Kim Larson has been involved in the healthcare industry for 25 years. In 2014, after she recognized a need for a digital publication devoted to the DSO and group practice space, she helped launch Group Dentistry Now and JoinDSO and is the CMO of both. She also consults for the ADSO, and several DSOs and emerging dental groups. Kim has spent the last five years exuberantly focused on the DSO space, committed to its success, and has a huge following of DSO and dental industry fans. Connect with her on LinkedIn.

You’re Finally a Dentist! Now What?


When you receive a DMD or DDS degree, you will have acquired well-honed clinical skills, a wealth of dental knowledge and most likely a great deal of debt. However, your training may not have covered the business management skills needed to be a successful business owner, team leader and people manager.

Real-Life Problems
The business acumen required to run a successful dental practice can be overwhelming, especially since most dental students have an education based in science, not financial management, insurance negotiations, marketing, IT or human resources. The business side of dentistry is often done after patient hours. Dentists entering the field, including growing numbers of women who often want a work-life balance that business ownership doesn’t necessarily provide.

Younger dentists are leaving dental school more deeply in debt than in the past, sometimes carrying half a million dollars in student loans. This debt, coupled with startup costs including securing real estate, hiring staff and buying expensive equipment prevents many from opening their own practices.

Real-Life Solutions
Many graduates will end up working for a dental support organization at some point in their career.

Upon graduation, well over 30 percent of all dental school graduates will join a DSO or multi-location group practice, and that number grows yearly. Working for a DSO upon graduation can not only assist the recent graduate in building clinical skills and confidence, but also allow them to expedite paying down loans and accumulating capital.

DSOs are not just training grounds for new graduates. In fact, according to a 2017 ADEA study, a significant percentage of new recruits were experienced dentists.

You may know some perceptions of DSOs and some general information about DSOs, but do you know what a DSO really is? Are you fully equipped with the knowledge to know if a DSO is right for you? Do you know how to choose the right DSO?

DSO 101
DSO is an acronym which can stand for either dental support organization or dental service organization. Regardless of whether the “s” stands for support or service, the meaning is the same. A DSO is typically a stand-alone legal entity, built specifically to handle the non-clinical functions of the dental offices which it manages. These non-clinical functions include human resources, accounting, legal, marketing, risk management, compliance, recruiting, payroll, IT, procurement and several other non-clinical services.

When a dentist decides to work for a DSO, one of the major draws is the fact that the dentist can focus on the clinical side of dentistry while leaving the administrative side to a team of business experts.

You go to dental school to change people’s lives through the art of dentistry, not necessarily to become a CEO (chief everything officer), skilled in insurance, procurement, equipment maintenance/ repair, payroll, HR, marketing and other business practices that are key a healthy dental office.

The right DSO can be a great place to start your dental career and fine tune your clinical skills without the sometimes-overwhelming distraction of figuring out and managing the business side of dentistry.

Aren’t All DSOs the Same?
Regardless of what you may have heard (good or bad) about working for a DSO, it is important to remember that each group or dental support organization is different. Each has its own culture, its own unique business model and its own opportunities and challenges.

There is an industry expression, “When you’ve seen one DSO, you’ve seen one DSO.” But they can vary in many ways, including:

  • Geographic footprint
  • Career path and opportunities
  • DSO ownership structure
  • Company culture
  • Doctor compensation models – salary, pay for production, student loan repayment
  • Potential ownership opportunities for dentists
  • Mentorship and training programs
  • Charitable causes
  • Career opportunities beyond the chair
  • The type of dentistry performed
  • Payor – fee-for service, Medicaid, capitated, mix
  • Mission
  • Business growth and exit strategies

With 1,100 DSOs to Choose From, How Do You Decide?

Much like each solo practice operates differently, each DSO also operates differently. According to The Association of Dental Support Organizations, there are 1,100 DSOs to choose from, and their numbers are growing.

Since DSOs come in all shapes and sizes: emerging, mid-market, and large; all offering different cultures and support philosophies, it is important to understand how you align with their culture, philosophy, and value system.

Opportunities abound for you, and you need to make sure that you choose the right DSO, not necessarily the first DSO you contact or the one that has free cocktails and dinner at a campus recruitment.

It is valuable to attend DSO campus events and become familiar with recruiters and their DSO’s culture. Talk to every DSO that comes to your campus. Go prepared to ask them the tough questions. Do they fit into your life plan? Do they meet your requirements? Do you share values and a common life philosophy? You also need to perform your due diligence online. Visit and join some of the many social media groups specifically geared for dentists on Facebook and LinkedIn. Use these groups to find other dentists that have worked for a DSO you may be considering and get their opinion and experience. But don’t just rely on one person’s opinion.

You may be more familiar with some of the larger DSOs, since they tend to have more doctor recruiters who can attend and sponsor various campus functions, however there are hundreds more to choose from. Don’t limit yourself. DSOs are not all created equal. Bigger is not necessarily better.

Gather information to make an informed decision. Research other smaller, emerging or mid-market DSOs that may be more regional in nature and offer unique benefits or opportunities in order to compete with the larger DSOs.

Online resources like the Association of Dental Support Organization’s website – as well as our websites, JoinDSO. com (with a free job board) and GroupDentistryNow.com’s free newsletter – will help you navigate the abundance of opportunities and give you more information to help you make the best decision.

Interview them and ask the tough questions like:

  • What are your student debt repayment opportunities?
  • How are patient treatment plans determined, managed and executed?
  • What is your DSOs business model, and how does a new dentist fit into it?
  • Do I have an opportunity to buy into the DSO or own a percentage of a practice(s)?
  • What type of charitable and philanthropic work or community outreach does your DSO do?
  • What does the work-life balance look like? Work hours flexibility?
  • Are there advancement opportunities beyond the chair?
  • What is your DSO’s growth strategy?
  • Who owns the DSO, and how does that influence how you operate?
  • Besides being patient-centric with centralized administrative functions, how do you differentiate yourself from other DSOs?
  • What type of training do you offer? Continuing education opportunities?
  • Is there a mentorship program? It may be true that newly graduating dentists have incurred a historic amount of debt. However, the good news is that there are more debt repayment options and countless career paths to explore and follow.

You’ve worked hard. You’re finally a dentist. And now your options are limitless. You can chart the course that is uniquely right for you!