For DSO Operators & Executives

You're buying practices faster
than you can integrate them.

The operating frameworks, financial models, and integration playbooks that sub-100-practice groups use to scale without breaking what they bought — written by someone who spent 25 years inside dental operations.

Get The DSO Operating System — $49 See the full table of contents

400+ pages · Companion calculator suite available · One-time purchase · Instant download

The Problem

The playbook exists. It's just not written down anywhere you can buy it.

Every multi-location group hits the same wall somewhere between the fourth and the twelfth location. The systems that worked at three offices stop working. Your best office manager is now running four offices badly. Nobody can tell you what a location actually costs to run, because the P&L allocations were set up when there was one.

The groups that get past this wall usually figure it out the expensive way — hiring a VP of Operations from a bigger DSO who brought the framework in their head. That works. It also tends to run six figures a year and take the better part of two years to pay off.

Here's what you have instead:

OPTION 1 — HIRE THE CONSULTANT

The engagement that produces a deck

Real expertise, real cost, and the framework leaves the building when the consultant does. Useful once, hard to hand to a regional manager.

OPTION 2 — THE CONFERENCE CIRCUIT

Good for relationships, thin on specifics

Nobody on a DSO panel is going to tell a room full of competitors exactly how they allocate corporate overhead or what their day-30 integration checklist looks like.

OPTION 3 — FIGURE IT OUT PER LOCATION

The most common choice, and the most expensive

Every location becomes its own experiment. By location nine you have nine slightly different operating models and no clean way to compare them.

None of these gives you something you can put in a regional manager's hands on a Monday morning.

Built For

Groups big enough to need a system. Not big enough to have one.

I.Emerging DSOs

Ten to eighty locations, adding several a year. You have a CFO and a controller. You don't have a corporate development office, and you're not ready to hire one.

II.Group practice owners scaling past three

The jump from three locations to six is the hardest one in dentistry — where owner-operator instinct stops scaling and process has to take over.

III.Regional & district managers

You inherited several offices and a mandate. Nobody handed you the SOPs, the KPI definitions, or the integration checklist, because they were never written down.

IV.Private equity operating partners

You underwrote the deal on a synergy model. Now somebody has to make the synergy real — this is the operator's side of that spreadsheet.

V.Transition CPAs & DSO advisors

Frameworks and models you can run across multiple client engagements without rebuilding them from scratch each time.

NOTE — If you already run a corporate development office

With a dedicated integration team, a standing SOP library, and a VP of Operations who's done this at scale, you're probably not the reader here — yours is likely tuned better to your model than anything off the shelf. The calculators might still be useful.

What's Inside

The book, and the calculators that go with it.

The operating manual

400+ pages across six parts covering SOPs, KPI definitions, billing and RCM structure, staffing models, compensation design, and the day-1-to-day-90 integration sequence. Built as a reference you pull off the shelf, not a book you read once.

II.

The companion calculator suite

Sold separately ($49): eleven Excel models built for this book — a 20-KPI monthly dashboard, a location P&L model, an A/R aging analyzer, an EBITDA normalizer for acquisitions, a 180-day integration milestone tracker, a staffing ratio calculator, and more. Enter your actuals once; the dashboard updates itself.

III.

The transaction context

How your operating numbers translate into what a buyer will pay, and which line items a Quality of Earnings team is likely to challenge. Most operators learn this during diligence, which is three years too late.

See the full table of contents →

Why This Exists

Twenty-five years on the supply side of the chair.

I spent my career at DCI Edge, selling and specifying dental chairs, units, lights, and cabinetry for practices and groups across the country — which means I've walked more dental offices than most dentists will see in a lifetime. I've watched groups scale well and I've watched groups scale badly, and the difference was almost never clinical talent. It was whether anyone had written the system down.

There are clinical journals for the clinical side. There are CE courses. For the business of running a multi-location dental group, there was a consulting market and not much else. That gap is what this is.

DSI is independent. I don't broker practices, don't take referral fees from DSOs, and don't sell your information. The books cost what they cost, and that's the whole business model.

Pricing

One purchase. Yours permanently.

The DSO Operating System

$49 · one-time

Full 400+ page operating manual (digital download)
Instant access, read on any device
Six parts covering SOPs, KPIs, billing, staffing, and integration

Companion calculator suite (11 Excel models) available separately for $49.

Get The DSO Operating System — $49

Stop running every location as a fresh experiment.

Download it tonight. Hand your regional managers something written by Monday.