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The DSO CEO with 5 implant vendors (and why he kept them)

Published 20 days ago • 4 min read

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 he's CEO of Smile Partners - 120-plus practices across the Midwest - and the way he leads comes directly from that experience. When his team evaluates a new technology or vendor, the business case is last. Not because revenue doesn't matter. Because he's seen enough practices to know: if it's good for the patient and good for the team, the numbers follow.
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The thing that stood out most in our conversation wasn't his framework. It was what he said about implant vendors.

Smile Partners has five. Not one. Five. Because when they acquire a practice where a doctor has used a specific implant system for 15 years, asking that doctor to switch is close to crossing the clinical autonomy line. So they don't force it. They have a clinician — not Dave — have that conversation peer to peer. And sometimes the answer is: we keep five vendors.

That costs money. They do it anyway.

That's the kind of decision that tells you what an organization actually values versus what it says it values.

If you're evaluating DSO partnerships right now, the questions worth asking aren't about revenue splits. Ask them what they've sacrificed to protect clinical autonomy. Ask if you can call a current partner - good experience and bad. Ask them directly: what's going to change after we sign?

If they say nothing, walk.

If you want to dig deeper into how to evaluate DSO partnerships and what to look for before you sign, reply to this email. Happy to point you toward the right resources.

Video of the Week

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Dave Gaspar, CEO of Smile Partners (120+ practices), pulls back the curtain on what it actually looks like to lead a DSO without a clinical background and why that forces better decisions. In this episode, Dr. Avi and Dave break down the three promises every DSO should make before a doctor signs, why clinical autonomy is only meaningful when you're willing to sacrifice for it, and how grit — not just IQ or EQ — determines whether a partnership actually works.

-Dr. Avi

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