Dave Gaspar didn't grow up wanting to run a DSO. He grew up in Arizona wanting to be a baseball broadcaster. Listened to Vin Scully every night. Got a communications degree. Worked in radio. Left when he realized small towns and small paychecks weren't the plan. He ended up in veterinary practice management. Then dentistry. And somewhere in between, a few doctors took him into the back of their practices and showed him what the job actually looked like from inside an operatory. That stuck. ow...

I have had this conversation more times than I can count. A doctor reaches out. They joined a DSO two years ago. They were told they would have clinical autonomy, a supportive team, and real income growth. They were told the organization cared about doctors. Then the first major business decision came down the line. And the doctor was not in the room. This is the most common friction point I hear. Not because DSOs are inherently bad. But because there is a gap between what gets promised...

There is a moment that happens in almost every aligner case. The patient leaves your office motivated. They have their trays. They know the rules. Twenty-two hours a day. Remove to eat. Clean before reinserting. And then real life happens. They grab lunch at their desk. They do not have a toothbrush. So they rinse with water, put the tray back in, and keep going. Happens at dinner. Happens at happy hour. Happens every single day for the length of their treatment. You already know what that...