Episodes

  • Season 2 Episode 5 - The Truth about DSO Ownership Equity

    Season 2 Episode 5 - The Truth about DSO Ownership Equity
    May 16 2024
    In this episode of Just Say No to the DSO hosts Bob Spiel and
    Nate Williams dive deep into the subject of ownership in a DSO, or what is called
    “Equity”. They describe why Equity is a self-made target that allows DSO’s to
    dramatically overstate their value, which leads dentists to believe their ownership is
    worth much more than it is.

    The discussion underscores the lack of transparency among DSO valuations, and why
    self-defined Equity is open to abuses. Ultimately, the episode aims to empower dentists
    to make informed decisions that safeguard their autonomy and financial well-being.
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    33 mins
  • Season 2 Episode 4 - Do DSOs Actually Overpay (Part 2)

    Season 2 Episode 4 - Do DSOs Actually Overpay (Part 2)
    May 8 2024
    In this episode of "Just Say No to the DSO" hosts Bob Spiel and Nate Williams dive deep
    into the deceptive tactics employed by Dental Service Organizations (DSOs) to lure
    dentists into unfavorable agreements. Through real-life examples and a critical analysis
    of a $29 million DSO offer, they highlight the hidden costs and risks that dentists often
    overlook in pursuit of financial gain.

    The discussion underscores the importance of diligence and transparency in evaluating
    DSO deals, urging dentists to seek independent advice and scrutinize all terms before
    relinquishing control of their practices. Ultimately, the episode aims to empower
    dentists to make informed decisions that safeguard their autonomy and financial well-
    being.
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    38 mins
  • Season 2 Episode 3 - Do DSOs Actually Overpay for Practices?

    Season 2 Episode 3 - Do DSOs Actually Overpay for Practices?
    Apr 26 2024
    The podcast is episode three of Season 2 for “Just Say No to the DSO." Hosted by Bob
    Spiel and co-host Nate Williams, it discusses reasons why dental practice owners
    should avoid selling to Dental Support Organizations (DSOs).

    This podcast episode is a warning to dentists who are thinking about taking DSO deals.
    The hosts do a deep dive into a $20 million DSO deal and reveal how deceptive these
    deals can be. They stress the importance of being critical and skeptical of these deals.
    The goal of the podcast is to help dentists make informed decisions about DSO deals
    and keep control of their practices.
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    25 mins
  • Season 2 Episode 2 - What is EBITDA, and Why do DSO’s Lean On It for Practice Purchases?

    Season 2 Episode 2 - What is EBITDA, and Why do DSO’s Lean On It for Practice Purchases?
    Apr 16 2024
    In this podcast episode of "Just Say No to the DSO," hosts Bob Spiel and Nate Williams discuss the importance of dentists maintaining control of their practices rather than selling to Dental Service Organizations (DSOs).

    They emphasize that smart business people don't overpay for practices and that DSOs are adept at making dentists think they're getting a great deal when, in reality, they may be giving away their practices for little to no value.

    The hosts explain the concept of EBITDA (earnings before interest, taxes, depreciation, and amortization) and how DSOs structure deals in a way that essentially allows them to acquire practices for free or at a minimal cost to themselves.

    They warn dentists to be cautious of promises made by DSOs regarding equity and future earnings, as these promises may not materialize. The episode concludes with a teaser for the next installment, where they will delve deeper into the realities of DSO deals.
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    21 mins
  • Season 2 Episode 1 - Are we still convinced to Just Say No to the DSO

    Season 2 Episode 1 - Are we still convinced to Just Say No to the DSO
    Apr 9 2024
    The podcast is episode one of Season 2 for “Just Say No to the DSO"; Hosted by Bob Spiel and
    co-host Nate Williams, it discusses reasons why dental practice owners should avoid selling to
    Dental Support Organizations (DSOs). Bob Spiel has an MBA and is a practice management
    consultant, while Nate Williams is a dental CPA. They have both been in dentistry for over 15
    years.

    Key points discussed: Introduction: Bob and Nate introduce themselves, emphasizing their
    experience in dentistry and financial consulting.

    Reasons to Avoid DSOs: They discuss three prevailing myths about selling to DSOs:
    ● Myth 1: Selling to a DSO will make more money.
    ● Myth 2: Selling to a DSO means earning passive income from others'; work.
    ● Myth 3: Selling to a DSO will make life easier.

    They then dive into:

    Reflection on Season 1: Bob and Nate reflect on Season 1's topics, emphasizing the
    importance of owning a dental practice for long-term wealth.

    Changes in the Industry: They discuss the rapid growth of DSOs and the
    challenges they face, such as contract expirations and recruitment difficulties.

    Case Study: Bob and Nate share a real-life example of a DSO facing financial
    difficulties and restructuring, highlighting the risks associated with selling to DSOs.

    Lessons Learned: They draw parallels with the medical industry's shift towards
    corporatization and caution against losing control over one's practice and profession.

    Preview of Season 2: Bob and Nate outline the topics to be covered in Season 2,
    including financial principles, contract analysis, equity considerations, and common
    pitfalls.

    Conclusion: Just Say No to the DSO! If you have any questions, please send them to
    questions@justsaynototheDSO.com

    Overall, the episode serves as a warning against the potential pitfalls of selling private dental
    practices to DSOs and provides insights to help dentists make informed decisions about their
    practices'; future.
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    30 mins
  • Episode 7 – Season 1 Wrap Up and FAQs

    Episode 7 – Season 1 Wrap Up and FAQs
    Sep 13 2023
    Concluding Season 1, the conversation focuses on the complexities and challenges associated with dentists selling to Dental Service Organizations (DSOs). Many dentists who engage in these DSO partnerships find themselves literally "paying back" their earnings over extended periods, without reaping any significant benefits unless their DSO is gobbled up (i.e. acquired) by a larger DSO. This model has an alarming turnover rate, with about 70% of engaged dentists leaving within the first two years, suggesting widespread discontent among the dentists who work within DSOs. While it is argued that one need for DSOs arises as dental graduates might not be ready for private practice because of modern dental education, many leave due to the unsatisfactory work environment.

    Bob and Nate further stress how the role of the dentist in a practice remains paramount. Their intrinsic value lies in the care they provide, and the episode emphasizes the vast growth and development opportunities available within the dentistry field. Throughout their careers, dentists have the unique opportunity to grow significantly in their clinical skills, and also grow in managerial, interpersonal, and leadership capabilities.

    The hosts passionately advise dentists to retain ownership of their practices and be cautious of the DSO model's allure. They anticipate potential challenges for DSOs in the future, especially in retaining top-tier talent and managing the associated financial constraints. Concluding the episode, there's a call to challenge the conversation about DSOs in the dental community, placing emphasis on individual dental practices over corporate DSO models.
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    53 mins
  • Episode 6 – The DSO Gold Rush: All that Glitters…

    Episode 6 – The DSO Gold Rush: All that Glitters…
    Sep 13 2023
    In this episode, the hosts discuss the nuances and complexities of joining Dental Service Organizations (DSO’s), particularly highlighting the illusion they create of community and unity. Although these groups promote the idea of collective strength, many doctors, after joining, still find themselves feeling isolated in their individual practices, realizing that the promised unity doesn't quite materialize.

    The allure of equity is another theme, with many doctors being tempted to sell their practices for a sizable upfront sum that promises future financial freedom. However, the hosts argue that genuine freedom derives from maintaining autonomy over one's practice and life decisions. Selling leads to a loss of both control and freedom, putting the doctor in a restrictive employee position.

    The episode touches upon the "fear of missing out" (FOMO) phenomenon. As doctors see their peers, especially successful ones, selling their practices, they feel mounting pressure to follow suit, fearing they might miss out on lucrative opportunities. Yet, the hosts draw an analogy to the gold rush, suggesting that in this dental "gold rush", like the gold rushes of old, it isn't the dentists who are profiting the most, but those brokering the deals.

    Furthermore, the hosts bring to light the non-disparagement agreements doctors sign when joining Dental Service Organizations (DSOs). These agreements legally bind doctors, preventing them from sharing any negative experiences, which might explain the dearth of negative testimonials about DSOs.

    Concluding, the episode emphasizes that while stories of regret about joining DSOs might be scarce due to various reasons, there are numerous tales of dentists who have stayed independent and found substantial financial and personal success.
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    40 mins
  • Episode 5 – The Medical Mess: Are DSO’s Pulling Dentistry into the Same Swamp?

    Episode 5 – The Medical Mess: Are DSO’s Pulling Dentistry into the Same Swamp?
    Sep 13 2023
    In this podcast episode, our hosts dive into the distinctions between the medical and dental industries. As the discussion unfolds, Nate interviews Bob drawing on his experience in medicine as a hospital and surgical center CEO, highlighting the trajectory in which medical doctors have found themselves, where doctors have lost almost all control over their careers, primarily becoming indirect government employees working for large hospital systems. They sound an alarm on the risk that if DSO’s are successful in dental industry consolidation, dentistry will follow a similar path, leading to government-driven pricing, and dentists and dental specialists becoming mere cogs in a larger machine. They argue that this outcome is both self-induced and avoidable.

    Through personal anecdotes, Bob and Nate underscore the long-term relationships dentists build with their patients and the potential repercussions of capitulating to larger corporate entities. As the episode draws to a close, they pose a poignant challenge to dentists: to ponder deeply on the significance of preserving the integrity, autonomy, and quality of the dental industry for the sake of its future. They encourage reflection on the consequences of dentistry following the path of medicine and the impact of such a devolution to future dentists, their teams, and patients.
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    42 mins