An introspective look at the decline of private practices and the growth of corporate dentistry

The decline of private practices is coinciding with the growth of dental support organizations, or DSOs. Jonathan Ford, DMD, a private practice dentist, says we should take a look at what private practitioners can learn from DSOs, instead of blaming them for our downfall.

Jonathan Ford, DMD

DENTAL SUPPORT ORGANIZATIONS (DSOs)are a controversial topic in the dental world, to say the least. Whether you are a raving fan or blame DSOs for the downfall of dentistry, one thing is for certain: DSOs are here to stay. DSOs currently own or control about 16% of practices in the United States, and they’re expected to grow by about 15% annually over the next four years.1 Additionally, DSOs are growing at a rate of 13% to 14%, while solo practices are shrinking by 7% per year.1

Those numbers are astounding but not completely surprising. DSOs have some competitive advantages over private practices. Instead of focusing on DSOs’ business methods and models, I’d like to take an introspective look at the traditional private practitioner. How can we, since I am one of them, become more efficient and effective? What can we do to improve our business models?

It is always easier to blame others or complain about things that other people do. Instead, let’s start having the difficult conversation, jump outside of our comfort zones, and open our eyes to common business practices that we can improve on.

Arguably, one of the most successful CEOs of the modern era is Jeff Bezos of Amazon. Amazon’s footprint touches or affects nearly every industry in the US economy. Early in his career, he wrote a letter to his shareholders focusing on a few key ideas.2 The specific points that were addressed were not unique to Amazon; rather, the letter was an exceptional blueprint for any business owner to follow.

Some of the key takeaways were as follows:

  • Remain future-oriented.

  • See the big picture.

  • Provide value.

  • Never stop learning.

I think it’s safe to say that the traditional model of private practice fails miserably in these key areas. Practice owners often select short-term profits at the expense of long-term growth. We focus on the small, menial tasks throughout the day. We see the time required for meaningful continuing education as a hindrance, rather than focusing on the benefits CE can provide to both the doctors and staff. We allow the dollar signs to skew our judgment when looking at equipment, rather than focusing on the value it can bring to our patients.

Private practice dentists have a difficult balancing act to maintain as shareholder, employee, and CEO all rolled into one. Oftentimes, the roles skew in one direction or another, creating inefficiencies. Private practitioners need to be aware of these tendencies. By maintaining the proper equilibrium of long-term and short-term thinking, we can keep our practices efficient and continue to have the private practice model be effective in the delivery of dental care moving forward.


1. Cooper M. Why the future is DSOs. Dental Practice Management website. Published April 19, 2017. Accessed August 2, 2018.

2. Bariso J. This original letter from Jeff Bezos to Amazon shareholders teaches some extraordinary lessons in leadership. Inc. website. Published April 20, 2017. Accessed August 2, 2018.

Jonathan Ford, DMD, is a general dentist at Ford Dental Group in Huntington Beach, California. He graduated from the University of Pennsylvania School of Dental Medicine in 2007. He served on the board of directors for The Dentist Service Company in 2015. He currently serves on a council for the California Dental Association and is a board member of the Orange County Dental Society. You can reach him by email at Visit his website at

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