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Stop Running the Practice Alone: A Better Model for Dentists

Dental Operations Unpacked · 2026-04-21 · 33 min

0:00--:--

Key moments - from our scoring

Substance score

50 / 100

Five dimensions, 20 points each

Insight Density10 / 20
Originality11 / 20
Guest Caliber13 / 20
Specificity & Evidence11 / 20
Conversational Craft5 / 20

Dentistry is experiencing significant economic pressure that's making solo practice unsustainable for most practitioners. Insurance reimbursement rates have stagnated for 20 years while operating costs - particularly labor - have skyrocketed, creating a squeeze that's pushing dentists toward group ownership or burnout. Meanwhile, large DSOs like Aspen Dental and private equity-backed groups are consolidating the market in ways that mirror healthcare's corporatization, which has left physicians dissatisfied and eroded their profession's appeal. Mike Baird's Accelerate Dental takes a deliberately different approach: maintaining minority ownership (under 50%), staying doctor-owned rather than private equity-backed, and committing to a perpetual model where the company will never be sold to outside investors. This structure allows dentists to retain autonomy and practice ownership while gaining access to shared expertise in procurement, HR, technology, and finance - essentially offering 'co-op' benefits. Rather than selling equity for an upfront check (which often represents surrendered future profits), practitioners swap partial ownership for equity in the entire group, aligning incentives across all locations. The model targets future dentists by offering true partnership pathways to ownership rather than employment that stagnates over time.

Key takeaways

  • →Insurance rates haven't changed in 20 years while labor costs and operational expenses have increased significantly, making traditional four-op independent practices economically unviable in most markets.
  • →Traditional DSO models promise autonomy but strip it away once equity is sold; Accelerate maintains true autonomy by staying a minority (<50%) partner, making dentists genuine partners rather than employees.
  • →Accelerate uses equity swaps rather than cash deals and avoids private equity, creating a perpetual doctor-owned cooperative structure modeled after law and accounting firms like Deloitte.
  • →Dentist compensation in DSO models typically decreases over time as corporate ownership percentage increases, whereas Accelerate's model aligns long-term profit growth with the practicing dentist.
  • →New dental graduates face a choice between earning $200k/year forever in DSO employment versus building ownership equity and long-term wealth through Accelerate's partner-track model.

In this episode

  1. 1Introduction and Background: From Healthcare to Dentistry
  2. 2The Changing Economics of Independent Dental Practices
  3. 3Limitations of Traditional DSO Models
  4. 4Accelerate's Three-Pillar Ownership Model: Minority Partnership, Doctor Ownership, and Perpetual Structure
  5. 5The Vision: Creating Equity and Long-Term Ownership Opportunities for Future Dentists
  6. 6Capital-Light Growth Strategy and Profitability Model

Mentioned

Accelerate DentalJake LarsonClint BerryMike BairdHenry ScheinWeaveAspen DentalHeartland DentalDeloitteADA

Guests

Mike BairdClint Berry

Topics in this episode

Henry Schein ONEPrivate equity in healthcareAccelerate DentalDSO (Dental Service Organizations)DPO (Dental Partnership Organization)Aspen DentalInsurance reimbursement stagnationDental associate recruitmentPractice ownership modelsPerpetual organizational structure

Questions this episode answers

Why are independent dental practices failing when they weren't 20 years ago?

Insurance reimbursement rates have remained flat for 20 years while labor, supply, and operational costs have risen dramatically. Additionally, DSOs and large groups can undercut pricing, recruit more efficiently, and leverage technology at scales solo practitioners cannot compete with.

What's the difference between a DSO and a DPO model?

A DSO acquires 100% ownership of practices, while a DPO (dental partnership organization) typically acquires around 70% and markets itself as offering 'autonomy.' However, Baird argues this autonomy is 'autonomy with an asterisk' because the majority stakeholder can force changes when acquisition chains occur.

How does Accelerate Dental make money if it doesn't charge upfront acquisition costs?

Accelerate charges an ongoing support fee to practices in exchange for services like accounting, marketing, HR, and procurement support; this fee is typically recovered within the first year through cost savings.

Why does Accelerate commit to never selling the company?

Private equity ownership structures incentivize profit extraction, creating pressure to recommend unnecessary treatments and prioritize shareholder returns over patient care. By remaining perpetually doctor-owned, Accelerate ensures clinical decisions prioritize patient outcomes over financial targets.

How can Accelerate afford to maintain minority ownership and stay debt-free?

Accelerate uses equity swaps rather than cash acquisitions, meaning dentists trade partial practice ownership for equity in the group. This requires no bank debt, no capital raise, and filters for committed practitioners rather than those seeking exit opportunities.

What our scoring noted

Our reviewer’s read on each dimension, with quotes from the episode.

Insight Density

10 / 20

There are a handful of genuine data points and a legitimately interesting structural model described, but large portions of the episode are pitch material, setup preamble, and platitude-heavy framing. The ratio of novel claims to filler is mediocre for a 33-minute runtime.

roughly 25 to 40% of DSOs are in bankruptcy or receivership is because they have massive amounts of debt
Dentists are literally making about 15% less today than they were 20 years ago. Uh, and they're actually working about 50 hours a year, or, uh, sorry, 100 hours a year more than they were for the last two decades

Originality

11 / 20

The perpetual-entity structure modeled on Deloitte and the equity-swap-instead-of-cash mechanism are genuinely non-obvious ideas in the dental DSO space. However, the broader critique of PE and DSO commoditization is a well-worn narrative that circulates heavily in dental industry media.

we wrote it into our operating agreement from day one that we are not allowed to sell the company
we do equity swaps. So we'll come in and say we're going to let you trade, you know, a quarter of your practice for ownership in the group as a whole

Guest Caliber

13 / 20

Mike Baird is a legitimate practitioner - former CEO of Henry Schein One and now founder-CEO of a 41-practice regional dental group - making him a real operator rather than a thought-leader figurehead. The appearance is promotional for his own company, which limits the candor somewhat.

I ended up getting recruited to be the CEO of Henry Schein one. Uh, so got deep in the dental software space for a number of years
we're kind of a regional, uh, dental group. Right now we're mostly in the West 41 practices and growing

Specificity & Evidence

11 / 20

The episode includes a meaningful cluster of specific figures (15% earnings decline, 100 hours/year more work, 25-40% DSO bankruptcy rate, sub-50% ownership, quarterly distributions) but many claims are unsourced assertions and the AI pilot claim of '100% ROI' is dropped without methodology or timeframe.

roughly 25 to 40% of DSOs are in bankruptcy or receivership
we went and evaluated a number of the AI platforms. We found six practices that wanted to run a pilot on it. Uh, we did the pilot, we gathered the before and after data

Conversational Craft

5 / 20

The hosts are disclosed commercial partners of Accelerate Dental, and the interview functions almost entirely as a promotional platform. Questions are open invitations to pitch, follow-ups are rare, and there is zero pushback on any claim - including unverified statistics and the guest's characterization of his own model as 'highly unique.'

I'm super sold. It makes me want to start a dental practice.
The model itself is, is really brilliant.

Conversation analysis

Computed from the transcript - who did the talking, and the words that came up most.

Share of words spoken

  • Speaker B80%
  • Speaker A17%
  • Speaker C3%

Most-used words

practice33dentist27group25dentists23different22mike21model20practices18autonomy16dentistry15part15dental14today14equity13partner13accelerate12

Episode notes

If you’re a dentist feeling stretched thin… you’re not alone. In this episode of Dental Operations Unpacked , we sit down with Mike Baird, CEO of Accelerate Dental, to talk about what’s really changing in dentistry - and why the traditional solo model is getting harder to sustain. From rising costs to insurance pressure, dentists today are being pushed into tough decisions: stay independent and carry the full burden… or join a DSO and give up control. Mike breaks down a third option. We dive into: Why solo practices are getting squeezed more than ever The real tradeoffs between independence and DSOs What most DSO models get wrong A new ownership model that keeps autonomy intact How dentists can scale without losing control If you’re thinking about the future of your practice - or the future of dentistry - this conversation is worth your time.

Full transcript

33 min

Transcribed and scored by The B2B Podcast Index.

Speaker A: Foreign. Hello everybody and welcome to another episode of Dental Operations Unpacked. I am your host, Jake Larson, here with my famous co host Clint Berry. Give us your two thumbs up. There it is. And a friend of ours, this is Mike Baird, uh, CEO of Accelerate Dental. Mike, thank you so much for taking some time with us. We are really excited about this conversation. Should be a fun one.

Speaker B: Awesome. Excited to be here.

Speaker A: Yeah. We've actually known Mike for some time. He lives in Utah. We cross paths, we work together on different projects. Uh, I won't give Mike's full background away, but he did work at uh, Henry Schein while we were at Weave and got to know. Um, so anyways, we're really excited to have Mike, good friend of ours and uh, the topics can be ah, a blast to discuss. Uh, today we're going to talk about different models inside of group dentistry. Uh, particularly the topic is stop running the practice alone, A better model for dentists. So Mike, before we dive into the topic and start in that conversation, I just want to give you a chance to introduce, uh, yourself to our listeners, share your background, share a little bit about yourself, um, and then we'll dive into it.

Speaker B: Awesome. Uh, yeah, the quick background. I ran a number of healthcare companies. Um, I ended up getting recruited to be the CEO of Henry Schein one. Uh, so got deep in the dental software space for a number of years and kind of through that, working with a number of large dental groups, decided that there was an opportunity for some differentiation and ended up starting a group of my own, Accelerate Dental, about two and a half years ago. And that's what takes all my time today. So we're kind of a regional, uh, dental group. Right now we're mostly in the West 41 practices and growing. But that's uh, that's the quick version of my background.

Speaker A: Yeah. Awesome. He's a very accomplished individual. If you don't mind, if you don't know Mike, go check him out on LinkedIn. Very, ah, accomplished and really, really smart individual. Uh, we're grateful to have him today. Um, let's talk about this, this topic really quick. Um, before, and then I'll tee up some questions for you, Mike. So there are a lot of different, um, models out there as far as group dentistry goes. It's group dentistry as a whole is growing. You've seen this take place outside of dentistry, right? Similar paths to what dentistry is on today and in your experience and some of the things that you've seen, maybe there's some concerns about the future of dentistry that the current models might be introducing or, uh, and you want to play a role in changing that. Um, so I would love to just give you a second, Mike, to kind of talk about what you've seen outside of dentistry in that, uh, as things have become more corporate or corporatized, um, and maybe what Accelerate is doing a little bit different.

Speaker B: Sure, yeah. It's really interesting I mentioned I was in the healthcare arena for a long time and kind of starting the 30, 40 years ago, the MSO concept of rolling up healthcare practices, hospitals, uh, everything really took off with private equity. And I always joke with my team that I come from the future.

Speaker C: Right.

Speaker B: Uh, sometimes we think dentistry is kind of five to ten years behind healthcare. And today in the broader healthcare industry as a whole, roughly 80% of doctors are part of a corporate owned group. And so, uh, when I came to dentistry and saw the growth of the dso, which is effectively the mso, um, similar, uh, entity, uh, were roughly, depending on how you look at it, 25% or so of doctors that are part of a group today. And we see that growing very, very quickly. I felt part of why we started Accelerate was we felt like there was a need for a different model because for the most part, most people aren't really big fans of what's happened in healthcare. You know, costs have gone up, insurance has remained a disaster. Most, if you talk to most general physicians today, they, they absolutely would not tell their kids that they wanted to be, um, a generalist. And I see kind of those same trends starting to happen in dentistry. And sort of one of my driving factors is how do you make an industry where, you know, if a dentist told his or her, you know, kids like, you know, you should do this career, it's an amazing career. And I feel like dentistry should be one of those careers. It can be very fulfilling. You're helping patients, transforming lives. You can have a good lifestyle, you can have a good living. And to me, some of that hinges on where the industry goes from here. And so that's a big part of the drivers and why we created Accelerate and why we've looked a lot at different group, uh, models and some of the passions we have there. So that's a little bit of the background of why we got into this.

Speaker A: And at this point, um, you know, a lot of dentists out there doing their own thing might feel like they're alone, um, and they might really enjoy the dental part of the, of what they do, but the other stresses and components of running an organization, uh, maybe aren't really fulfilling for them and they want to just focus on that. So what are some of the trade offs that being independent versus being a part of a group, um, that you see out there, that people are experiencing?

Speaker B: I think what's really changed the industry changes the industry, if that makes sense. If you went back 25 years ago where insurance rates were largely the same as they are today, but costs were a lot less, it was a lot easier for a dentist coming out of school to buy a practice. You could have a four op practice, you could get the staff you needed to, you could make a good profit. If you look at where we are today, where suddenly you've got one fourth of your, um, competitors or fellow dentists are working for a group, well, that's a very, very different environment. Uh, ah, I always liken it a little bit to the Walmart curve. You know, when Walmart comes to town, the mom and pop shops kind of disappear and we don't really have, you know, Walmart equivalents. There aren't hundred thousand square foot, you know, dental practices. But a lot of the trends are really similar. And so if uh, nothing is Aspen, but if Aspen dental moves to town, that's very different, ah, than you know, another dentist opening a practice down the road. This is an entity that can build a 20 to 30 op practice that can literally advertise during the super bowl, that can have their own hygiene schools and recruit whatever they need that gets very different supply, uh, costing and things than you do. And you could substitute Aspen with any number of other large DSOs and have some of those same trends. That's just a very different model. And so if you're a 4op dentist trying to compete down the road, you're not structured that way. Uh, and so I think that's what's changed. There will always be an upper decile 10% of dentists that, you know, run some crazy successful 5, 6, 7, $10 million practice that, you know, you see some of these guys on Instagram or whatever and they're in a different class. But that's not the bread and butter of most, most dentists. Most dentists are, you know, running a, like I said, a four op, maybe a million dollar practice. And suddenly the economics have changed in a big way. Those insurance rates have not changed in 20 years. They're, their labor has absolutely changed. Uh, and so there's a squeeze factor there that um, I mean, just keeping it really simple, if all your costs are going up and your revenue doesn't change, or in some cases is even going Down. If you look at things like AI on the side of, uh, the insurance, uh, companies, I mean, they're denying more requests than ever, um, just as a matter of business. So there's a literal squeeze that happens there that I think is making it really, really tough for the average dentist. Doesn't that there won't always be some that are hyper successful. But I think what it takes to be successful now is very, very different. This is a true CEO role. Like, how do I optimize my procurement and supply chain? How do I optimize my HR and benefits and recruiting function when literally one out of three offices is trying to recruit a hygienist, an assistant, an associate, whatever. How do I optimize, um, you know, my uh, AI tools and technology and keep up with the new things that are happening next door. And all these things have costs and things associated with them. And so it ends up being just a tremendous burden on a role that traditionally doesn't necessarily have a lot of business experience to begin with and they don't really even know how to evaluate it. And so sometimes they get lucky and things happen to go really well. Uh, or they live in an extremely rural area where they're the only dentist for 100 miles. That works pretty well too. But if you're just, uh, a regular dentist, uh, with four ops in a large metropolis, it's getting a lot harder, uh, to be successful. And I think that that's what's sadly pushing a lot of dentists to feel like the only option they have is to join a group. Um, and. Or they just work themselves to death. I mean, you can look at the stats from the ADA. Dentists are literally making about 15% less today than they were 20 years ago. Uh, and they're actually working about 50 hours a year, or, uh, sorry, 100 hours a year more than they were for the last two decades. So, you know, that that actually translates to like two or three hours a week. And you know, when you think about that doesn't sound like a lot, but if you think about the percentage of free time you have, if you only have 10 hours a week of free time and you lost two of those, that's a big deal. So those are the things that are really driving a lot of change in the industry right now and causing dentists to rethink what they want. And, you know. Yeah, a lot of them are feeling alone.

Speaker A: Yeah. And there's a lot of benefits. Right, that those single, um, independent practices, uh, can have. But, um, where do you see that the Traditional DSO model falls short as these, um, doctors consider joining.

Speaker B: Yeah, I mean, there's pros and cons with every decision. I think the classic, um, variables are autonomy. Right? So, hey, if I'm solo, I can have autonomy. I can choose everything that I want. You know, I can run the practice the way that I want, the market the way that I want. I pay my staff the way that I want. On the flip side, that means I have to do everything myself.

Speaker C: Right?

Speaker B: Uh, if you look at, you know, a dso, well, they take a lot of the guesswork out of it.

Speaker A: It's.

Speaker B: It's kind of like the McDonald's playbook. It's really nice to know exactly how you should do different procedures. You know, if you walk into a heartland office, it's exactly the same, and they have their process nailed down, you know, from, you know, decades of figuring out how to do this. But there is no autonomy there. And I would even add another layer of sort of risk and upside, like part of why, um, when you give up that risk and you kind of sell out, well, you don't really have the upside either. And I think that's another variable that's a little tricky. And look, for some people, that may be the right answer. It may be that they don't want the stresses of running a practice. They just want to show up and, uh, have their schedule filled and see the patients and then go home and not stress about it. But I think what happens in these businesses is over time as that, um, these corporate models take hold. Well, let's say today that they're paying 30% of production of those dentists, and then Tomorrow it's actually 28%, and then it's 26, and then it's 25. Because guess what? There's not really alternatives. And so they can change those things. I think those are some of the trends that we saw in medical that we hope don't happen in, uh, dentistry today. And so that's kind of what forced us to think through. Are there other ways to do this where you can sort of have the best of both worlds that segues us

Speaker C: into that new way. What's the new way, Mike, that you've

Speaker A: come up with the new model?

Speaker B: Well, and I won't pretend that we've solved it all the way, but I will tell you what we're trying to do. So we stepped back and looked at this and said, is there a way to kind of have some of the benefits of scale, uh, the benefits of data, the benefits of knowledge and shared Expertise, but still maintaining the autonomy. And I'm actually really. Autonomy, uh, is a trigger word for me because if you go to any, uh, in the DSO world, there's been this big trend over the last decade in particular towards the DPO model. Uh, so there's DSOs, which everything's a DSO, right? But DSO traditionally is sort of the 100% we buy you out. The DPO kind of came with this concept of, well, what if we only bought 70% of your practice out? You know, and if you go to. And those are really the popular models today, if you go to any one of their websites, I promise, you know, on the first half of the page, you're going to see autonomy. You know, you're going to have autonomy, autonomy, autonomy. And I always say it's actually autonomy with an asterisk, uh, because its autonomy up until the point where they disagree with you. Um, because at some point when you give up a majority of your entity that has strings attached to it, uh, and. Or maybe you like the first group, but every group's trying to sell to another group. And when that new group buys you and, uh, needs to figure out how to make profit, well, guess what? You sold. And so they have the ability to make the changes that they need to drive profit. So autonomy is a big part of the equation. And so when we looked at, uh, a different way forward, we interviewed over 100 dentists, we looked at models across the country, and we settled on three things that we thought needed to be a little bit different. The first is the ownership model. So at Accelerate, we are always a minority partner, meaning sub 50%. Uh, which means it's literally impossible for us to force the dentist to do something, um, which we thought was important. It meant from day one that we were set up as a partner in the practice, a consultant, a mentor, a peer, but not a manager. And so it forces us to bring ideas and insight that the dentist wants to deploy. Because if they don't want to deploy, they'll say, well, that's really nice, but that's not how I want to run my practice. Um, there's downsides for us in that there are certainly things I wish we could, we could force sometimes, but we've just chosen to make it real autonomy. Because we believe that that clinical trust that exists between a doctor and a patient is so important that, that doctors need to be able to run the practice the way that they want, but they do get a partner that can help them with insights. So that's, number one is we're always a minority partner in the practice. Number two is, you know, I have nothing against private equity and the things that they do to grow markets. But we feel very strongly in clinical realms that private, uh, equity usually isn't for the best of those industries. So if you look at hospitals as an example, private equity owned hospitals have higher death rates than non private equity owned hospitals. Uh, that's a fact. It's not, it just literally is a different style of management and a different source of prioritization. And we believe by having a group that is owned by doctors and owned internally as opposed to externally, not only are we aligned at the practice level, the way we partner at the practice level, but as a group we're moving towards things that the doctors want. That doesn't mean that we don't want to make profit and have good operations, but we will likely always make some trade offs that tend to be more in the favor of patient care than perhaps profit. So that's the second thing and that as we grow, all those benefits accrue to the dentist, um, which they really like and appreciate. Uh, I think a lot of dentists that get, uh, caught up in these DSL models realize they're actually, they get a nice little upfront payment, but then especially if they're working for 10 plus years, the rest of their life, they're actually working to generate profit for somebody else. And in our model, um, they're generating that problem for themselves. And so when we say, hey, we're going to be a part owner in this practice, it's actually not some weird P firm, it's a bunch of other dentists. Like we love to say to dentists, well, what if you were to swap, you know, a quarter of your practice for ownership in 40 other practices? And now you had a group that was invested in your success and wanted to share best practices and help you and was motivated to do so. So that's our second pillar. The third is what we call the perpetual model. And again, I come from the future. What happens when uh, these private equity based models is eventually you roll everything up, it gets bigger and bigger and bigger and it goes public. Now you've got a publicly traded health care entity and when you go to the dentist, do you want to feel like the dentist is recommending work because he's got to hit a 30% shareholder growth target or because he feels as a clinician this is the right thing for you to do? And so our solution to that, we call it the perpetual model. It's that we wrote it into our operating agreement from day one that we are not allowed to sell the company. It's meant to be a perpetual entity. And so we've copied other, uh, entities like law firms and accounting firms where they're partner owned in perpetuity. So think of like a Deloitte, you know, a big accounting firm. It's not owned by private equity, it's not publicly traded. When you retire as a partner at Deloitte, you're selling to another up and coming partner. And we've kind of copied that for dentistry where we say, hey, a dentist should sell to a dentist. And so they know that their legacy, their quality of care, the things that they've worked on, will continue to be owned and operated by a dentist, uh, in the future. And so those three things taken together are incredibly unique. There's about three groups in the country that will be a minority partner. There's probably, uh, lots and lots of groups have some form of dental ownership, but not nearly as much as we would have. And this idea that we never want to sell, I've yet to meet a single group that has that philosophy. And when taken together, we've built something that's highly unique. But what it then does. So what's the takeaway from this is as a dentist, you still own your practice. It's your name on the door. You have a thought partner to help you with all the same things that a DSO would, you know, help me with finance, help me with reporting, help me with benefits and recruiting and procurement and all those things. But I as the dentist still get to make the choices on running the practice that I want to run, and yet still getting some of those benefits of scale. And so that's the needle we're trying to thread, uh, with our setup. But we feel like when we look forward to the future, where most experts believe that we'll see somewhere between 50 and 75% ownership of practices by DSOs over the next 10 years. We like a world where we can envision going to the dental student of the future and saying, hey, you could go work for dso and it might sound really great coming out of school. You're going to make $200,000 a year. We're going to help you pay your student debt down. But guess what, fast forward 20 years, you're still going to be making $200,000 a year. It's never going to grow. We go to them and say, hey, how would you like to come work for another experienced dentist? Uh, you're going to have the opportunity within a year to buy into that practice. You are going to have equity. We are going to help set you up to be a long term owner and you, you're going to make that profit. Uh, and you're not doing it alone. Because today, you know, all that a dentist can really afford is like a three op practice. They have so much debt that it's really hard for them to get something going. And that practice doesn't really pencil anymore with uh, the economics of dentistry. And so we're trying to create a different future that we think uh, maximizes opportunity and we hope gets the future dentists excited about staying in this profession. Because we still believe dentistry is a fantastic place place to live and operate. As an entrepreneur and as a clinician.

Speaker C: Mike, I'm super sold. It makes me want to start a dental practice.

Speaker B: You should and then you should join us. We want everyone to join us.

Speaker C: At the very least I should find a dentist that is part of Accelerate because I love the vision of it. Uh, I'm curious like from the business model then if the way you structured things, you can't force the offices to do anything. So I have two questions for you. Does that make it harder for you to raise capital because it looks riskier from the outside if you are not a majority shareholder. Like uh, theoretically a dentist could still run their company to the ground and then the. Well, let's start there.

Speaker B: Yeah. So first off we don't really need to raise capital. So our setup is not to come in and do a big check. One of the things that ends up messing with Dennis minds is they think when they sell to a dso, I'm getting this million dollar, two million dollar check. It's amazing, you know, and they don't ever think about o there's taxes and usually they put a lot of private equity things in here like clawbacks and earn outs and things like that that rarely actually end up being as big of a number as they think they're going to get. But more importantly, what they don't realize, especially if they have more than about four years of time to keep working, is what they've sold is their future profits. And they think that this check is going to change their life. But they've given up on 10, 15, 20 years of future profits that actually end up being way more of their long term value. When we partner, we actually almost never are, uh, exchanging any cash. We do equity swaps. So we'll come in and say we're going to let you trade, you know, a quarter of your practice for ownership in the group as a whole, no money is exchanged, which also helps us filter out. We're not looking for people that want an easy out. We want people that want to continue to build their practices. And so there's no capital required, which is a wonderful thing. I'm not going to banks and getting 90% leveraged debt on these practices. And part of why we're seeing roughly 25 to 40% of DSOs are in bankruptcy or receivership is because they have massive amounts of debt that then when they have bumps in their operations, they end up, uh, being owned by the bank and not able to execute. We have very, very little debt. We have some practice debt from equipment and stuff, but we don't have any debt for buying the practices. So that's been really great. And it's been a low capital intensive model, uh, and that really helps with the growth, uh, when you don't have to go, I don't have to take out 100 million loans to buy practices. I just need to find doctors that want, that choose to partner in and are joining almost like a co op, uh, where they can work together and have shared benefit.

Speaker C: Okay, that's super fascinating. So then how does accelerate money? Is it just a, uh, distribution from profits?

Speaker B: Yeah. So we do charge a support fee to our practices, uh, to help pay for, for the services that they get. We generally cover that within the first year because we're getting rid of their marketing costs and their accounting costs and a lot of their procurement costs, et cetera. Uh, and so that helps pay for the salaries and things that people supporting. But yeah, those profits that we get then get redistributed back down to, uh, our dentists. And so it's another highly unique thing. Very few of the DSOs pay a distribution, and we have since day one, we pay distributions out of all of our profits to our dentists every single quarter because again, it's their money. So not only are they hopefully getting profits from the practice side, they're getting profits from the Topco. And they literally have equity. And, uh, we reprice it every quarter based on the practice growth and the profitability growth that we have. And they can sell that anytime to other partners in their group. So they're actually relatively liquid versus a DSO model where they're captive, um, waiting on some future recap that may or may not happen. And it ends up making them, uh, have a lot more flexibility in the model.

Speaker C: Fascinating. This is like, fascinating to me. So you convince a dentist to give up a percentage, well, to trade a Percentage of their trade.

Speaker B: Yeah, that's a good way to describe it. So could I come to you? Yeah, yeah. How would you like to be part of a group? And so, yeah, swap a piece of your practice for ownership and all these other practices and now you're part of the club. Right. But it ought to start sharing insights and ideas.

Speaker A: It also does the same kind of stepping back to where we started this as we kind of framed the challenge. A lot of these independent practices have, um, they see the writing on the wall with a lot of the challenges Mike outlined with competing DSOs in their area. Um, they feel the burden of managing their own HR and their own payroll and all these other things. And then Mike rolls around with an alternative to be able to have that support, um, not give up the autonomy and to put a portion of their equity into a larger organization of dentists that are all trying to do the same thing. So I can see how there's a lot of alignment. My question for you, Mike, is as you sit in a seat, helping and supporting these, uh, practices, with them having the autonomy to choose what to implement. How do you balance that? Uh, to me it seems like it takes a great salesman, right. To be. You're constantly selling them as to why these changes are important. Right. To implement, but they're not required to. But you can see that if they do it, it's going to make a big difference for them and the organization as a whole. So how do you sit in that middle seat of influencing change for the better with them still having the autonomy whether to follow or not?

Speaker B: It's a great question, Jake. Uh, I think a lot about hard power and soft power.

Speaker A: Right.

Speaker B: Uh, private equity firm loves to have hard power. I own 51%. Therefore, you have to do what I want you to do. What they end up finding, though, is you can, even if you wholly own a dentist, you can't find, force them to do things that they don't want to do. And they actually have a lot of challenges with this, you know, well, you're going to do it this way. Maybe I will, maybe I won't, you know. Ah. And in my career, I've always believed that at the end of the day, if it's not the right answer, you're going to have compliance, uh, issues regardless. And so I'm a much bigger believer in soft power. Meaning, well, let's find something that's mutually agreeable and makes sense to you. So there are certain things that are non negotiables. If you join our group, we're going to do the financials and accounting and stuff. Stuff, because otherwise it would be chaos. Right. But we let you use whatever PMS you want to use. Uh, as long as it's one of the four that we can get data out of and support with Cola's help and others. Um, but generally what's nice about this is when we come to a dentist, let's say, let's pick a change like merchant services. If I go find a better merchant service account and I come to a dentist and say, hey, I found this new merchant service account, I think it's going to save you 1.5%. You're actually going to get more of that upside than I am. I've, uh, done the math for you. Do you think this is something you want to do? Well, nine times out of 10 they're going to say, that sounds like a great idea, Mike. Thank you for doing that work for me. Let's put this in place. Sometimes they may not and that's okay. Right? Um, but I feel like you always have non compliance, even in a wholly controlled model. And it puts the pressure on us to find good solutions and resources. I'll give you another example. Our dentists really want us to look at AI, um, two years ago. So we went and evaluated a number of the AI platforms. We found six practices that wanted to run a pilot on it. Uh, we did the pilot, we gathered the before and after data, we came back and said, hey, we recommend this. We saw whatever, 100% ROI on this. We negotiated a deal with our favorite provider. It gets better and better pricing. Every time we recommend that you do this. Three out of four dentists will say, that sounds great and they'll sign up, um, for it. A few of them will say, I just don't really want to do AI. I don't need that in my practice. And a few will say, I actually like a different vendor. Okay, you're welcome to do that. You may not get as big of a benefit, you may not have. You know, when we do trainings and things, we're really good at the one that we're using across, you know, two thirds of our practices and probably less good on the others. So there's always trade offs that you're accepting as a dentist. But again, every model is going to have some trade offs. And we came in knowing that while we'll always have compliance issues, if you were to phrase it that way, I at least have dentists that, uh, get to do what they want and they are convicted in that. And so if they choose to go a different path, it's usually because of local insight they have that usually generates better results for them in their practice. And I'm okay with that. Right. At the end of the day, we're all trying to deliver great quality care for our patients as well as run a good business. And we just tend to believe in a more decentralized way of trusting the person that's on the ground. And so you'll find a few areas where they're passionate about it and want to. You know, I really just prefer this AI, you know, versus that one. But in most areas, I mean, how many people really care about their merchant service provider? Not. Not really. Right. How many people really care, uh, you know, about certain aspects of, you know, procurement or, uh, what phone system they use? They really. Most things, they just want it to work. And they appreciate having a group that can take the consolidated data and resources of 40 other practices and bring them good insights and better deals. And so in the end, I think we have pretty good compliance, just as any other DSO would do. And we just do it because they choose to do it. And what we always love is in every single situation, the doctor will make more. If this is a profitable move, then we, the top coat, will, and therefore we're on the same side of the table figuring out if there's a benefit. It's not a, uh, well, this is good for me, but I'm not sure it's good for me. For you.

Speaker A: Right.

Speaker B: Uh, we really like to get rid of that.

Speaker A: I really like how the model itself creates a natural alignment between the two. It seems like it just opens the doors for a lot of trust that you're not going to recommend something that's not in their best interest as well. Right. Because ultimately they're still the majority owner. And like you've said multiple times, they're going to benefit from it more than the organization will, um, as a whole, which is fascinating. The model itself is, is really brilliant. So, uh, Mike, I know we've taken a bunch of your time. The listeners don't even know this, but we had a good conversation even before this. So Mike has been very, very generous with his time. So, uh, out of respect for that, Mike, we want to thank you for joining us and give you a chance to give just a quick closing thought and takeaway. A lot of our audience are operators, um, inside of DSOs, owners like, uh, yourself. What's a single takeaway or two that you would give to them from your experience and the success you're seeing, uh, at Accelerate with this different type of model, um, that, uh, you've implemented at Accelerate.

Speaker B: Yeah, I think I'd say, uh, two things. One is that the market is ever changing, and if you fail to grasp all the things that are happening, you're going to get left behind. So whether that's AI, whether that's technology changes, whether that's how do we deal with labor shortages, you can't sit still, or you're going to get left behind. And I think that's part of the message, I guess, for my solo dentist friends out there on, um, the group side, it's more of, hey, we're trying to do something different, and we don't mind if people copy it. We are very much in the realm of we think this is better for the industry. We think dentists just haven't ever thought of this as an idea. Um, and yet it's really good for them. And we hope someday, just like there's a Deloitte and a PwC and, you know, other accounting firms, we hope there's other groups following the same methodology. And so we're always happy to chat with folks and share the way we're going up this market because we actually think it's fantastic, uh, for dentists. And we're very passionate about setting up the industry for great things in the future.

Speaker A: Well, if you want to be like Clint and start your own dental practice and join Accelerate now. But, yeah, Mike, how could people get in touch with you if they want to learn more? If they have some additional questions, uh, what would be the best way for them to reach out to you?

Speaker B: Yeah, you can find us@acceleratedental.com I'm Mike@acceleratedental.com Love to chat with folks anytime, and we're always here to be a resource.

Speaker A: Fantastic. Well, Mike, thank you so much for taking some time with us. We really appreciate it. Um, uh, we love being a partner of Accelerate, and it's been really cool to learn more about your model. Uh, I think that you sold both Clint and I, so we're ready to, to start a practice and come join. But anyway, thank you again. Thank you, everybody, for listening to this episode of Dental Operations Unpacked. Um, we will catch you next time on our next episode. Bye. Bye.

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