I’ve spent the last couple days at the ADSO Summit and it’s been an eye opening experience to say the least. What’s impressed me the most has been the abundance mindset that is so blatantly obvious in every single ADSO member I’ve met thus far. I don’t know why it’s shocking to me that members of this group would take the position that more is good and that there is plenty of room for more providers and more players in dentistry. I guess it’s the lingering effects of my dental school training and the resulting brain damage that we dentists share, but nonetheless it was shocking to be in a room full of people who welcome new competitors and innovators in “their space”.

And that got me thinking, why are DSOs growing so rapidly all across the US? The answer is simple. Mindset.

In this increasingly competitive marketplace there are basically two schools of thought. On one side you have a group composed of traditional dentists in traditional practice; Local, state, regional & national dental associations; State dental boards; and Dental educators. The other side of this group of stakeholders consists of the multi-specialty, multi-location dental practices (DSO supported practices). Let’s have a look at the differing views of the two groups so we can get a feel for what we are dealing with:

• The traditional group is vehemently opposed to DSO supported practices. DSO supported practices don’t care what traditional practices do as long as they follow the law and provide dental care on a level playing field.
• The traditional group wants to enforce ancient laws or create new ones to stop fellow dentists who want to work hard and DSO supported practices from doing things the traditional dentists cannot or will not do. DSO supported practices think that as long as a licensed dentist is the one delivering care, that care should be delivered to as many people as possible.
• The traditional group believes that a dentist who works for a DSO supported practice is less of a dentist than one in their camp and the traditionalists do whatever they can to further their misguided notion and impress it upon young dentists and dental students (much like traditional MDs did 30 years ago). DSO supported practices don’t care if you are in traditional practice or in a DSO supported practice and often invite members of the traditional group to join their organizations.
• The traditional group believes that there are too many dentists and too many dental offices and try to suppress supply. DSO supported offices think the market will determine such things and that market participants shouldn’t be allowed to regulate the marketplace to protect their own interests and the dental cartel as state boards do now.

Which viewpoint is correct? Is it possible to know? How do we judge? Simple! In a free market you only have to look at and compare the results to gain insight. Which group has been around the longest? The traditional group, by far. For decades the traditional practice was the only model tolerated by state boards but despite the incumbent status and having state boards on their side, traditional practices are losing market share. Which group is gaining market share? The DSO supported offices are on the rise and now make up 20% of the dental care delivery in this country. Some estimates predict that in the next 5 years that number will increase to 50%. The marketplace has spoken and it’s pretty obvious that the public is choosing DSO supported practices. Don’t be distracted by anecdotal claims from traditional dentists that DSO supported practices are bad or low quality. The studies show this to be false AND the dentists delivering care in a DSO supported practice were trained and licensed by the same people as those in traditional practice.

But here’s the funny thing. Even though the DSO supported practices are the future and will come to dominate dental care delivery in this country, there’s still plenty of work for everyone no matter what practice model a dentist chooses. 1/3 of Americans didn’t visit the dentist last year so we have a lot of work to do and a ton of patients to see before we saturate the market!

As the mindset and laws in dentistry follow the same progression medicine did 30 years ago, competition will increase, prices will decrease and access to care will increase massively. This is not a good thing it’s a great thing! This is not a likely scenario, it is a certainty. We dentists KNOW how things should be done because “that’s how we have always done it”. This traditional mindset is killing the practices and happiness of those dentists who refuse to open their minds and accept the new reality and the new paradigm in dental healthcare delivery. Don’t let this happen to you. Don’t let it happen to your dental students. Look at the dental landscape with as much objectivity as you can muster, escape the groupthink that dominates the majority of dentists and you will see the facts are self-evident (and not what you were told in school or at the ADA meeting). You need to change your mindset if you want more market share. That’s your only option because you cannot change or control others!