Just Say No To The DSO

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 fordentists to critically assess DSO offers and understand the financial biases at play thatdrive toward consolidation – while leaving dentists in the dust. Bob and Nate aim toeducate dentists and empower them to make decisions that align with their bestinterests 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 summarizeSeason 2 of "Just Say No to the DSO" – foreshadowing the end of Season 2 (althoughthere will be one more bonus episode #9 coming.) In this episode, they dive deep intothe 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.

Dentists should carefully review contracts, understand their implications, andassert control over their practices to safeguard their long-term interests and wealth. Bob shares insights from his mentor, stressing the importance of negotiating from a position ofstrength and being willing to walk away from a deal. Identify key contract clauses to scrutinize, including non-disparagement agreements, non-compete clauses, workweek expectations, compensation structures, termination provisions, and equity arrangements.

In this episode of Just Say No to the DSO hosts Bob Spiel andNate 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 todramatically overstate their value, which leads dentists to believe their ownership isworth much more than it is.The discussion underscores the lack of transparency among DSO valuations, and whyself-defined Equity is open to abuses. Ultimately, the episode aims to empower dentiststo 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 deepinto the deceptive tactics employed by Dental Service Organizations (DSOs) to luredentists into unfavorable agreements. Through real-life examples and a critical analysisof a $29 million DSO offer, they highlight the hidden costs and risks that dentists oftenoverlook in pursuit of financial gain.The discussion underscores the importance of diligence and transparency in evaluatingDSO deals, urging dentists to seek independent advice and scrutinize all terms beforerelinquishing control of their practices. Ultimately, the episode aims to empowerdentists 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 BobSpiel and co-host Nate Williams, it discusses reasons why dental practice ownersshould 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 thesedeals 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 dealsand 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 andco-host Nate Williams, it discusses reasons why dental practice owners should avoid selling toDental Support Organizations (DSOs). Bob Spiel has an MBA and is a practice managementconsultant, while Nate Williams is a dental CPA. They have both been in dentistry for over 15years.Key points discussed: Introduction: Bob and Nate introduce themselves, emphasizing theirexperience 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 theimportance of owning a dental practice for long-term wealth.Changes in the Industry: They discuss the rapid growth of DSOs and thechallenges they face, such as contract expirations and recruitment difficulties.Case Study: Bob and Nate share a real-life example of a DSO facing financialdifficulties and restructuring, highlighting the risks associated with selling to DSOs.Lessons Learned: They draw parallels with the medical industry's shift towardscorporatization 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 commonpitfalls.Conclusion: Just Say No to the DSO! If you have any questions, please send them toquestions@justsaynototheDSO.comOverall, the episode serves as a warning against the potential pitfalls of selling private dentalpractices to DSOs and provides insights to help dentists make informed decisions about theirpractices'; 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.

In this episode, hosts Bob Spiel and Nate Williams focus on the impact of Dental SupportOrganizations (DSOs) on the dental industry and their mission to dissuade dentists from sellingtheir practices to DSOs. They address various aspects of this issue in three parts:1. Bob and Nate emphasize the difference between wealth as cash and true wealth, which theydefine as owning productive capacity, particularly in the context of dental practices. Theydiscuss the risks associated with selling a dental practice, such as rapid depreciation in valuewhen the dentist is no longer actively involved.2. Bob and Nate explore the factors contributing to the rapid growth of DSOs, includinggovernment funding during the COVID-19 pandemic, low interest rates, and surplus capital-seeking investment opportunities. They share a personal anecdote about a dentist who chosenot to sell his practice to provide his son with an independent dentistry opportunity.3. Bob and Nate delve into the tactics used by DSOs to entice dentists into selling theirpractices, such as offering equity in the buying DSO and recruiting influential doctors to createnetwork effects. They express concerns about doctors being complicit in the consolidation ofpower by DSOs and debunk the myth that selling to a DSO benefits a dentist in the long run.Overall, Bob and Nate encourage listeners to share their message with colleagues and friends inthe dental industry, raising awareness about the potential downsides of selling to DSOs and theimportance of considering the long-term implications. With any questions, please email us at questions@justsaynotothedso.com

In this podcast episode, Bob and Nate discuss the reasons why dentists should not sell their dental practices to Dental Support Organizations (DSOs). Nate emphasizes the importance of owning a business and the wealth generated by owning productive assets, such as a dental practice. He also highlights the unique nature of dentistry, where the dentist's trained mind and hands are the product. Bob and Nate discuss the benefits of owning a dental practice, including control over how the work is done, freedom to manage time, and the ability to create and maintain the practice's culture. They acknowledge that owning a business comes with increased responsibility, but they believe it's worth it for those who have the desire and courage to take on the challenge.Bob and Nate mention that many aspects of practice management that DSO's tout they can take off a dentist-owners plate, such as accounting, payroll, HR support, and marketing, can be delegated or hired out. They stress the importance of investing in oneself and seeking coaching and consulting help to build a team that supports the dentist's vision while retaining ownership and control of the practice.They share examples of successful dentists who have built thriving practices by delegating non-clinical tasks and focusing on their clinical expertise. They also discuss the downside of not delegating and being the bottleneck in practice growth. Ultimately, their experience shows selling to a DSO will almost always lead to making less money while having less control over the practice, and ultimately giving control of the dental industry to non-dentist business people who are ultimately in it to harvest profits, not care for patients or create healthy relationships with doctors or their teams. Overall, the episode encourages dentists to retain ownership of their practices, embrace the challenges, and build a team that allows them to maintain control while enjoying the financial benefits of ownership. With any questions, please email us at questions@justsaynotothedso.com.

In this episode, Bob Spiel and Nate Williams introduce their podcast "Just Say No to the DSO." They discuss their purpose, which is to persuade dental practice owners not to sell their practices to Dental Support Organizations (DSOs). Their experience is that selling to a DSO will almost always lead to making less money while losing control over their practice and life, and ultimately give industry control to non-dentist businesspeople. They share their backgrounds, with Nate being a dental CPA and financial planner at his nationwide, multi-specialty firm with over 300 dental clients, and Bob having an MBA and 15 years of experience consulting in dentistry. Before consulting in dentistry Bob was a hospital and surgical center CEO, so he had a front row seat to the corporatization of medicine. They emphasize that they have no financial interest in promoting this message and are dedicated to helping dentists protect their independence and the dental industry as a whole. They also outline the topics they plan to cover in upcoming episodes, such as the consequences of selling to a DSO, understanding DSO players and tactics, and the trajectory of the dental industry. The podcast aims to provide dentists with information to make informed decisions about their practices. With any questions, please email us at questions@justsaynotothedso.com.

In the trailer we share who Bob Spiel and Nate Williams are, why we are so passionate about the future of dentistry being owned by dentists and not corporations, and what are the questions Season One addresses.