The advantages of a DSO: Part 2 -- Focus on technology and best practices

2014 05 28 13 22 16 358 Hassled Doctor 200

In the second of this two-part series, the partners and associates from the law firm McGuireWoods look at some of the advantages of dental services organizations (DSOs), including technology, best clinical practices, capital, and more.

Technology and software

Technology and software help dental service organizations ensure clinical excellence and improve the patient experience. A DSO can aggregate orders between multiple practices and use greater purchasing power to get the latest technology and software at a substantial savings, which allows small and individual practices to access technology and software they could not otherwise afford.

In addition, a DSO can establish expertise in the area of technology and software, and it can use this expertise to research the latest technology on the market, establish relationships with technology companies to develop and deliver technology to dental practices, and provide training to dentists on new technology. For example, Pacific Dental Services (PDS) recently entered into an agreement with Quality Systems, an information technology company, to provide more than 400 PDS dental practices with QSIDental Web. This new cloud-based software program will provide dentists easy access to patient data anytime, anywhere. It also allows for enterprise management, such as record keeping and patient scheduling, and improved efficiency and patient care quality for the practices that use them.

Implementing clinical best practices

The American Dental Association (ADA) and the American Academy of Pediatric Dentistry (AAPD) both set forth clinical guidelines that included statements intended to optimize patient care. These statements were formulated after an assessment of the benefits and harms of alternative care options. Association of Dental Support Organizations (ADSO)-supported dental practices model their internal clinical standards for activities such as patient evaluation and diagnosis, patient treatment, and supervision of clinical staff on the ADA's and AAPD's guidelines. For example, Allied Dental, a New Jersey and Pennsylvania DSO, adheres to high professional standards by implementing sterilization and cross-contamination procedures recommended by the ADA, the Occupational Safety and Health Administration (OSHA), and the Centers for Disease Control and Prevention (CDC). These standards include correctly cleaning and disinfecting environmental work surfaces, implementing safe injection practices, practicing appropriate hand hygiene, and preventing transmission of blood-borne pathogens. Many DSOs, such as Smiles Dental, a Washington-based DSO, also promote clinical excellence by encouraging their team members to regularly attend dental lectures, meetings, and dental conventions.

Leadership and advocacy

These organizations offer management and operational expertise to dental practices so dentists can focus on what they were trained to do: clinical dental services. Experienced DSO managerial and administrative staff can make dental practices' businesses more efficient and also provide them with a proven path for growth. In addition, the DSO can ensure that dental practices stay ahead of market trends, new technologies, and efficient practice management resources.

Dental practices can also look to DSOs to help coordinate leadership and professional training for their dentists and administrative staffs. Further, DSOs through associations such as the ADSO can provide dental practices with an effective voice for advocacy on federal, state, and local levels.


“While reducing overhead expenses does not just increase profits, it allows dental practices to provide services at lower costs and cope with low Medicaid reimbursement rates.”

Besides providing leadership and implementing best clinical practices, a DSO can provide capital to establish and maintain dental practices. This reduces the need for dentists to make large investments, which can be difficult for independent practitioners, particularly early in their careers. These financing options provide a path for new dentists to operate a practice sooner without having to secure bank financing on top of student loan debt.

Some DSOs even offer development programs that educate dentists in owning and operating practices, while the dentist works at a DSO-affiliated practice. Dentists who are interested in practice ownership can advance quickly through these programs, while earning a steady paycheck and without having to take a significant capital risk before they are knowledgeable in the business aspects of practice.

DSOs are also able to aid newly established dental practices with expensive regulatory mandates and advances in medical innovation that force them to invest in diagnostic and treatment equipment, electronic health records, and other technology. DSOs can provide the necessary capital to keep up with these advancements.

Promoting efficiency

DSOs also promote efficiency by providing dental practices with support services, such as handling time-consuming administrative, nonclinical tasks, including staffing, training, billing, scheduling, payroll, accounting, marketing, housekeeping, property management, and insurance. They provide the infrastructure to work more efficiently with payors and complex governmental entities that oversee regulatory compliance and federal or state reimbursement programs.

Also, reduced operating costs through economies of scale promote efficiency. Using bulk purchasing and greater negotiating power, these organizations often obtain lower prices and rates on supplies. While reducing overhead expenses does not just increase profits, it allows dental practices to provide services at lower costs and cope with low Medicaid reimbursement rates. Because routine preventive care for indigent patients at dental offices is much less expensive than crisis care in emergency rooms for major problems, DSOs contribute to greater overall efficiency in America's healthcare system.

While some legislative and regulatory hurdles remain for DSOs and dental practices, the advantages and benefits that DSOs (such as the members of the ADSO) offer to dental practices are significant.

McGuireWoods is the eighth largest healthcare practice in the U.S., according to the American Health Lawyers Association in its annual Top Honors rankings. For more information, visit

The comments and observations expressed herein do not necessarily reflect the opinions of, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.

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