North Texas Dentistry Volume 9 Issue 5 2019 ISSUE 5 DE | Page 28
practice models
THE
PAST
PRESENT AND
FUTURE
OF THE
DSO
by Brian Colao and Meredith Tavallaee
First, what is a DSO?
A Dental Services Organization or “DSO” provides non-clinical administrative support services to dental practices that are
100% owned and controlled by licensed dentists. A DSO is not a licensed dentist and cannot practice dentistry, own a dental
practice or interfere with the independent professional judgment of a licensed dentist. Rather, a DSO can provide non-clin-
ical support services to a contractually affiliated dental practice. The key feature of a DSO is that it can be owned by non-
dentists who generally have access to more capital than licensed dentists and can provide much higher rates of return for
practice owners who choose to affiliate with a DSO.
DSO 1.0 - The 1990s
DSOs have been around since the 1990s
when a group of successful orthodontists
in Atlanta created a model to manage
other orthodontists and provide a retire-
ment plan by locating orthodontists to
take their place when they wanted to
retire. Unfortunately, the orthodontists
lacked the capital to implement their
model and had to obtain non-dentist
investors. As a result, the model that was
created differed considerably from the
initial vision of the founding orthodon-
tists in that it was owned by non-dentists
that did not understand dentistry or the
dental regulations. The non-dentist own-
ers did not get along with their contrac-
tually affiliated dentists, did not follow
the required regulations and the result
was massive litigation by dentists who
sought to terminate their contracts. In
the end, the First Generation DSO model
was almost a complete failure. However,
the original vision of the model was
appealing and the door was left open for
future revised models.
28 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
DSO 2.0 - Present Day
In the early 2000s, the DSO model was
tried again and improved upon with the
knowledge from the failed first genera-
tion. The new DSOs got along with their
contractually affiliated dentists and
attracted friendly dentists who were
onboard with the DSO model. Although
generation 2.0 did meet with success, it
still failed to follow all of the regulations
and had trouble attracting and retaining
talent due to a lingering perception that