<img height="1" width="1" style="display:none" src="https://www.facebook.com/tr?id=1509085172462112&amp;ev=PageView&amp;noscript=1">

Patient Prism's Dental Expert Blog

Get valuable viewpoints from dental professionals
to help illuminate the way forward

As small group practices add new locations and build the infrastructure needed to become a dental support organization (DSO), they need to take a close look at their accounting practices.


Using best accounting practices for a DSO is especially important if the group is planning to sell in the future. Just like selling a home, practice owners need to make their DSO appealing to buyers. However, instead of upgrading home appliances, you’ll want to update business accounting practices to draft a clean, reliable blueprint of your practice’s financial stability. And while brand-new appliances may appeal to homebuyers, potential investors want finances with history. This means you should make sure you are using the appropriate accounting practices years ahead of seeking a buyer.


DSOs need to move from cash-based to accrual-based accounting. 

TUSK Partners recommends having at least two solid years of accrual-based accounting, known as generally accepted accounting principles (GAAP), in place before attempting to sell. No matter how meticulous, detailed, and organized cash accounting statements may be, GAAP financial statements are always more reliable and, as such, are preferred by investors. This is because potential investors are looking for consistent financial results. In the year you change from cash-based to accrual-based accounting, your financial statements are going to look a little different. 

  • Cash-based accounting -- In cash-based accounting, revenue and expenses are recognized as they occur. The statement tracks the exchange of money. Revenue appears on the statement when the income “cash” is received. Expenses appear on the statement when they are paid. 
  • Accrual-based accounting – In accrual-based accounting, revenue is recorded when a transaction occurs (is “earned”), not when it is actually paid. The inclusion of accounts receivable and accounts payable on the statement enables your DSO to predict future cash flow and financial gain--profitability.


Larger companies always use accrual-based accounting. The goal of accrual accounting for dental groups or DSOs is to create quarterly financials for comparison and a 12-month rolling period to provide an accurate financial picture. From this you and potential buyers know if your DSO is financially stable and consistently profitable or growing in profitability. Not only is this of importance at the time of selling your DSO or when seeking an investor but also important when making decisions to hire C-suite staff, add locations, renovate locations, invest in new technology, expand the operations of your business infrastructure, grow the support and training you provide your dental teams, compensate employees, and much more.


Hire a CPA, who will be your consultant.

While the transition may create a bit more work for your bookkeeper, the heavy lifting should be done by a CPA. You don’t have to hire an in-house CFO. As you scale, a consulting CPA can get you started. The CPA will guide your team and designate exactly how things should be tracked. 

Here are some tips to get you started on your accounting conversion, in collaboration with a CPA and under the CPA’s expert guidance:

  • Accounting platform: Discuss and choose an accounting software program that your team can efficiently and comfortably use. Outline the process by which bookkeeping will be done in your office…who, how, when, why, reporting to CPA, and so on.
  • Chart of accounts:  Create a chart of accounts that will be used in every location of your practice. This consistency is key in establishing a direct comparison between locations.
  • Training and support: Create a training plan for your administrative team members. Provide this training. Identify who or what published resource or chat line they can turn to for support when questions arise. It may be a call to the CPA. 
  • Quality control: Create a plan for frequent review of administrative staff performance at the beginning and continue review of performance on an appropriate schedule, usually quarterly, to assure accounting information is accurately recorded in your accounting platform.
  • Periodic review: Review your financial statements with your CPA on a regular basis and learn from them. Along with profits, EBITDA (earnings before interest, taxes, depreciation, and amortization) are used as an indicator of the overall profitability of a business. EBITDA figures significantly in a financial profile. Learn more about this from your CPA.
  • Business guidance: Ask your CPA for guidance in making financial decisions. Specific metrics are key to making better business decisions. Are you and your CPA on top of these? 


What are the key expense metrics your DSO should monitor?

TUSK Partners recommends DSOs focus on these three key expense metrics: 

  • Wages
  • Lab costs 
  • Supply costs


Take time to sit down with your CPA and discuss how these components can lead to better business decisions and strategies as you grow. Consider things like whether a new formulary could be beneficial, or whether your increased scale allows for the negotiation of better rates with laboratories.


Learn more about best practices for scaling a DSO.

Growing your dental practice or small group means making the appropriate upgrades to your practice, including accounting practices. Plus, planning ahead will make for a smoother, faster sale if that is your ultimate goal. The advice of industry experts will help you perform better as you build your DSO infrastructure and expand your DSO to demonstrate scalability. TUSK Partners is one of the country's leading dental mergers and acquisitions advisory firms and can help you understand your goals before or during the expansion of your dental group or DSO.

Share Post:

Complimentary Demo

Patient Prism will not only help you schedule more patients but so much more!

We are here to help you increase and recover lost revenue by supporting your front desk. Patient Prism provides your team with the tools and coaching they need to succeed!

Schedule Demo

Related Posts

The DEO: helping emerging DSOs overcome challenges

Growing a business is challenging under the best of circumstances. It is even harder when there is a global pandemic. Ja...

Leading a Dental Support Organization through a Pandemic

It took 10 years for Rodeo Dental in Texas to grow to 30 practices. It had established itself as one of the premier dent...

DSO Hygiene Excellence: A Community for Dental Hygienists

During the summer of 2020, DSO Hygiene Excellence founders Sarah Varney and Christine Diehl sent out a national survey t...