Becker's Dental + DSO Review

23 BECKER'S DENTAL + DSO REVIEW - VOL. 2021 NO. 4 THOUGHT LEADERSHIP way they have always done them, they will be left behind. Peter Grumbos, DDS. Gentle Dentistry of Las Colinas (Irving, Texas): Solo practice ownership is dwindling as new dentists graduating with such exorbitant school loans are buried in debt to the point that their only option is to work for a DSO. DSOs attempting to make quarterly proj- ects are buying practices at higher multi- ples, and thus solo dentists are selling to DSOs versus their own associates if they have associates. DSOs also limit some of the procedures that general dentists are proficient in (such as orthodontics and surgical placement of implants) and only allowing specialists to do the treatment, as a specialist will on one hand receive higher fee reimbursements, but the DSO will have to compensate them more be- cause they are specialists. DSOs don't understand that most specialists ser- vice DSOs as a side gig, but without the general dentist, the DSO doesn't have a company. So why favor specialists? Build the competency of the general dentist, have the general dentist make more money (if proficient in the service), and thus DSOs will reduce their high dentist turnover percentages. The solo practice owner often does not have the patience to mentor a young dentist. In the DSO world, there is some education (usually not one-on-one men- torship and guidance), but the young dentist will either sink or swim. Harold Biller, DDS. Jamaica Estates Dentist (New York City): The biggest challenge that dentistry faces today is a perfect storm of increase in the num- ber of graduates of dental schools, poor distribution of dental practitioners and increased participation in dental insur- ance programs. Most dentists in the U.S. practice in major metropolitan areas. Most graduates tend to try and prac- tice there too. But the graduates have an average $400,000 of student loan debt and feel forced to participate in any and all insurance programs no mat- ter how poor the reimbursement. This allows the insurance companies to try and lower their level of contracted fees in the area. Meanwhile costs of running a practice continue to rise. Dentistry is be- coming more efficient due to the ability to use digital workflows, but the costs of equipping an office with a [cone-beam computed tomography system], scanner and/or [computer-aided design/com- puter-aided manufacturing], plus the monthly support costs to maintain this digital workflow, are out of reach of most solo practitioners. This allows DSOs to attract more patients with their larger ad- vertising budgets and deep pockets to equip their offices with digital workflow solutions. The only way dentistry will sur- vive in the practitioner-proprietor model is as group practices, allowing for fixed assets to be used as many hours a week as possible. n

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