R. Dustin Dixon, DMD, discusses DSOs—what they are and how to grow your dental practice with the support of one.
Q: What is a dental service organization (DSO)?
A: Please allow me to answer this, and the following questions, from my direct experience working with a DSO, Aspen Dental Management, Inc (ADMI).
Aspen Dental is a brand name for dental practices owned by local dentists that have a business relationship with a DSO called ADMI. The easiest way I can explain it is as follows: If you were Dr. John Smith and wanted to bring on a marketing company to manage all of your private practice’s advertising needs, you would hire them and develop a business agreement for their services. That is how ADMI functions; however, rather than contract for one individual service, ADMI provides an entire array of world-class business services and support. ADMI doesn’t own dental practices; they help support leading dentists in growing and developing Aspen Dental brand practices.
Q: Must the practices be named “Aspen Dental?”
A: Yes! It’s one of the most valuable parts of the agreement with ADMI because my practice gets the benefit of a brand name. This brand awareness helps the clinician-owner take advantage of all of the economies of scale that ADMI has to offer, helping also to ensure a steady stream of new patients.
Q: How did you get involved with a DSO?
A: After a short stint in private practice, I worked at an Aspen Dental practice owned by a husband-and-wife team and, within a year, I had done well enough to be in a position to buy it. Now, only 8 years later, I will be opening my 15th Aspen Dental office. My company, R. Dustin Dixon DMD Holdings, currently consists of more than 30 general dentists, 2 full-time specialists, and about 200 employees, with a projected gross revenue (2018) of $30 million in patient services.
Q: Looking at the national average income for private practice owners vs a lead dentist in one of your offices, how are your dentists generating more income?
A: That’s easy to explain but sometimes difficult for many dentists to understand. When you own your own private practice with no business support, you have to be the expert in every area of the business—marketing, human resources, insurance—in addition to clinical skills. With ADMI, the clinician has the support and expertise of hundreds of business professionals, allowing one to concentrate on delivering dentistry.
Q: As a clinician owning 15 dental practices, what does your day-to-day schedule look like?
A: Around 2 years ago, I found myself practicing minimally and learned that I would like to see more patients. Since then, I’ve entered into partnership agreements with several doctors at my offices who are as interested in leading and growing the practices as much as I am, and, as a result of those partnerships, I now spend about 60% of my time treating patients and the remainder on mentorship and growing my practice. Clinically, I really enjoy IV sedation and implant surgery and prosthodontics—all services that positively impact all of my offices and team members. Operationally, I focus on hiring and then training new doctors, especially in the areas of treatment planning and presentation, and clinical efficiency. I strive to create a culture that encourages growth and a “team first” mentality that results in positive patient experiences. Without the support that ADMI provides, it would be an extremely daunting task to both run and grow my company and to be a dedicated clinician!
Q: How do you hire and then further develop clinicians?
A: I focus on hiring new and/or recent graduates out of GPR and AEGD programs as associates. Then I concentrate on developing lead dentists who can eventually become partners. I now have 5 partners across 7 offices. My partners are put on a growth plan to own about half of my offices, basing the buy-in price on my start-up costs instead of the value of the office when they’re buying in. A focus is also placed on professional growth. We start with efficiency in treatment planning basic procedures and then move on to the more advanced clinical procedures. I want all of my clinicians to be confident in offering basic implant surgeries and delivering the prostheses.
Q: How could one of our clinician-readers become an Aspen Dental partner/owner? Any advice for new dentists?
A: One of the interesting things about Aspen Dental is that you can’t just come in as an owner (partnership is another form of ownership). You join in as either an associate or a lead dentist, in order to learn more about the model and the culture and to make certain it’s the right fit. Then, the clinician decides if ownership is the right way to go. The owner of the practice will then help onboard you, and coach you on the opportunities for growth as both a clinician and as a leader. Ultimately, one needs to learn how to work in partnership with ADMI’s operations and support team. For example, I work closely with ADMI’s real estate team to develop my own growth plan, and we are partners in finding and building new locations.
At the end of the day, to better serve others, the best advice that I can share with new dentists is to be a sponge: listen more, talk less, and always strive to improve needed clinical skills and continue the journey of personal growth. If you focus first and foremost on serving the needs of the patients who come to you for help, then the practice will be successful!
Dr. Dixon is a graduate of the University of Louisville School of Dentistry. He is a majority owner and managing partner of R. Dustin Dixon DMD Holdings, PLLC, operating 15 brand-name Aspen Dental locations. He can be reached via email at
dustin.dixondmd@gmail.com.
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