Not because they're evil. Because there's a better deal — and nobody told you about it.
You sell your practice. You keep working. You take home half of what you used to. Same hours. Same patients. Half the money. They call this a "partnership."
White Coat InvestorMost DSO deals require you to hit production targets for years after the sale. Miss them, and 20–30% of the purchase price — the "holdback" — doesn't fully pay out. You're an employee in the business you built, working to earn money that was supposed to already be yours.
Dentist Advisors / McLerran & AssociatesThe average employee dentist lasts about 18 months in a DSO position. That's not a talent pipeline. That's a revolving door. And your patients are the ones who notice.
Dentistry IQMaterials, scheduling, treatment plans — all subject to corporate protocols. Which instruments you use. Which lab you send to. How long you spend with a patient. Your clinical judgment is now a line item on someone else's spreadsheet.
ADA / National Dental Development ServicesPrivate equity buys DSOs, restructures, and resells — often within 3–7 years. When the DSO that bought your practice gets sold to another PE firm, the terms of your deal? Not guaranteed. You're an asset on a balance sheet being optimized for someone else's exit.
White Coat Investor / Engage Advisors"Anecdotally, there are more stories filled with regret, frustration, or outright rage when it comes to DSOs than stories centering on relief, excitement, and gratitude."
"After 5 years, they essentially gave away their practice for free."
— Dentist Advisors, on earn-out structures
"The DSO had no provisions for restorations as they knew them, offering only extraction if a tooth was broken."
"My biggest regret from the sale was trying to go it alone."
— McLerran & Associates, on dentists negotiating without representation
"Staff and doctors locked out of the workplace with minimal notice. Patients abandoned mid-treatment."
— Dentistry Today, on Xenith Practices (Texas DSO collapse)
Sounds nice. Like a spa day for your practice. Just relax, doctor. We've got it from here.
You're still seeing patients 8 hours a day. But now you have production quotas set by people who've never held a handpiece. Miss the targets, and your holdback doesn't pay out. That's the "partnership."
They put it in the pitch deck. Sometimes even in the LOI. You'll have "complete clinical independence."
Corporate decides which supplies you order, which lab you use, and how many patients you see per hour. Your "autonomy" lasts until it conflicts with their margins.
The magic words. Cash out. Retire on a beach. You've earned it.
They buy based on a multiple of your current collections. With proper marketing, you could 1.5–2x those collections in a year — and double what your practice is worth. They're buying low. On purpose. That's the model.
They love this word. Partnership. As if you're equals. As if you both have a say.
You can't leave. You can't practice within a wide geographic radius around any of their locations — and they keep acquiring. Your "equity" often comes with clawback provisions that didn't turn out to be what you thought.
A major DSO used tracking pixels to collect sensitive patient data and shared it with Facebook and Google without consent or HIPAA-compliant safeguards.
Becker's DentalCharged patients for services advertised as "free" — new patient exams, x-rays, oral cancer screenings. Returned up to $750K to affected patients.
Massachusetts Attorney GeneralPromised to relieve dentists of management burden. Within 18 months: staff unpaid, leases defaulted, debts ballooned. One dentist lost over $300K.
Weence / DrBicuspidSo why do smart dentists still sell?
Not because they want to. Because running a practice alone — the marketing, the billing, the HR, the compliance — is drowning them.
The DSO promises to make it stop. And in that moment of exhaustion, signing away your equity feels like relief.
But what if you could make it stop without signing anything away?
| Sell to a DSO | Work with Liking | |
|---|---|---|
| Marketing | Included — run by corporate, with their priorities | Included — run by AI, built for your practice |
| Your ownership | Gone | 100% yours |
| Your income | Cut 40–50% | Unchanged. Growing. |
| Clinical autonomy | Subject to corporate protocols | Full. Always. |
| Production quotas | Required during earn-out | None. Ever. |
| Cost to you | Your equity + your income | A flat monthly fee |
| If you want out | Non-compete. Good luck. | Cancel anytime. |
| Practice value | Sold. Gone. Not yours anymore. | Growing. Yours. Worth more every year. |
We're not saying DSOs are evil. For some dentists — especially those who genuinely want to exit — a DSO sale makes sense.
But if the only reason you're considering selling is because you're tired... if you love the dentistry but hate the business... if you'd keep your practice in a heartbeat if someone just handled the work you don't want to do...
Then selling is the wrong answer. And this is the right page.
See what your practice looks like with real marketing behind it. Before you sign anything away.
30 minutes. We'll show you your competitive landscape, your opportunities, and what DSO-level marketing looks like — without the DSO. No broker tactics. No pressure. Just data.
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