---
title: What Keeps CEOs of Dental Service Organizations Awake at night
description: AJ Acierno, DDS, is the CEO of DecisionOne Dental Partners. He talks about the challenges involved with growing a DSO, and the one thing that keeps him awake at night.
image: https://blog.patientprism.com/hubfs/Blog/Featured%20Images/DecisionOne-AJAcierno.png
---

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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: Alan J Acierno, DDS
- 6 min read

# [What Keeps CEOs of Dental Service Organizations Awake at night](https://blog.patientprism.com/what-keeps-dso-ceos-awake-at-night)

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August 2018--Dental support organizations (DSOs) are thriving in the United States and could account for 30% of all dental practices by 2021, according to a report published in Dental Practice Management. As DSOs scale up, they face new challenges. There is one challenge that keeps the focus of the co-founders of DecisionOne Dental Partners. This challenge can even keep them awake at night.

 

If you are a DSO founder, owner or non-owner CEO, many things can keep you awake at night, but staying true to the vision of your DSO is likely a key part.

My brother, dentist Mike Acierno, and I co-founded DecisionOne Dental Partners in 2011. We started with our two private practices and expanded the DSO to include 25 dental practices by August 2018. What keeps me awake at night is the same thing that led us to start a DSO in the first place: the legacy my brother and I want to leave behind.

## Staying True to Their Vision

We want to look back and say we changed the way dentistry was being done in order to improve lives. Honestly, any decision that we ever make is based on that. So, what keeps me awake at night are questions related to that mission:

- Can we leave a legacy of improving others’ lives? 
- Are we achieving that through our organization? 
- Is our voice big enough to be able to achieve that? 
- Are we growing at a pace that we can make a big difference?”

## Examples of How Our DSO Lives Out Its Vision

- Making oral health care more predictably affordable: People are increasingly faced with a reduction in dental benefits or a loss of benefits completely. Our approach emphasizes helping everyone have access to oral health care by helping them afford care. We offer a dental benefits plan that makes costs known up front for routine care and for unplanned dental expenses. With easy enrollment, immediate savings and no restrictions, membership in the DecisionOne Dental Plan gives patients instant access to savings on all dental services and peace of mind.
- Keeping down the cost of delivering quality dental care: Our affiliated practices also have economy of scale for marketing, accounting, modernizing our offices, purchasing new technology, purchasing dental supplies, contracting for vendor support and much more. We pass on the cost savings to our patients to keep dentistry more affordable so they can have the improved health they need. 
- Improving the lives of dentists: Our centralized businesses services allow dentists to focus on their patients and doing what is best for patients instead of worrying about all the aspects of managing a business. Dentists working in DSOs can easily balance their time between serving patients and having a healthy personal life.
- Giving back to the community: We are community of practices serving neighborhoods of Chicago, and we want to give back to our community accordingly. DecisionOne Dental Partners has created “A Reason to Smile,” an event that takes place six times a year to help provide dental services for residents of Clearbrook, a local facility that provides services, programs and support for children and adults with intellectual or developmental disabilities. We have pledged $100,000 annually towards assisting Clearbrook.

## Other DSOs Look Up to DecisionOne Dental Partners

There are other entrepreneurial dentists sharing our vision of wanting to do better for our colleagues and patients. They are saying, “I want to make dental care more accessible and to improve lives everywhere.” And if we don't achieve our vision within our own DSO, we let a lot of other DSO leaders down in addition to our communities and ourselves. So, achieving the mission we set out for ourselves is not only important to my brother and me as owners of a large-scale business, it’s important to the lives other dentists, and it’s also important to the thousands of people in our communities we can give access to quality care and serve extremely well. 

## More Patient Prism DSO Resources

Join us at [Patient Prism Academy](https://academy.patientprism.com/) to view our DSO Videos series. There you will find videos that tell the complete story of DecisionOne Dental Partners’ development and multiple DSO owners’ and DSO consulting experts’ advice for overcoming the challenges of starting and scaling a DSO.

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