This dentist found his own solution to joining a DSO

How this dentist established his own DSO

Nov. 10, 2023
When Dr. John Bocchi couldn't find what he wanted in a DSO, he came up with his own approach, and he would recommend it for his fellow dentists.
Gary Kadi, Founder of NextLevel Practice

When it comes to joining a DSO, I could talk about what I’ve learned as a consultant and mentor until I’m blue in the face. But I can’t give you that one thing you want to hear, and that’s a personal experience.

That’s why I invited my good friend, Dr. John Bocchi, owner of Sierra Smiles Complete Health Dentistry in Reno and Lake Tahoe, Nevada, to talk about his experience as a dentist who established his own DSO. 

More from Gary Kadi:

If you join a DSO, how do you know you’re getting a good deal?

Gary: Tell me a little about your practice. 

John: I started Sierra Smiles in 2006, not long after I graduated from dental school. My wife Jen runs the practice with me. 

Gary: How has your career played out so far? 

John: When I graduated from dental school, I thought I was going to own a little boutique practice that focused on cosmetic dentistry. At first, that’s what I did. But when the Great Recession hit a couple of years later and I saw other practices like mine shut around the city, and I knew I needed to do things differently. 

Gary: Like what? 

John: I wanted to create a foundation of families that were loyal to our practice, and focus on top-notch, comprehensive care, not just cosmetic. With that change in mindset, opportunities started opening up for me. I expanded my patient base, moved to a new location, and during the next 10 years, I bought three additional practices. After the pandemic, I also started a sleep and airway practice as well as a dental assisting academy. 

Gary: Amazing! How did this change your goals? 

John: Learning to become a business-minded dentist really opened up my horizons. When I focused not just on working in my business but also working on my business, the possibilities were incredible.  

Gary: So life became a cakewalk? 

John: (Laughs.) Not exactly. Running a business with multiple locations takes a lot of work. All the business work took me away from time chairside. At times it was really overwhelming. 

Gary. Had you considered DSOs at this point? 

John: Definitely. Having someone help with the business side of the practice sounded really enticing. I also knew that at this point I had grown my practice larger than a single dentist could probably afford when I was ready to sell. 

Gary: What kept you from joining a DSO? 

John: Even though I wanted help with the business side, early DSOs focused so much on profits that everything else, especially the quality of patient care, was left behind. I didn’t ever want to compromise my patients’ health. 

Gary: So what changed your mind? 

John: Well, I formed my own small DSO management company to run my four practices. And to be honest, we struggled. I got stuck doing the jobs I didn’t enjoy, and frankly, I wasn’t very good at doing. It's not easy to invent or develop a platform that runs effectively. 

Gary: That sounds like a nightmare. Is this where DSO 3.0 comes in? 

John: Yes! It’s the best of both worlds. The management company already has systems and processes in place to run the business things that were sucking up all my time, but I still got to customize their level of involvement. So, I get help on the aspects that I don’t want to do, but I’m not completely under their control. I’m still calling the shots, especially about patient care. 

Gary: I love it. Any other benefits? 

John: By taking off the burden of the business I also now have time to mentor the next generation of dentists. And if I need to pull back clinically to be able to have a greater impact, I can do that. 

Gary: And I have to ask: how’s the money? 

John: The average retirement age is what, 65? Before DSO 3.0, I had the goal to retire at 55. I’m 10 years away from that and I have a lot more flexibility now. I could taper off sooner knowing that my family is financially secure, or I could even see myself practicing longer since I can now choose to do only what I really enjoy doing. 

Gary: I’m so excited for John and Jen. DSO 3.0 really has checked all their boxes—business support, continued level of patient care, mentorship possibilities, and financial freedom (even early retirement!). 

It all comes down to this—if you want a DSO experience without the compromises of DSO 1.0, you don’t have to reinvent the wheel. DSO 3.0 could be the answer you’ve been looking for. Sound interesting? Investigate a free DSO strategy session and I’ll see you back here next month.


Founder of NextLevel Practice, Gary Kadi is on a mission to help dentists beat the odds. While most dentists now don’t retire until age 69, and 96% of them aren’t financially free, Gary has developed the strategies and methods to empower dentists to retire on their terms. The more than 6,000 practices he’s worked with generate over $1 billion in combined collections. Gary has helped them discover true freedom—becoming time-free, debt-free, and frustration-free.


Editor’s notes: NextLevel Practice is a recent financial supporter of Dental Economics.

This article appeared in the November 2023 print edition of Dental Economics magazine. Dentists in North America are eligible for a complimentary print subscription. Sign up here.

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