re considering working for a DSO or selling to one, it’s on you to figure out:

  • What is their growth model?
  • How do they define success?
  • What do they expect from you post-transaction?
  • How long do they expect you to stay?
  • What does autonomy actually look like?

Every model is different.

You can’t outsource that clarity.

⸻

Most dentists are not clear on what they actually want.

And that’s where the problems begin.

If you only want to work two more years after selling… But the DSO expects five…

You will be unhappy.

If you want full clinical autonomy… But they’re tightening systems and KPIs…

You will feel trapped.

Misalignment isn’t evil. It’s unclear expectations.

The best partnerships start with uncomfortable conversations.

Be straight up. Ask direct questions. Say what you actually want.

Clarity filters out the wrong fit before it becomes regret.

⸻

There is a real disconnect between leadership and the operatory.

This one surprised me less, but it’s real.

Many DSO CEOs don’t deeply understand what dentists experience day to day.

That’s not malicious.

It’s structural.

They’re focused on growth, EBITDA, operations, capital, expansion.

Yes, most groups have a Chief Dental Officer or clinical leadership. But even then, decisions often tilt toward numbers.

From the outside, this can feel frustrating.

From the inside, it often looks like blind spots.

And blind spots create gaps.

⸻

The education and mentorship gap is bigger than most realize.

When I propose solutions to help educate doctors and bridge that gap, some DSOs immediately understand.

Others hesitate.

Not because they don’t believe it would work.

But because they don’t even realize it’s a problem.

If you talk to dentists on the front lines, they know.

Confidence gaps. Mentorship gaps. Implementation gaps.

They’re real.

The interesting part is watching which leaders are willing to lean into that reality and which aren’t.

That tells you a lot about the future of their organization.

⸻

I’m having more and more of these conversations.

With CEOs. With clinical leaders. With solo doctors. With vendors trying to build better solutions.

There are people in this industry genuinely trying to make it better.

But alignment matters.

Clarity matters.

And asking better questions matters.

If you’re navigating DSOs right now and have questions, send them my way.

The more conversations we have openly, the better decisions this industry will make.

Video of the Week

video preview​

-Dr. Avi

Ever wonder how much opportunity you're sitting on in your practice?

Take the aligner growth assessment to see what's possible below...

Want to learn more from me?

​Free Trainings​

​Courses​

​DSO Solutions​

Follow me on social

Why You’re Receiving This Email: You’re receiving this email because at some point, you opted in to receive updates, news, or information on a specific topic we’ve previously discussed or shared. Whether it was through a subscription, a form submission, or another form of communication, your information was shared willingly, and we respect your decision to connect with us. If you’re wondering about the nature of our correspondence, rest assured that we aim to keep all emails relevant, timely, and free from unnecessary clutter. This includes respecting your inbox and refraining from sending irrelevant messages. Your Privacy is Important: We value your trust and take your privacy very seriously. The information you provide is securely stored and never shared, sold, or used outside the purpose for which you provided it. If you ever want to review how we handle your data, feel free to contact us directly. Transparency is our priority, and we’re happy to address any questions you might have. You are always in control of the information you share. If you feel that any part of your subscription or interaction needs clarification, let us know. We’re here to provide accurate answers and ensure your satisfaction. How to Unsubscribe or Manage Your Preferences: We understand that everyone’s inbox is different. If you ever find our emails no longer relevant, there’s no hard feelings. You can easily manage your email preferences or unsubscribe using the link provided below. By clicking the unsubscribe link, you’ll be taken to a page where you can either adjust your communication preferences (such as receiving fewer emails or only on specific topics) or completely remove yourself from our list. The process is straightforward, and any changes will take effect promptly. We don’t use tricks or gimmicks to keep you subscribed. Our priority is to ensure that our emails add value to your day, and if they don’t, we respect your decision to part ways. Accessibility and Communication: If you have any trouble accessing the unsubscribe page, managing preferences, or understanding why you’re receiving this email, you can reach out directly to our support team. We aim to provide a response within a reasonable time frame and address your concerns effectively. Our communication is designed to be as inclusive as possible, but we know there’s always room for improvement. If you have any feedback on how we can make our emails more accessible or relevant, please don’t hesitate to share. A Commitment to Non-Intrusive Emails: We aim to create a non-intrusive communication experience. This means we won’t overwhelm your inbox with excessive messages, and we work hard to ensure our content remains clear and concise. The purpose of this email is to stay connected with you and provide updates or information that we believe is meaningful. If we ever fail to meet these standards, we encourage you to let us know. Feedback, whether positive or constructive, is always appreciated. Your thoughts help us understand how we can do better and improve our communication approach. While we cannot guarantee every suggestion will be implemented, we will take the time to carefully review and consider your input. We strive to ensure all communication channels are open and readily available to you. Whether it’s a question, comment, or concern, our team is ready to assist.

Don't want to be part of the newsletter community anymore? No worries! Unsubscribe here​

600 1st Ave, Ste 330 PMB 92768, Seattle, WA 98104-2246

If you do not want another email from me ever again - unsubscribe below. I will be sad to see you go as I plan to continue to bring as much value as I can for you - but I understand if you don't find any of this valuable. Best of luck with everything and thanks for your time!
​Unsubscribe · Preferences​

Get Clear Insights Straight to Your Inbox

by Dr. Avi Patel

Sign up for Clear Insights – your weekly source for all things Clear Aligners! I share exclusive insights, practical tips, and industry news that will help you take your Clear Aligner game to the next level - delivered straight to your inbox every week! Sign up below!

Read more from Get Clear Insights Straight to Your Inbox
youtube

One of the things I get asked a lot by dentists is: "Does social media actually matter for a dental practice?" The answer is yes — but only when it’s done the right way. Some dentists are already doing this incredibly well. Doctors like Joyce the Dentist, Dr. Tejas Patel, Dr. Jordan Brown and Dr. Joy are great examples. They’re not just posting random content. They’re using social media to clearly communicate three things: • Who they are• Why they do what they do• How they help patients...

7 days ago • 3 min read
youtube

A patient recently paid more for treatment… and didn’t blame me for it. He came in with crowded teeth and an unbalanced bite. During the exam I pointed out a few cracks forming in his molars. Nothing catastrophic yet, but the bite was clearly putting stress on those teeth. I explained the bigger picture. If we balanced his bite with aligners, we could likely prevent those cracks from getting worse. If we did nothing, the chances of future fractures were high. He listened. Then he said he...

14 days ago • 4 min read
youtube

I just got back from the Chicago Midwinter Meeting. It’s one of the biggest dental conferences in the world. And three things became very clear to me. There are more people trying to help dentists than dentists trying to receive help. That’s not a bad thing. It means there are solutions. It means innovation exists. It means people care. But it also means something else. When the market gets crowded, quality gets diluted. A lot of people from outside dentistry see opportunity here. Dentists...

28 days ago • 4 min read