Just Say No To The DSO

In this episode of Just Say No to the DSO, hosts Bob and Nate tackle a letter from oral surgeon Louis D, unpacking whether new grads should join a DSO for quick reps or hold out for private practice. They map the career like a baseball diamond—nail clinical skills as solid second base before you even think about rounding third into business ownership—and caution that the wrong DSO can actually send your skills backward while the right private practice offers mentorship and a real path to partnership. Debunking the usual pitches around zero startup costs, “abundant” marketing, free CE, and...

In this episode of Just Say No to the DSO, hosts Bob and Nate examine the current DSO landscape and the groups of people they do not envy: DSO management teams managing unhappy doctors, founders whose original vision was lost in subsequent recaps, doctors who recruited friends for commissions, professionals who leveraged their reputations to push DSO deals, private-equity players left holding the bag when financing conditions tighten, and operators of cash-bleeding platforms that cannot recapitalize or exit. They restate their core position that the producing dentist—not an abstract “practice”—is the true economic engine and asset of dentistry, and that...

In this episode of Just Say No to the DSO, hosts Bob and Nate take on the ethics of selling a dental practice, sparked by a lengthy Dentaltown post from Howard Farran that frames the decision almost entirely around which buyer offers the highest financial return. They push back on the idea that money is the sole (or highest) standard, arguing that work should be a meaningful calling rather than just a means to an end, and that short-term profit-maximizing thinking erodes both personal satisfaction and the long-term health of the profession. Drawing on real client stories, a farmland analogy...

In this episode of Just Say No to the DSO, hosts Bob and Nate debrief their recent conversation with Dr. Whitney Weiner, an influential periodontist and Chief Growth Officer at Icon. They examine her role as a polished DSO/DPO “influencer,” question the financial struggles that led her to sell her practices, and push back on claims about arbitrage, doctor ownership, and the long-term viability of the Icon model. The hosts ultimately argue that Icon represents “same wolf, different clothing” and that the pitch to sell into such structures still doesn’t add up for independent dentists.

Nate and Bob open this episode of Just Say No to the DSO by dissecting a recent email from broker Chip Fitchner that treats Walmart’s quarterly numbers and the next recession as proof every dentist should sell to an IDSO immediately. With a mix of straight analysis and pointed humor, they walk through the fear-and-hype playbook—liquidity, “chips off the table,” and the promise of fewer headaches—and show why those talking points collapse under even modest scrutiny. The takeaway is the same one the show was built on: a well-run independent practice still beats handing over the golden goose to s...

Bob Speil and Nate Williams open with the starfish principle—one doctor who doesn’t sell is worth the whole podcast—then analogize DSO dealmaking to Big Tobacco: a fortune in getting people hooked, almost nothing in talking them out of it. They take a highlighter to Chip Fichtner’s LPS 2025 scorecard and “just reconnect” emails, knocking the 6.75–11x EBITDA headlines down to work-backs, minority equity, and a commission machine now waving BlackRock, yachts, recruiting teams, and AI as reasons to hand over the name on the door. The closer is the real question under the sales copy: when private equity and fam...

In this episode, Dr. Whitney Weiner shares her journey from private practice to joining ICON Dental Partners, discussing the motivations, challenges, and industry insights related to group dentistry and private equity involvement. We explore the nuances of practice ownership, valuation, and the impact of DSO models on dentists and the profession.

This is a special Just Say No episode with a dentist who entered into a DSO and realized it was the wrong way forward for himself as his patients. Dr. Brad Langley recounts his tale of not only saying yes to a DSO but finally breaking free and finding new freedom after getting out. Here is a great quote from today's episode:

"After spending years in a DSO, I realized the corporate grind was squeezing out the personal touch. I started feeling disconnected, especially when it came to valuing my team. The constant push for profit often overshadowed...

In this episode, Dr. Stephanie Klasner shares her journey through the dental industry, her experiences with DSO models, and her insights on ethical practice and ownership. Discover how she navigated challenges and found success by prioritizing relationships and integrity.

In this episode, Dr. Michael Davis discusses the pitfalls of DSO affiliations, legal settlements, and the importance of ethical practice in dentistry. He highlights recent cases like Aspen Dental's legal issues and offers advice for dentists considering partnerships.

This episode features Dr. Mike Davis discussing the complex financial restructuring of major DSOs like Dental Care Alliance and Affordable Care, revealing the risks for dentists and the industry. We explore the implications of private equity ownership, debt-for-equity swaps, and the future of dental practice investments.

As a dental professional, you may wonder about the implications of selling your practice to a DSO versus a private buyer. In this episode it's case study time as we delve into crucial insights on this topic, including tax considerations, the time value of money, and what it means for your practice.

We've looked at serveral dentists deep into their careers and gone over how a DSO doesn't really make sense...what about the doctor with all of the promise in the world on the very front of his career...does a DSO make sense there? In this episode, Brendan Gallagher, an oral surgeon and podcaster, shares insights on the impact of DSOs on dentistry, the importance of practice ownership, and strategies for young dentists to maximize their careers and income potential.

This episode exposes the realities behind DSO equity and why selling to a DSO often results in less financial benefit than expected. There is a magic trick all DSOs are trying to pull...the magically disappearing equity. Nate and Bob dissect the myths, true principles, and risks associated with DSO deals, empowering dentists to make informed decisions about their practice futures.

Starting a dental practice can be daunting, but with the right insights and support, it can also be incredibly rewarding. Mike and Christy Crockett, who have navigated the complex world of dentistry together, share their journey—from Mike’s schooling to their eventual ownership of a successful dental practice. In this post, you'll discover key lessons on building a practice, the importance of relationships in business, and how to make informed decisions like when to Say No to a DSO, this is the awesome conclusion to a great interview with Nate and Dr. Mike Crockett and his great wife Christy.

Starting a dental practice can be daunting, but with the right insights and support, it can also be incredibly rewarding. Mike and Christy Crockett, who have navigated the complex world of dentistry together, share their journey—from Mike’s schooling to their eventual ownership of a successful dental practice. In this post, you'll discover key lessons on building a practice, the importance of relationships in business, and how to make informed decisions including when to Say No to a DSO. Enjoy meeting the Crocketts with Nate in this awesome 2 part series.

This episode exposes the hidden truths behind DSO deals in dentistry, revealing how dentists are often financially fleeced through complex deal structures. Bob and Nate bring you their expert analysis to break down the mechanics of these deals, showing why saying no to DSOs is crucial for dentists' financial health.

In this in-depth interview, a blue blooded Tar Heel, Dr. Travis Nixon shares his insights on the rise of DSOs, legislative challenges, and how dentists can protect their profession through education and advocacy. Not only does Dr Nixon have great insight into the current dentistry pipeline of practitioners, he also shares incredible insights into the business and structural changes of medicine and draws parallels to dentistry. You are going to love this episode with Dr Nixon

This episode explores the six fundamental principles that reveal why DSO deals are detrimental to dental practitioners. Hosts Bob and Nate dissect the realities of private equity models, emphasizing the importance of maintaining control, understanding the true value of your practice, and making informed decisions to protect your wealth and profession.

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In this episode, Dr. Michael W. Davis shares critical insights into the private equity influence on dentistry, the risks of DSOs, and how dentists can protect their practices and patients. A must-listen for dental professionals concerned about industry integrity and patient care.

Nate sits down with the Orthodontic Pearls podcast in order to give his take on owning your own practice and why to stay away from selling out to PE and DSO groups. It's a full panel lineup with Drs. Chris Teeters, Andy Sarpotdar, and Brian Anderson.

This episode features a candid discussion on the realities of DSOs in dentistry, highlighting industry failures, ethical concerns, and the importance of dentists making informed decisions about their practices. Hosts Bob Nate share insights, stories, and call for transparency and honesty among dental professionals. Bottom line...DSOs suck

In this conversation, Nate and Dr. Joe Feller discuss the complexities and challenges faced by orthodontists when considering selling their practices to DSOs. Dr. Feller shares his personal journey in orthodontics, his experiences with DSOs, and the reasons he ultimately decided against selling his practice. The discussion highlights the emotional and financial stakes involved in such decisions, the misleading nature of DSO promises, and the consequences faced by colleagues who chose to sell. The conversation serves as a cautionary tale for practitioners contemplating similar paths. In this conversation, Nate and Dr Feller discuss the implications of private equity in dental...

In a conversation between two of the most soothing voices on the internet, Bob Spiel interviews Jonathan Martin, a CPA with extensive experience in dental transitions. They discuss the complexities of selling dental practices, the myths surrounding DSOs, and the importance of financial planning for dentists. Jonathan emphasizes that many dentists are not adequately prepared for retirement and often make significant financial decisions without proper representation. The discussion highlights the need for careful planning and consideration of all options before deciding to sell a practice, particularly to a DSO.

In this conversation, Bob Affleck shares his extensive experience in the dental industry, discussing the implications of selling dental practices to DSOs. He highlights the challenges and regrets many dentists face after selling, particularly regarding autonomy and financial expectations. The discussion also covers the importance of leadership and business acumen for young dentists preparing them for practice ownership. Overall, the conversation provides valuable insights into the current state of the dental industry and the future of practice ownership.

Nate sits down with Dr. Blake Maxfield on this amazing interview with a practicing doctor who went through the entire courting and recruitment process where he almost signed the dotted line for a DSO to purchase his practice. At the last minute, something didn't feel right and he backed out. Because he listened to his gut (and his wife) things are infinitely better in his life and current practice is booming.

In this episode, hosts Bob and Nate delve into the myths surrounding DSOs, particularly focusing on the allure of DSO equity. They discuss the reality of ownership structures, the dilution of shares, and the potential pitfalls of believing in inflated equity promises. The conversation emphasizes the importance of maintaining control over one's practice and making informed decisions about practice transitions.

In this conversation, Dr. Maksim Montatskiy sits down with Bob and Nate to discuss the complexities of partnerships, particularly focusing on the value and decision-making dynamics involved. He expresses concerns about the nature of partnerships where he feels more like a paying associate than an equal partner, questioning the benefits and decision-making power he holds within these collaborations.

The conversation explores the myth surrounding the belief that dental practices are too large to sell to private buyers. It delves into the origins of this misconception and its impact on the dental community, emphasizing that size should not deter practice owners from considering private buyers.

In this conversation, Nate speaks with Dan and Aaron Lewis about the complexities of dental practice transitions, particularly focusing on the implications of selling to Dental Service Organizations (DSOs). They discuss the emotional aspects of practice transitions, the financial realities of selling to DSOs versus maintaining private practice, and the importance of relationships in the dental industry. The Lewis family emphasizes the need for education and awareness among dentists regarding their options and the potential pitfalls of DSO partnerships.

Bob and Nate are back to discuss the common misconception that DSOs pay more for dental practices than private buyers and they are bringing receipts. They delve into the concept of EBITDA, explaining its significance in practice valuation and how it impacts the financial outcomes for practice owners. Through a hypothetical example, they illustrate the true costs associated with selling to a DSO, revealing that many dentists may end up paying more than they realize. The conversation emphasizes the importance of understanding the financial implications of selling a practice and encourages dentists to maintain control over their practices.

In this episode of 'Just Say No to the DSO', hosts Bob and Nate discuss the complexities of transitioning dental practices, particularly for those with multiple locations. They address listener questions about ownership options, financing, and the importance of goodwill in practice valuation. The conversation emphasizes the need for clear pathways to ownership and the potential pitfalls of seller financing, while also exploring strategies for divesting practices effectively.

Bob and Nate discuss the complexities of transitioning a dental practice without selling to a DSO. They explore the concept of a walk away sale, addressing common uncertainties and fears among practice owners. The conversation also debunks prevalent myths about the dental market, particularly regarding younger dentists' willingness to own practices and the availability of financing for buyers. The hosts emphasize the importance of hiring qualified brokers and being realistic about expectations during the selling process.

In this conversation, Bob and Nate discuss the complexities of transitioning a dental practice, particularly focusing on the implications of selling to a DSO versus bringing on an associate. They explore the emotional and financial uncertainties that dentists face when considering their exit strategies, emphasizing the importance of planning and understanding the realities of practice management. The discussion highlights the pros and cons of various transition options, including the challenges of hiring associates and the need for a clear vision of the future of the practice.

In this conversation, Bob interviews Brandon Collier, a lawyer and president of Collier & Associates, about the current state of DSOs and their impact on the dental profession. They discuss the historical context of DSOs, the pros and cons of selling to them, and the importance of protecting private practice. Collier shares insights on contract negotiations for new dentists and emphasizes the need for advocacy in favor of traditional dental practices. The discussion culminates in a proposal for a foundation aimed at promoting private practice and countering the influence of DSOs in dental education and practice.

In this conversation, Bob Spiel and Steven J Anderson delve into the evolving landscape of dentistry, particularly focusing on the impact of Dental Service Organizations (DSOs) on the profession. They discuss the importance of grounding oneself in key principles before making decisions, the necessity of understanding one's market, and the significance of mastering patient interactions. The conversation emphasizes the need for dentists to surround themselves with the right people, continually improve their leadership skills, and build their personal brand. Additionally, they highlight the value of mastermind groups in fostering growth and decision-making. Ultimately, the discussion advocates for dentists to take...

In this episode, Bob and Nate discuss the evolving landscape of dental service organizations (DSOs) and the implications for private practice owners. They explore the risks associated with selling to DSOs, the changing nature of DSO offers, and the importance of retaining control over one's practice. The conversation highlights the historical context of DSO contracts, the value of dentists in practice ownership, and the potential pitfalls of partnering with DSOs.

Bob and Nate continue discussing the implications of selling dental practices to Dental Service Organizations (DSOs). They argue that selling to a DSO can lead to financial loss and loss of control for dentists. The conversation highlights the hype surrounding DSOs, the influence of celebrity endorsements, and the pressure tactics used to encourage practice sales. The hosts emphasize the importance of maintaining ownership and the potential pitfalls of selling practices, urging dentists to consider their long-term financial independence. Put down the margaritas, understand your true value and make it work for yourself!

In this episode of 'Just Say No to the DSO', hosts Bob Spiel and Nate Williams discuss the implications of the DSO movement in dentistry. They emphasize the importance of private practice ownership, the challenges faced by dental practice owners, and the impact of insurance and government intervention on the industry. The conversation highlights the benefits of maintaining control over one's practice and the potential pitfalls of selling to a DSO.

Nate ventures out into the wilderness and is guest with Gary Bird for today's episode. This is a collabortive project and highlights the great being done to further the conversation around dentistry and it's future. 


For those not familiar, Gary Bird is the founding owner of SMC National, the dental industry’s top-rated marketing partner chosen by more than 60,000 dental professionals. A recognized thought leader, Gary hosts the popular shows Dental Marketing Theory and Dental Marketing Goat, where he shares evidence-based strategies that help practices grow revenue, attract high-value patients, and build winning teams. Under his leadership, SMC...