Just Say No To The DSO

Full steam ahead with no going back! The show is picking up incredible momentum thanks to our great listeners. Nate grabs another incredible guest this week in Scott Haley from Premier Orthodontics Practices. Scott has heard about the great work being done on Just Say No and wanted to hear it directly from the sources.

How do professionals begin and interact with the dental industry? So many great people from various backgrounds are attracted to this amazing field and we have one of the best today. John Van Leeuwen joins the crew remotely today for an awesome interview.

Here the amazing conclusion to the conversation between attorney Jason Wood and Nate as they disect where deals seem to stop making sense.

Just Say No to the DSO is coming off of some hot interviews and following up with experts all over the country to go over the details and discerne between fact and fiction. Nate sits down with attorney Jason Wood in order to dive deep into DSO deals. Here the amazing back and forth and find out where they agree and where they don't. Part 2 will follow shortly.

After the Chip interview, Bob and Nate breakdown an actual DSO deal offer in order to get a better idea and understanding at what the tangible numbers look like. We wish we were making this stuff up…but we aren’t.

After our amazing interview with Chip Fichtner, we've let the dust settle a bit and had time to digest as well as think over what was said. Bob and Nate discuss what iDSOs are really offering dentists and how the math cannot compute.

We are back for an amazing start to season 3. Bob and Nate sit down with one of the biggest iDSO brokers in the world, Chip Fichtner. This is an amazing interview to showcase what the otherside is thinking and trying to sell.

In this final episode of Season 2, Bob Spiel and Nate Williams emphasize the need for dentists to critically assess DSO offers and understand the financial biases at play that drive toward consolidation – while leaving dentists in the dust. Bob and Nate aim to educate dentists and empower them to make decisions that align with their best interests and long-term goals. Teasing Season 3, they promise deeper exploration through interviews with dentists who have resisted DSOs or exited them, sharing their experiences and insights.

Get ready for a candid and insightful chat as Bob Spiel and Nate Williams summarize Season 2 of "Just Say No to the DSO" – foreshadowing the end of Season 2 (although there will be one more bonus episode #9 coming.) In this episode, they dive deep into the nitty-gritty of selling dental practices to Dental Service Organizations (DSOs), offering up wisdom, wit, and a healthy dose of skepticism.

Bob and Nate encouraging dentists to reject DSO sales pitches and maintain ownership of their practices for long-term success. Reiterating the importance of staying engaged in their work and understanding that DSOs won't overpay or make practice ownership easier.

In this episode of “Just In this episode of "Just Say No to the DSO," hosts Bob Spiel and Nate Williams dive deep into the subject of DSO sale and employment contracts, and the surprises that dwell inside each. The discussion underscores how DSO contracts are driven by dollar signs and the DSO’s need to exert control in the business relationship.

In this episode of Just Say No to the DSO hosts Bob Spiel and Nate Williams dive deep into the subject of ownership in a DSO, or what is called “Equity”. They describe why Equity is a self-made target that allows DSO’s to dramatically overstate their value, which leads dentists to believe their ownership is worth much more than it is. The discussion underscores the lack of transparency among DSO valuations, and why self-defined Equity is open to abuses. Ultimately, the episode aims to empower dentists to make informed decisions that safeguard their autonomy and financial well-being.

In this episode of "Just Say No to the DSO" hosts Bob Spiel and Nate Williams dive deep into the deceptive tactics employed by Dental Service Organizations (DSOs) to lure dentists into unfavorable agreements. Through real-life examples and a critical analysis of a $29 million DSO offer, they highlight the hidden costs and risks that dentists often overlook in pursuit of financial gain. The discussion underscores the importance of diligence and transparency in evaluating DSO deals, urging dentists to seek independent advice and scrutinize all terms before relinquishing control of their practices. Ultimately, the episode aims to empower dentists to make informed decisions that safeguard their autonomy and financial well- being.

The podcast is episode three of Season 2 for “Just Say No to the DSO." Hosted by Bob Spiel and co-host Nate Williams, it discusses reasons why dental practice owners should avoid selling to Dental Support Organizations (DSOs). This podcast episode is a warning to dentists who are thinking about taking DSO deals. The hosts do a deep dive into a $20 million DSO deal and reveal how deceptive these deals can be. They stress the importance of being critical and skeptical of these deals. The goal of the podcast is to help dentists make informed decisions about DSO deals and keep control of their practices.

In this podcast episode of "Just Say No to the DSO," hosts Bob Spiel and Nate Williams discuss the importance of dentists maintaining control of their practices rather than selling to Dental Service Organizations (DSOs). They emphasize that smart business people don't overpay for practices and that DSOs are adept at making dentists think they're getting a great deal when, in reality, they may be giving away their practices for little to no value. The hosts explain the concept of EBITDA (earnings before interest, taxes, depreciation, and amortization) and how DSOs structure deals in a way that essentially allows them to acquire practices for free or at a minimal cost to themselves. They warn dentists to be cautious of promises made by DSOs regarding equity and future earnings, as these promises may not materialize. The episode concludes with a teaser for the next installment, where they will delve deeper into the realities of DSO deals.

The podcast is episode one of Season 2 for “Just Say No to the DSO"; Hosted by Bob Spiel and co-host Nate Williams, it discusses reasons why dental practice owners should avoid selling to Dental Support Organizations (DSOs). Bob Spiel has an MBA and is a practice management consultant, while Nate Williams is a dental CPA. They have both been in dentistry for over 15 years. Key points discussed: Introduction: Bob and Nate introduce themselves, emphasizing their experience in dentistry and financial consulting. Reasons to Avoid DSOs: They discuss three prevailing myths about selling to DSOs: ● Myth 1: Selling to a DSO will make more money. ● Myth 2: Selling to a DSO means earning passive income from others'; work. ● Myth 3: Selling to a DSO will make life easier. They then dive into: Reflection on Season 1: Bob and Nate reflect on Season 1's topics, emphasizing the importance of owning a dental practice for long-term wealth. Changes in the Industry: They discuss the rapid growth of DSOs and the challenges they face, such as contract expirations and recruitment difficulties. Case Study: Bob and Nate share a real-life example of a DSO facing financial difficulties and restructuring, highlighting the risks associated with selling to DSOs. Lessons Learned: They draw parallels with the medical industry's shift towards corporatization and caution against losing control over one's practice and profession. Preview of Season 2: Bob and Nate outline the topics to be covered in Season 2, including financial principles, contract analysis, equity considerations, and common pitfalls. Conclusion: Just Say No to the DSO! If you have any questions, please send them to questions@justsaynototheDSO.com Overall, the episode serves as a warning against the potential pitfalls of selling private dental practices to DSOs and provides insights to help dentists make informed decisions about their practices'; future.

Concluding Season 1, the conversation focuses on the complexities and challenges associated with dentists selling to Dental Service Organizations (DSOs). Many dentists who engage in these DSO partnerships find themselves literally "paying back" their earnings over extended periods, without reaping any significant benefits unless their DSO is gobbled up (i.e. acquired) by a larger DSO. This model has an alarming turnover rate, with about 70% of engaged dentists leaving within the first two years, suggesting widespread discontent among the dentists who work within DSOs. While it is argued that one need for DSOs arises as dental graduates might not be ready for private practice because of modern dental education, many leave due to the unsatisfactory work environment. Bob and Nate further stress how the role of the dentist in a practice remains paramount. Their intrinsic value lies in the care they provide, and the episode emphasizes the vast growth and development opportunities available within the dentistry field. Throughout their careers, dentists have the unique opportunity to grow significantly in their clinical skills, and also grow in managerial, interpersonal, and leadership capabilities. The hosts passionately advise dentists to retain ownership of their practices and be cautious of the DSO model's allure. They anticipate potential challenges for DSOs in the future, especially in retaining top-tier talent and managing the associated financial constraints. Concluding the episode, there's a call to challenge the conversation about DSOs in the dental community, placing emphasis on individual dental practices over corporate DSO models.

In this episode, the hosts discuss the nuances and complexities of joining Dental Service Organizations (DSO’s), particularly highlighting the illusion they create of community and unity. Although these groups promote the idea of collective strength, many doctors, after joining, still find themselves feeling isolated in their individual practices, realizing that the promised unity doesn't quite materialize. The allure of equity is another theme, with many doctors being tempted to sell their practices for a sizable upfront sum that promises future financial freedom. However, the hosts argue that genuine freedom derives from maintaining autonomy over one's practice and life decisions. Selling leads to a loss of both control and freedom, putting the doctor in a restrictive employee position. The episode touches upon the "fear of missing out" (FOMO) phenomenon. As doctors see their peers, especially successful ones, selling their practices, they feel mounting pressure to follow suit, fearing they might miss out on lucrative opportunities. Yet, the hosts draw an analogy to the gold rush, suggesting that in this dental "gold rush", like the gold rushes of old, it isn't the dentists who are profiting the most, but those brokering the deals. Furthermore, the hosts bring to light the non-disparagement agreements doctors sign when joining Dental Service Organizations (DSOs). These agreements legally bind doctors, preventing them from sharing any negative experiences, which might explain the dearth of negative testimonials about DSOs. Concluding, the episode emphasizes that while stories of regret about joining DSOs might be scarce due to various reasons, there are numerous tales of dentists who have stayed independent and found substantial financial and personal success.

In this podcast episode, our hosts dive into the distinctions between the medical and dental industries. As the discussion unfolds, Nate interviews Bob drawing on his experience in medicine as a hospital and surgical center CEO, highlighting the trajectory in which medical doctors have found themselves, where doctors have lost almost all control over their careers, primarily becoming indirect government employees working for large hospital systems. They sound an alarm on the risk that if DSO’s are successful in dental industry consolidation, dentistry will follow a similar path, leading to government-driven pricing, and dentists and dental specialists becoming mere cogs in a larger machine. They argue that this outcome is both self-induced and avoidable. Through personal anecdotes, Bob and Nate underscore the long-term relationships dentists build with their patients and the potential repercussions of capitulating to larger corporate entities. As the episode draws to a close, they pose a poignant challenge to dentists: to ponder deeply on the significance of preserving the integrity, autonomy, and quality of the dental industry for the sake of its future. They encourage reflection on the consequences of dentistry following the path of medicine and the impact of such a devolution to future dentists, their teams, and patients.

Episode 4 dives deep into the financial intricacies and emotional pressures associated with Dental Service Organizations (DSOs). Initially, the hosts explore the selling tactics of DSOs, emphasizing the allure of immediate money. These tactics involve offering dentists a significant sum upfront for their practices. However, they caution that this is merely an advance against future earnings, not a bonus. Bob and Nate highlight that the DSOs expect the dentists to earn back this money (i.e. pay it back) by working for the corporation over a designated period, often amounting to five years. In essence, the dentists are trading their practice's autonomy for immediate financial gratification – while in the end the autonomy is gone and so is the money. Drawing parallels to emotional purchases, such as the decision to buy new golf clubs even when old ones suffice, the hosts discuss the human tendency to justify decisions emotionally made with logic afterward. The decision to sell to a DSO is framed similarly – an emotionally driven decision that many dentists come to regret, especially when locked into multi-year commitments without a clear vision of the future except knowing in leaving the DSO they almost always are contractually restricted from working within the same area. Throughout the conversation, Bob and Nate underline the substantial risks for dentists: loss of their asset (the practice), loss of autonomy, the financial loss from repaying the upfront money, and emotional regret. Conversely, DSOs and those facilitating these deals stand to benefit significantly, with the former acquiring valuable assets and the latter reaping hefty commissions. This episode culminates with a strong message advocating for dentists to retain their practices. While the initial offer from a DSO might seem enticing, in the long-term, holding onto one's practice is presented as the more financially sound and personally/professionally rewarding decision.