Episode : #1,179: Yes, You Can Win Against DSOs, Even As a Private Practice

Podcast Description

Private practices — ever feel like you can’t win against the DSOs? Kiera talks about what your practice can continue to produce that DSOs, with their multiple locations and bigger budgets, can’t replicate.

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Transcript:

Kiera Dent- Dental A Team (00:00)

Hello, Dental A Team listeners. This is Kiera, and I am excited. Today’s gonna be a fun rift of a podcast for you. It’s gonna be like, can independent practices like private practice still beat DSOs if you want to? This isn’t a rag on DSOs, it’s not a rag on private practices. It’s just can private practice, independent practices still win against the DSO? Because I think a lot of people are losing faith and confidence and feeling like if I’m not a part of a DSO, I can’t win. So I wanna just tickle our brains today.

Think about it in a different way and let’s have a fun rift because you remember this is the best place. Dental A Team is the place where we are obsessed about helping you have your best life. We call it the Yes Success Model, where we focus on you and your vision, earnings and profitability, and then systems scale and structure for you. So that way you’ve got the systems, the structure, and the scalability for long term. I’m obsessed with helping teams and doctors align. I’m obsessed with dentistry. My last name’s Dent for crying out loud. I love this. So let’s do a good rift. Let’s talk about.

Can we really still win? It feels like DSOs, they got so much money over there and like they don’t have to worry about margins. But I don’t think that that’s necessarily true. And I do believe last year, now I believe I know, DSOs had their first down year last year. So like I said, there is no I don’t have a dog in the fight. My dog in the fight is which I don’t even know where that phrase comes from. So if someone wants to pen pal me and tell me about this, I mean I could sure I could look it up. But like if you know, send me an email, [email protected]. I’m Kiera. It’s fun. It’s fun to have a good pen pal over there.

But I I think my dog in the fight is what’s gonna be the best for dentistry long term. That is my dog in the fight. I wanna make sure that we as a population, money talks. I don’t blame you. Getting a good multiple for your practice, like, why not? You’re in you’re in the golden era of dental practices. Or so they make it put on paper. Make sure it really is the golden era for you if you choose to go that route. and a lot of people have been very happy. A lot of people have also had the shorts burned off them. Tell me why that’s a thing too. Like,

How does someone get their shorts burned off them? I also want to know that phrase. I’m here for the phrases today, too, on the rift. And also, I’d love to know your opinion on this. So I’m gonna rift on my side and then shoot me an email. I’d love to hear. [email protected] so okay, the rift today. DSOs are all like, okay, let me just go back, backing it up. Ultimately, I hope that we preserve the sanctity of great dentistry for patients forever.

That’s my hope. I don’t care if it’s DSOs, I don’t care if it’s private practice, I don’t care what it is. But I do not dental practices are businesses. I also work in dentistry as a clinician. And I’m not okay with us squeezing margins and compromising care to hit margins. To me, that’s just unfair. It’s unfair for patients. I look at a lot of things in our healthcare system and I don’t love it. And so I think that dentistry has been kind of the wild, wild west, and we’ve stayed out of a lot of it. And so I just hope that while we make

Decisions financially and personally, I hope that we think about our long-term consequence. And that comes for a lot of new ones. I think that there’s more senior doctors who have been in dentistry for a long time. Like they’re not as worried about the multiples. I think a lot of our newer doctors who have a lot of debt on this, there’s an easy cash payout. I would just say and a caution and an ask is let’s just remember that we’ve had pioneers ahead of us who have paved the way.

Let’s continue to be those pioneers that are able to preserve and sanctify dentistry, whether that’s through DSOs or private practices. So that’s Kiera’s dog in the fight. And I hope that you agree. And maybe you have a different opinion. So like let’s have a good conversation. This is what we talk about in our monthly masterminds. So come chat, hang out. I’d love to have you there. okay. So can we win? Here are some thoughts of how private practices can still win against DSOs. So like DSOs, they do have more locations. They got bigger budgets, they’ve got bigger teams.

But I do feel like there’s still things in private practice that DSOs can’t replicate. So I think the biggest threat is if you feel like you can’t compete and you give up because there are ways and you can still win. you don’t have to outspend a DSO. You don’t need to out execute them. I do think that there’s still competitive advantages. And so really leaning into whatever is going to be best for you. And again, remember, my my long term opinion is let’s just make sure that we protect and sanctify dentistry for the health of our patients. And yes, I want you to be a profitable business owner.

I think you can have both. I don’t think it has to be one or the other. DSO or non-DSO. Now, private equity. I do have my opinions about private equity and I don’t believe that they’re always there for ethical reasons. and so I just say like make sure that the decisions you’re making with your practice and your patient is going to help long term, the greater good. So those are my two cents on it. So anyway, just we work with a lot of practices. So I think that there’s still ways that you can still compete against large corps, corporations. So number one.

I think is independent practices, private practices, they have a connection that I think a lot of DSOs lack. DSOs tend to have a burn and churn model. So patients actually knowing their doctor, trusting their team, feeling remembered, feeling valued, and making sure that it’s not a constant churn. Now I will have a call out. There are a lot of private practices that I know that are also on a burn and churn. They’re churning associates left and right. They’re turning team members. I get that it’s hard right now, but I will say that if that’s your practice, you are not competing against those corporate organizations that have.

run of the mill doctors. So I think that private practices can have a consistent provider relationship. I absolutely hate going to the dentist. I actually have transferred away. Like I can get multiple doctors across the road, guys. I don’t know if you know what I do for a living, but I work with a lot of dentists. So if I want sporadic care, aka I go into one practice, but I see different providers all the time. And I know we have the whole phrase of they’re provide their patients at the practice, which is not wrong.

But I’d say the more consistent you can have of team of providers that’s going to help you win. I’m not saying to keep team members just because of longevity. I am here to say though, consistent provider relationships I do think will outshine. Just like I hate getting a new hair person, I hate getting a new nail person. People don’t like to change that. So I think that that’s going to be a zone for you. So personalized experience and long-term patient loyalty. Those are going to be

key places that I think private practices can win. Now, DSL is listening, guess what? This is your edge as well. Like this is how you can have an edge. And ultimately we’re all here for it. But these things need to stay and maintain. so I do believe that patients who see the same doctor, the same team for years are much less likely to leave based on price or convenience. Like they’re going to stick with you. Why why? They don’t want to change that up. I don’t want to go show someone else my mouth and have that awkward moment where I just

Don’t like I don’t have this, so just know that it’s a space where like you gotta you gotta be connected, you’ve gotta help them feel seen and known. And I do believe that that’s that is a zone. Daos are gonna scale systems, but like being able to scale genuine relationships, I do think is a harder thing. So in private practices, watch yourself. Look to see do you have those genuine connections? Are we scaling genuine relationships? Is that something that we’re doing in those personalized pieces? You can stand out and still scale and still be profitable. So

I just think maybe like if you’re looking at this, looking at your team, wanting to have a reflection, what’s a way that we can connect and create more personalized patient experiences? How can we keep like, if we want to keep a patient for life, what’s gonna make them want to choose us consistently? If there’s a competitor of price, if there’s a competitor of convenience, how do we make sure those patients stay loyal to us? another thing I think that private practice can win on is believe it or not, in private practice, you can typically move faster.

So I know a lot of people when they interview coming to Dental A Team coming from large organizations, like, I love that there’s not as much red tape, Kiera. I love that you can move quicker, that we can make decisions faster, we’re more nimble. And I think that that is a a huge selling point for private practices to be able to out outpace. You can have faster decision making, you can have faster implementation, you have less red tape, you’ve got greater flexibility. That can also create chaos. We gotta make sure that we don’t we don’t flex too much. But

If patients are wanting something, we can usually make those calls. We can have a more personalized experience. We can have like great water bottles. We can have different things that make patients have it. So, like you can change scheduling systems, you can change patient experience protocols, you can have like different pieces that your patients can recognize and see. Where in large organizations, a lot of times it does take like months to implement these items. So I do think agility does create opportunity. And so for you to just look at this and think like, all right, what ways can we be more flexible, more adaptable?

Like you don’t have to have permission to improve things. So if you don’t have to have permission to improve, what are we waiting to improve? What things could be improved upon? How can we make a better patient experience? How can we make a better team experience? there’s a doctor that I was talking to the other day, and he said, Kiera, I have like a lifestyle practice and I want to attract team members for that lifestyle practice. And I just thought, like, how crazy cool is that? Because I think like that is the agility, that’s the flexibility of a private practice that also makes it a great working place.

For team members. Like it’s not just about patients, it’s also about team and attracting those. So that’s another zone where I think private practice can still outpace a DSO for sure. and then I do think that systems can win more than size in a lot of ways. So a lot of times we think bigger is better. And I know a lot of times I’m intimidated as a smaller business, if you will, smaller, medium sized business compared to large organizations. You’re like, they just have all of it, but it’s not true. So

I’ve seen in a lot of our practices very profitable independent practices, really strong leadership, great patient experiences, clear accountability. And you actually can have scheduling protocols and case acceptance systems and leadership systems and financial systems. Smaller scale practices can actually have great, incredible systems in place. So I do believe that a well-run single location or maybe two or three locations oftentimes will outperform on profitability than larger organizations because of.

execution is a lot stronger. So it’s having those systems that are clear, having those and I know a lot of people are like, but what systems? And our team kind of boiled it down. There’s about like 10 to 15 core systems that every practice that they’ll implement and execute on, they’re going to thrive. And it’s scheduling case acceptance, leadership, like our billing protocols, things like that, morning huddles, very basic, non-sexy, but having those systems is going to be much grander than size.

And the larger you get, yes, they try to implement these, but I do still feel like those systems can create those predictable experiences. They can have a more customized experience. And then if we don’t like it, we can pivot that system, we can refine that system, we can make it better. So I just think it’s like, how do you have the best run practice? Not necessarily the biggest practice. And so I would look at your practice and what are the systems? What are the gaps? Where do we slip? Where do patients maybe fill that? Where does our team fill that? Let’s fix that. Let’s organize that. Let’s let’s have that. That way we’re able to.

To be able to outpace. And so there’s lots of ways. I think having those genuine connections, making sure that we’ve got systems that grow with us, having strong leadership teams, having a great, like, I don’t know, community feel. There’s just something different. Think about it. I have a fee-for-service chiropractor versus corporate chiropractor. I’ve gone to both. And one is like run of the mill. I come in, I’m out, checked in, checked out, it’s cheaper. But they don’t know me. They don’t have an experience. They don’t spend time with me. I do think time that doesn’t mean like,

10 minutes, it means genuine connection time. Those things you still can win. And believe it or not, a lot of our practices are sitting at 20, 30, 40% profit margins. You can still be very profitable and not need to be in a DSO. They have a ton, they can scale a lot, but I also think there’s an autonomy piece, there’s a creativity piece, there’s a branding piece of you being able to brand your location as you, to be able to give an experience that is very custom to you, to your audience. So I do believe that there’s still a way that private practice can.

win against DSLs. I think there’s space for both. I don’t think one’s right or wrong. But again, like I said, my dog in the fight is whatever we choose to do, whatever pieces we’re doing, let’s just remember to keep the sanctity of dentistry pure. Let’s make sure that we’re doing what’s in the best interest of our patients. Let’s make sure we’re not cutting corners on dentistry. We’re not trying to fit people in to hit production goals just to hit production goals. We’re not compromising the the products that we use to be able to to hit the right profit margins. I believe that

being the best for our patients will always, always follow profitability. So with that, right now, let’s remember, like relationships, you get it. You guys also have speed and flexibility and agility. And you also do have systems that you can put into place that will like beat size. They have other things. They’ve got billing, they’ve got it, but think about it, you’re gonna sell to them anyway. You might as well get those things in place and you might as well try on your own. So

You think they’re gonna take over all your problems? You can do this on your own and you don’t have to sell your practice. I had a dentist who was wanting to sell his practice. He’s like, Kiera, I’m gonna sell to a DSO. And I said, Great, like I’m here for it. Let’s rally. And then he’s like, I said, let’s just think through. Like when they buy you, what are they going to do? He’s like, they’re gonna expand the practice and they’re gonna put systems into place. And I said, Well, do you wanna do that? And he was like, Yeah, like I’m gonna sell to them and they’re gonna make all the money on the things that I could just do. And I was like, I’m really proud of you because you’re exactly right.

So if they’re gonna do that anyway, why not do it yourself and reap the rewards? We’re here to help you. I helped that practice. We went took them from eight eight ops to 15 ops. They’re doing amazing. They’re on track to be a five million dollar practice this year. All those things the DSO would have done. We were able to put the systems in place, build the leadership team, expand the practice. They’re crushing it. They’re doing incredible over there. So again, flexibility, agility, great patient care. And where they go, because people are like, well, a DSO is the only person who’s gonna buy me. That’s not true. Stop limiting yourself.

There’s lots of people. There’s lots of options. Do you know how many people come out of school wanting to buy? They come out and they do want to buy. So don’t limit yourself, you guys. People are like, they can’t afford homes. That’s not true. There’s a lot of people willing to there might now need to be two partners instead of just one partner. It’s okay. It’s gonna look a little different, but that doesn’t mean that that’s the only option. So I really do think that private practice dentistry can absolutely thrive. I do believe that the practice is winning today, DSO or private practice.

Aren’t the ones with multiple the most locations? They’re the ones with the strongest leadership, strongest systems, best connection, best patient care. Those are the ones that are winning. So look at it. Do we have the best leadership? Do we have the best systems? Do we have the best patient connection? Do we have the best experience? And if so, fantastic. Make sure that all your patients know it. Make sure that people are talking about it. You guys can do this. I love helping private practices. Whatever your dream is, whatever your goals, if it’s DSO or not, I don’t care. I just want you to have your best life. And like, hey, before you sell, maybe let’s chat.

Let’s talk about it. Let’s see if there’s a way that we could actually take that load and that stress and that annoyance off and you reap the rewards before you go and sell. there’s so many ways that we can do this. So reach out. [email protected]. And as always, thanks for listening. I’ll catch you next time on the Dental A Team podcast.