--- title: 5 Principles of Growing a Multi-Location Dental Group or DSO description: Running group dental practices takes a different skill set than running just one. Here are five principles needed for DSO growth. image: https://blog.patientprism.com/hubfs/Blog/Featured%20Images/TheDEO-DarinAcopan.png --- - [Contact](https://patientprism.com/contact/) - [Patient PrismLOGIN](https://web.patientprism.com/) [![Patient Prism | Healthcare Lead Tracking Software](https://blog.patientprism.com/hs-fs/hubfs/2024_Patient-Prism_Logo_Blue.png?width=800&height=247&name=2024_Patient-Prism_Logo_Blue.png "Patient Prism | Healthcare Lead Tracking Software")](https://blog.patientprism.com/hubfs/PP-Logo-2024.png) - Product - ![](https://patientprism.com/wp-content/uploads/2018/10/Patient-Prism-Product-Overview-@2x.png) ### [Product Overview Learn more about Patient Prism's key features and benefits](https://patientprism.com/product-overview/) - ![](https://patientprism.com/wp-content/uploads/2020/09/Patient-Prism-Case-Studies@2x.png) ### [Case Studies Learn how Patient Prism transforms dental practices](https://patientprism.com/case-studies/) - ![](https://patientprism.com/wp-content/uploads/2018/10/Patient-Prism-Dental-Practice-Customers@2x.png) ### [Customers Discover the amazing dental practices that utilize Patient Prism](https://patientprism.com/customer/) - Solutions - ### [Private Dental Practice Our software is perfect for single dental practices. 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Visit our help center for quick answers and tutorials.](https://support.patientprism.com/hc/en-us) - ![](https://patientprism.com/wp-content/uploads/2020/09/Affiliate-Program@2x.png) ### [Affiliate Program Be a part of Patient Prism's growing network of affiliates.](https://patientprism.com/affiliates-program/) - [Contact](https://patientprism.com/contact/) - [Patient Prism LOGIN](https://web.patientprism.com/) - [Schedule Demo](https://patientprism.com/schedule-demo/) Patient Prism's Dental Industry Blog Here you'll find hundreds of articles and video interviews with dental industry experts on the topics of DSO and practice growth, dental software, call-tracking technology, patient experience and artificial intelligence fueling the dental industries ability to treat more patients and change lives. - by: Darin Acopan - 11 min read # [5 Principles of Growing a Multi-Location Dental Group or DSO](https://blog.patientprism.com/mastering-multiple-locations-dso) - [Dental Practice Leadership](https://blog.patientprism.com/topic/dental-practice-leadership) - [Multi-Practice Growth](https://blog.patientprism.com/topic/multi-practice-growth) - [AI Call Intelligence (1)](https://blog.patientprism.com/topic/ai-call-intelligence) - [Dental Call Tracking (23)](https://blog.patientprism.com/topic/dental-call-tracking) - [Dental Marketing (33)](https://blog.patientprism.com/topic/dental-marketing) - [Dental Practice Leadership (192)](https://blog.patientprism.com/topic/dental-practice-leadership) - [Dental Technology (71)](https://blog.patientprism.com/topic/dental-technology) - [DSO (42)](https://blog.patientprism.com/topic/dso) - [Multi-Practice Growth (95)](https://blog.patientprism.com/topic/multi-practice-growth) - [![](https://cdn2.hubspot.net/hubfs/6464971/blog_9_wow_design/facebook-logo%20(2).svg)Share](https://www.facebook.com/sharer/sharer.php?u=https%3A%2F%2Fblog.patientprism.com%2Fmastering-multiple-locations-dso) - [![](https://cdn2.hubspot.net/hubfs/6464971/blog_9_wow_design/twitter%20(5).svg)Tweet](https://www.twitter.com/share?url=https%3A%2F%2Fblog.patientprism.com%2Fmastering-multiple-locations-dso) - [![](https://cdn2.hubspot.net/hubfs/6464971/blog_9_wow_design/linkedin-logo%20(2).svg)Post](http://www.linkedin.com/shareArticle?mini=true&url=https://blog.patientprism.com/mastering-multiple-locations-dso) - [![](https://cdn2.hubspot.net/hubfs/6464971/blog_9_wow_design/envelope%20(1).svg)Mail](http://www.linkedin.com/shareArticle?mini=true&url=https://blog.patientprism.com/mastering-multiple-locations-dso) March 2019--Running multiple dental locations takes a different skill set than running just one. That’s why, in this article, we’ll go through many dental office organization ideas that can take your dental practice to the next level. But what are the key principles in growing a multi-location dental group or DSO? Growing your dental service organization involves hiring excellent people, implementing optimal processes, and synergizing these in a culture focused on rapid growth.   Here we’ll go through examples from dentists and DSO owners who have successfully mastered scaling up. Table Of Contents - [Considerations of Every Emerging Dental Group or DSO](https://blog.patientprism.com/mastering-multiple-locations-dso#chapter01) - [5 Key Principles to Dental Entrepreneurial Success](https://blog.patientprism.com/mastering-multiple-locations-dso#chapter02) - [Reasons to Join The DEO: Is It For You?](https://blog.patientprism.com/mastering-multiple-locations-dso#chapter03) ## Considerations of Every Emerging Dental Group or DSO When you start, there are many considerations, for example: - What KPIs do you track? - How do you obtain financing? - When do you hire C-suite executives? - How do you increase profitability in each location? - How do you standardize the patient experience? - How do you create a culture in alignment with the core values and goals of the DSO? - How do you stay in compliance with regulations? - How do you find and retain A-list players? With so many questions like these (and more), the Dentist Entrepreneur Organization (DEO) was founded to help owners of dental groups and DSOs find the correct answers.  The average DEO member has five to six locations and generates about five to seven million annual revenues. We have some that are smaller and some that are a lot larger.  And we have a faculty group that mentors them through mastermind sessions, online webinars, in-person seminars, and its annual conferences. ## 5 Key Principles to Dental Entrepreneurial Success ![5 Key Principles to Dental Entrepreneurial Success](https://blog.patientprism.com/hs-fs/hubfs/5%20Key%20Principles%20to%20Dental%20Entrepreneurial%20Success.jpg?width=1254&name=5%20Key%20Principles%20to%20Dental%20Entrepreneurial%20Success.jpg)What does take for you to scale and have a successful dental practice? There are five keys to entrepreneurial success for dental service organizations, and also smaller dental practices looking to grow. ### #01 - There Are Many Right Ways to Scale There is no single blueprint for scaling a DSO. There are probably hundreds of ways to do it. And at the end of the day, it comes down to what you think about using debt to finance growth, using your own cash to bootstrap your way, or going to private equity.  There is no correct answer. A combination is a usual scenario, with dentists combining cash and debt. Then as they develop a platform with good processes and people, private equity becomes interested in helping them move to the next level. ### #02 - There Are Ways to Incentivize Dentists to Stay One of the most significant problems facing DSOs is the retention of their affiliated dentists. Again, there are multiple ways to give their dentists skin in the game, resulting in greater productivity and retention. Some DSOs allow associate dentist buy-in at the DSO level. Some DSOs allow associate buy-in at the local dental practice level. Some buy-ins can be economic ownership without legal ownership. ### #03 - Track the Right Metrics of Growth for EBIDTA Profitability is what matters for a private equity group to be interested in your DSO. Private equity looks at your EBITDA. The number of locations you have is arbitrary at that point. Some members in the DEO track the number of operatories per location and the production per operatory. Still, it’s the predictable profitability of your locations that is key. Having more employees does not necessarily mean you have a better DSO. It means more overhead, but you can justify spending money ahead of time on A+ players. ### #04 - Optimize Your People, Processes, and Platform They are your business accelerators. When you have experts solving your problems, you can efficiently improve your processes and create that scalable, profitable platform that you can “rinse and repeat” to grow. To avoid hiring the wrong person under pressure, hire ahead of your growth. That way, you will have the infrastructure with leaders capable of facilitating profitability and growth. If you don’t have that, the business can quickly fall apart. When hiring A+ players, understand that you may have to pay more. That is still worth the investment, even though your P&L will look worse in the short run. ### #05 - Develop an Incredible Culture for Rapid Growth Dentists know how to do dentistry and will develop their behavioral and clinical skills to become top performers, especially if they have skin in the game. Top performance is more problematic when it comes to other team members who do not have skin in the game. The culture of the DSO is crucial. By this, I mean there should be standards for every patient’s experience and how things are done that are effective and teachable. According to Deming, 94% of your problems are systems issues. Only 6% are people issues, so you need standardized systems to meet your goals. Take the patient experience, for example. You want to make that experience as perfect as possible, or you don’t stand out among your competitors. To make a perfect patient experience, your dental practice must have standard ways of bringing patients through your locations that are motivated and guided by the core values of the DSO. To be intentional about this, you have flow charts of what each team member does in interaction with the patient and the checklists they follow. Creating and establishing a foundation that guides everything your teams do takes thoughtful effort. But, when you map things like this, you can figure out at what point something broke down at the interface between people and processes, and then you can fix that and not manage by gut, putting out fires. ## Reasons to Join The DEO: Is It For You? Members of the Dentist Entrepreneur Organization have many opportunities to learn (from experts and each other) ways to operationalize the five principles I have outlined. Many successful entrepreneurs are willing to share their experiences so you can learn from their mistakes and successes. Then it’s up to you to consider multiple paths that fit your situation as you strive to build a platform across numerous offices. I encourage dentists and dental practice owners considering growing a multi-location group or DSO to join the DEO to get insight from members doing fantastic work. You can get help with the following: - Financing - Hiring - Building processes - Optimizing their platform - Scaling Being involved with such individuals can definitely accelerate your practice’s growth. ## Final Thoughts It takes a different skill set to manage numerous dental practices than one. Employing top talent, putting the best processes in place, and combining them in a culture that prioritizes quick development are all essential to growing your dental practice. The dental industry isn’t the same for everyone. Practice management, patient care, office supplies, patient referrals… There are so many different variables involved in practice growth. A DSO cannot be scaled according to a single plan. There are several options available. Ultimately, it boils down to whether you prefer to bootstrap your way to success using your own funds, use loans to finance development or turn to private equity. Patient Prism’s software platform enables dental groups and DSOs to optimize patient engagement and conversion. Looking to increase new patient revenue? 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We're committed to your privacy. Patient Prism uses the information you provide to us to contact you about our relevant content, products, and services.  You may unsubscribe from these communications at any time.  - Recent - Popular [Dental Practice Leadership](https://blog.patientprism.com/topic/dental-practice-leadership) ##### [Bulletproof: Patient Prism Equips Private Dentists to Compete with DSOs](https://blog.patientprism.com/bulletproof-patient-prism-equips-private-dentists-to-compete-with-dsos) [Dental Practice Leadership](https://blog.patientprism.com/topic/dental-practice-leadership) ##### [Bulletproof: Did a New Patient Call and Then Fail to Schedule? 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Patient Prism provides your front desk team or call center with the tools and coaching they need to book more new patients on the first phone call.  [![Schedule Demo](https://no-cache.hubspot.com/cta/default/3321879/0b902015-8fd3-4970-b9f9-fd203c36af1c.png)](https://cta-redirect.hubspot.com/cta/redirect/3321879/0b902015-8fd3-4970-b9f9-fd203c36af1c) ### Related Posts - [by Deborah Bush](https://blog.patientprism.com/author/deborah-bush) - 6 min read #### [Bulletproof: Patient Prism Equips Private Dentists to Compete with DSOs](https://blog.patientprism.com/bulletproof-patient-prism-equips-private-dentists-to-compete-with-dsos) August 2023 In Bulletproof Dental Practice Podcast Episode 302, hosts Dr. Peter Boulden and Dr. Craig Spodak ask Patient... - ##### [Dental Practice Leadership](https://blog.patientprism.com/topic/dental-practice-leadership) - [by Deborah Bush](https://blog.patientprism.com/author/deborah-bush) - 4 min read #### [Bulletproof: Did a New Patient Call and Then Fail to Schedule? 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