A Dental Support Organization (DSO) is a business model that is changing the landscape of professional dental care. A DSO is an independent management company that partners with existing dental practices. This structure allows licensed dentists to concentrate solely on providing patient care while the business entity handles administrative and operational responsibilities. This model represents a shift from the traditional dentist-owned and operated solo practice.
Defining the Dental Support Organization
A Dental Support Organization functions as a business management and administrative partner for a dental practice. Its purpose is to provide a suite of non-clinical services that support the operations of the facility. These support services include human resources, payroll, managing billing and insurance claims, marketing, and information technology (IT) support.
The DSO model is defined by a clear separation of duties. The licensed dentist remains responsible for all aspects of patient treatment and clinical decision-making. The organization itself does not provide clinical care or employ the dental hygienists or assistants who treat patients. This division allows the practitioner to focus on dentistry while the DSO manages complex business logistics using centralized resources.
The Legal and Operational Structure of a DSO
The operational framework of a Dental Support Organization legally separates the business management entity from the licensed clinical entity. This separation is necessary due to state regulations, often called the “corporate practice of dentistry” doctrine, which prohibit non-dentists or corporations from owning or controlling a dental practice. This doctrine ensures that only licensed professionals make clinical decisions.
To comply with these rules, the DSO, which may be owned by non-dentists or private equity, owns the physical assets, such as the building, equipment, and technology. The affiliated dental practice, owned by a licensed dentist or group of dentists, enters into a long-term service agreement with the DSO for management support. This arrangement must ensure the dentist retains clinical autonomy, including the final say on all treatment plans and patient relationships.
Why DSOs Are Transforming the Dental Industry
The growth of Dental Support Organizations is driven by economic pressures and professional trends. Running a private dental practice has become complex due to rising overhead costs, the need for advanced technology, and navigating insurance and compliance regulations. DSOs offer efficiency and economies of scale, allowing practices to negotiate better rates for supplies, equipment, and laboratory services.
Investment from private equity firms is a factor, as these entities view DSOs as scalable platforms for growth. The capital allows DSOs to acquire practices and invest in infrastructure and technology across multiple locations. DSOs also provide an exit strategy for dentists approaching retirement, offering a way to sell their practice at a favorable valuation without finding an individual buyer.
How DSOs Affect Dental Professionals
Working within a DSO-supported practice offers professional benefits for dentists and hygienists. The removal of administrative tasks, such as billing, payroll, and human resources, allows providers to dedicate more working hours directly to patient care. This reduction in management responsibility contributes to a more predictable schedule and a better work-life balance.
Affiliation with a larger organization provides access to capital for expensive equipment and technologies that might be out of reach for a solo practice. Newer graduates often benefit from structured mentorship programs, continuing education opportunities, and competitive salary and benefits packages. However, some practitioners may experience a perceived loss of control over day-to-day operations or face pressure to adhere to standardized protocols or production goals set by the management company.
What DSOs Mean for the Patient Experience
A patient visiting a DSO-affiliated practice may experience several differences compared to a traditional solo office. One change is the presence of standardized care protocols and consistent technology across all supported practices. This standardization leads to a more predictable experience, focusing on efficiency in scheduling and treatment delivery.
The business structure affects how insurance and billing are handled, as the DSO’s centralized team manages complex insurance claims and fee negotiations. Efficiency gains often translate to greater access to care and more convenient appointment times. However, a common public concern is whether the business goals of the DSO overshadow patient well-being. Practices supported by DSOs generally invest in modern facilities and advanced equipment, which improves the quality and range of diagnostic and treatment options available.
Questions to Ask When Visiting a DSO-Affiliated Practice
Patients should ask questions to understand the structure of the practice they are visiting. A direct question to the dentist about who determines the final treatment plan can clarify the level of clinical independence.
Patients should inquire about the following:
- Who makes the final decision on the recommended treatment plan, and will I be presented with all reasonable options?
- How is my insurance processed, and what is your practice’s philosophy on recommending out-of-pocket procedures?
- What is the tenure of the staff, and has the practice experienced high turnover?
- How does the relationship between the clinical staff and the management company affect patient care?