The conversation usually starts the same way. A practice owner has just run the numbers on their PPO contracts — or they've been handed a 4% fee reduction notice from a major plan — and they're thinking, seriously this time, about whether there's a way out. Going insurance-free is one of those ideas...

EBITDA. You'll see it in every DSO letter of intent. You'll hear it in every M&A conversation. And if you ask most practice owners what their EBITDA actually is, you'll get a shrug and a rough number that's almost certainly wrong. That's not an insult — it's just the reality. EBITDA is a financial c...

Every dental practice owner gets a number eventually. It might come in the form of an LOI from a DSO. It might come from a broker during a preliminary conversation. It might be a figure your accountant throws out at year-end as a rough estimate of what your practice is worth. The question isn't whet...

The letter of intent arrived on a Thursday. It looked good — 7x EBITDA, a two-year earn-out with solid upside, rollover equity with a projected second-bite return. The dentist called his accountant, who said the number looked reasonable. He signed the LOI the following week. Eighteen months later, h...

I've sat across the table from a lot of dental practice transactions — as an advisor, as a consultant, and now as the person who built the software that tries to solve a problem I watched happen over and over again. Here it is: nobody actually knows what the equipment is worth. Not the seller. Not u...

If you've received a letter of intent from a DSO, you've seen the term EBITDA. You may have nodded along as your broker explained it. You may have accepted the number your accountant produced without fully understanding how it was derived. This matters more than almost anything else in your transact...

You got the letter of intent. The number looks right. The buyer's team has been professional, the process has moved quickly, and everyone keeps telling you this is a strong deal.

Then the Asset Purchase Agreement arrives — three hundred pages of legal language — and somewhere in Article 6 is the ...

The math on PPO participation gets worse every year. Write-offs that once felt manageable now consume 35 to 45 percent of production in many markets. Fee schedules that haven't moved in a decade are being applied to a cost structure that has. And yet the conventional wisdom — that you can't exit PPO...

  You negotiated hard. You got a strong multiple. The letter of intent is signed, due diligence is underway, and closing is scheduled for next quarter. The total consideration looks excellent on paper — but a meaningful portion of it isn't paid at closing. It's deferred, contingent on future perfor...

Every dentist eventually hears the pitch. A well-dressed rep from a regional or national dental support organization sits across from you, slides a deck across the table, and starts talking about "partnership." The numbers look interesting. The promises sound reasonable. And somewhere in the back...