The Group Dentistry Now Show: The Voice of the DSO Industry

Kim Larson, Co-founder & COO, and Bill Neumann, CEO of Group Dentistry Now, recap 2024 and discuss what to expect in the DSO and dental industry in 2025. The duo discuss:

M&A
Industry layoffs
The election
DSO events
2025 predictions

To watch the What to Expect in 2025 podcast with Jon Fidler, Dr. Roshan Parikh & Rich Blann visit – https://dso.pub/4fciEhF

If you would like to apply for the Emerging Groups to Watch in 2025 please email us at info@groupdentistrynow.com

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DSO Declassified 2024 Podcasat with Kim Larson & Bill Neumann. 2024 Dental Industry & DSO Recap.

Bill Neumann:
Hey everybody, welcome to DSO Declassified. I’m Bill Neumann, and this is Kim Larson. Yeah, and Merry Christmas. We are recording this on Christmas Day, hence the Christmas tree and the setting. So Merry Christmas, everybody. And we’re going to do a wrap up of 2024, some of the thoughts that we have on what happened in the DSO dental industry, and then talk a little bit about thoughts on 2025 and wrap up the year that way. Sounds good. Kim, why don’t we start with DSO deals. You handle the DSO deal roundup. You’re in touch with the DSOs, the emerging groups, with their acquisitions and their de novo. So what were your thoughts on 2024 and DSO deals?

Kim Larson: So things had dwindled down a great deal. 2023 into 2024, we started to see activity gaining momentum in 2024, still not great, but it’s starting especially from the bigger groups. But in 2020, 2025, I really think that we’re going to see a lot more deals taking place. You just did a podcast, and you talked a little bit about that.

Bill Neumann: Yes, we had Rich Bland from DC Advisory, Dr. Roshan Parikh, from DSO Strategy and John Fidler from Fidler and Associates. So we covered the gamut from deals, de novos, inflation, the election and also the impact of that and then also with John talks a little bit about recruitment and retention and the state of the industry, which we’re going to try and cover a lot of that. But you had some thoughts for the DSO leadership summit, and there was some talk about, you know, then the pending election.

Kim Larson: So Brian Kaleo, and he was on a panel with some bankers, and they had said that Really, dental was in a position where the election had to go in a certain way in us in order for the DSO space to pick things up or the dental space to pick up. And well, I guess it was really for the DSOs. But it did happen the way that they had suggested it might happen. And that is good news for the DSO industry. So we are optimistic that 2020, 2025, we’re going to see a lot more consolidation and that… And growth, you know, investment in private practice as well. So, yeah, I mean, I… Well, did you say on the podcast that there were about 25 deals and only about two, this is in 2024, some seriously nice deals in 2024. And of those, whatever, 27, only two or three went through.

Bill Neumann: Yeah, there were a lot of groups that were looking to recapitalize or looking to sell. And there were very few deals that actually got done. And so you’re going to have some pent-up demand. You’ve had a lot of the hold times on these private equity-backed DSOs. I believe the number is in that 30 range where you’ve got 25 or 30 of those that have been held five to seven years or even a little bit longer. So they’re ready to turn. So I think there’s pent-up demand for sure. So you have the election, the outcome. We’ve got inflationary pressures that continue. There was another interest rate reduction, although I don’t know what kind of effect that really had on the market. But I do think that, you know, again, cautiously optimistic. I think if our government can control its spending, which is a big ask, I think there’s, you know, the inflation definitely needs to be kept in check.

Kim Larson: Yeah, and we’re seeing in the DSO space a lot of layoffs. And we’re seeing vendors go into DSOs and DSO people go into the vendor side. But remarkably, a lot of layoffs happening. I’ve never seen so many layoffs happening. So if you don’t follow us on LinkedIn, I highly recommend it. Sometimes we will post jobs on there. People do reach out to us a lot. So please do follow us on LinkedIn. And is there anything else that you want to talk about that or?

Bill Neumann: Yeah, on the layoff side of things, and John Fidler kind of discusses that in the podcast that we referenced. We’ll drop the link to that in the show notes. Yeah, I mean a lot of the layoffs have been on the vendor side of things, distributors. Manufacturers added technology company specialty companies where maybe a specialty lake orthodontics for example or ortho starts are down so we are seeing a lot of layoffs on the industry side of things and i would just. You know, I don’t think that, you know, magically 2025 people are going to start hiring. That’s not what I think at all. I think it’s, yeah, and it’s going to take a while. So I would think even with the deals, same thing. We’re not just going to see, you know, it’s on a light switch. You know, it’s not like the new administration gets in and all of a sudden everything, you know, changes. So I think, you know, you’re going to see this lag and it’ll be, and I’ve heard this from others, this isn’t, you know, I’m not the person that got to have this idea. It’s going to Q3, Q4, you’re going to start to see a lot more activity. Speaking of layoffs. Well, just one second on the layoff side of things. You know, I do think that people that have DSO experience, group practice experience, are in much better position than someone that maybe just has that solo practitioner experience. And not to say you can’t learn the space, but I would. certainly start to hone those skills to learn how to talk to, market to, sell to, multi-site, private group practice in DSOs. So go ahead, and you were gonna- 100%.

Kim Larson: Well, and that kind of leads into the next point about layoffs and the market. A big publication, big dental publication just abruptly went out of business. It was shocking and not shocking. It was not shocking in that I guess how they deliver their message and who their audience is. It wasn’t shocking, much differently than the way that we do it, but it was shocking that it was so abruptly. It was one day, I think they were at Greater New York and business as usual, and then here we are just a few weeks later and they’re completely shut down. Bill does not want to give the name, which is fine. But hopefully, by the time you listen to this podcast, you’ll have figured it out. If not, you can email us, maybe. But anyway, so that’s a shame to see that happen. But it’s really just a sign of the times. I mean, the space is going more and more. Talk to Brian Kaleo. It’s becoming more and more consolidated. People like their messaging and their information delivered. in a certain way, it’s the way that we choose to deliver our content. So, yep.

Bill Neumann: Yeah, that was pretty surprising. And it’s, again, it’s sad for all the people who lost their jobs. Yeah, people that were affected. Something must have happened. Yeah, I don’t like to speculate. So I just think that they were focused on a different market in the dental space. And we could talk publishing here, and not too many people would care. On a positive note, we’ve had our best year ever. So we’re not going anywhere. We’ve got, you know, we can talk about that in 2025.

Kim Larson: Another thing that in 2024 that we started to do is companies, big companies, as well as vets have asked us to do a presentation on how to market to DSOs because it is such a specific way. There is a specific, I don’t know if you want to say formula, but there are do’s and there are don’ts. We like to share that information with people. I think sometimes it’s hard for people to switch gears. They’re so used to marketing towards the dental space to solo practitioners and clinicians a certain way, and that has worked for them for a number of years. But once you come into the DSO space, there is a different way to message. We do try to help and guide people so it’s been great for us to be able to get out and provide that message to people and kind of tie back into the layoffs issue that we were speaking about earlier and the marketing issue kind of goes hand in hand is that if you’re not using LinkedIn please try to use LinkedIn. I use LinkedIn 10 minutes a day. That’s all I think people should be using LinkedIn. It is a social media and absolutely 10 minutes a day is all you need to do. This past year in 2024, I had over 1,100,000 impressions on my content on LinkedIn. So I highly recommend, like I said, I spend 10 minutes a day on it. So try to put yourself out there a little bit, comment. Thoughtfully, I always tell people to comment thoughtfully. Don’t say like, that’s awesome, or that’s great, or just reiterate whatever they had written because that looks like AI. Actually be authentic and connect with people. Post things that would actually resonate with people. If you have a product that solves a problem for a DSO, explain how. Data and stacks is always your best friend when you’re trying to market to a DSO. So that’s been a great thing for us to be able to try to get that message out there to people. And we really, really hope that you take some of that advice and put it to practice. And I think that if you do, you’ll be happy with what you, you don’t have to spend a lot of money, but you do have to be consistent.

Bill Neumann: Emerging Groups to Watch deadline.

Kim Larson: OK, right. So that’s a good thing. So one of the highlights of the year for us as a company and for us personally is the Emerging Groups to Watch. We had our Emerging Groups to Watch awards at the DSO Leadership Summit in Atlanta in September. Actually, it was kind of bumping up against a hurricane, but nonetheless, it was a successful for us awards and panel discussion. It was the most diversified group of groups we had ever had. We’ve had, we have like a mobile clinic. We had an Australian group and it was great to have our friend from the Australian group Impression Dental Group. They’re making waves over there. Marco Ryan come over all the way over here to the United States. It was quite an honor to meet him and I hope that he found the event fruitful and the experience fruitful. One of the things that the emerging groups to watch, like to do is learn from each other and the groups in the audience are learning from them. And then the bigger groups say, who would I like to buy or who’d I like to try to buy? So the emerging groups to watch list. For 2025, the deadline to submit your submission is the 31st of December. If you don’t have submission information, contact us at info at groupdentistrynow.com and I will provide or Bill will provide what you need to give to us to submit your company for that. And that’s a great honor. It gives you a lot of Not only are you learning throughout the way, but you’re getting the name of your emerging donor group out there. You’re learning from other groups. It’s a great exercise, and it’s a one-year commitment in terms of, you know, we have webinar, we have podcasts, and we have the awards. So it’s not a commitment in terms of you have to do anything, but we will help promote your company, and any issues that you have or questions that you need answered, that’s what we’re there to help with.

Bill Neumann: So meeting attendance in 2024, just thoughts around DSO, dental meetings, the attendance, you know, you’ve got a lot of thoughts.

Kim Larson: We talk about this probably, I don’t know, an hour to a week. It’s kind of the same conversation. It feels like that over and over and over. There are too many meetings and the meetings that we do have are too long. So not only are the DSOs having meetings, of course the dental industry is having meetings, but now the DSOs are having their own partner meetings. So vendors are expected to be at the vendor meeting, I mean at the partner meeting, then they’re expected to be at the DSO meeting and the dental meeting. It’s not only expensive, but there’s only so much time people have. So we’re seeing a lot of overlap. We saw that multiple times this year. So vendors have to go or DSOs have to go, whoever the people are, they have to go from one meeting immediately into another meeting. It’s a lot, it’s a big ask, and we’ve been saying, or I, maybe it’s mine, I’ve been saying, you don’t have to have a two or three day meeting to make your meeting worthwhile, or to make it worth someone’s while, because the thing is, a lot of times we see people leaving on the last day, and if you’re a vendor and you’re paying to speak in that last morning, and everyone’s already left, it’s just not great for the show, it’s not a great look. So, ideally, we’ve talked about this, we think it’s best to have, you know, an evening optional cocktail hour or dinner, and then the next day, panels and discussions and all sorts of meetings and networking and just go hard from 8 a.m. until like 5, and then that’s it. I think sometimes, I’m not gonna say what my thoughts are as to why people seem to make these shows go on forever, but There are so many meetings, and they struggle. There is not one meeting that doesn’t struggle to get people there.

Bill Neumann: Well, I’m sure there might be. There are a couple. So what I would say is I agree with Kim on the length of time. I agree on a lot of things, one being way too many meetings. People came out of COVID, wanted to get Back to in person meetings and then people, people being companies started to add meetings on top of meetings that already existed and I think it just is, it’s become really crowded it’s apparent from the support or the lack of support from sponsors as much as it used to be. There’s not quite as much there, more to go around. It’s more expensive to have a meeting now. So everything is more expensive. It’s more expensive for the people putting on the meeting, therefore they have to charge the sponsors more. I mean, every, yeah, the travel’s expensive. So I think that’s part of it. I think there are some meetings out there, you know, shout out to, you know, Dykema. I think that, you know, having a longer, they can have a longer meeting and actually,

Kim Larson: Well, I guess I’m speaking like in general terms. I’m not, yes. Generally speaking, the meeting’s gone too long. That doesn’t mean that there aren’t, there isn’t a room, there isn’t a time and a place for a meeting to go longer.

Bill Neumann: Yeah, yeah, no, I know. But I think in general, people would like short and, because to your point, people do leave early, so.

Kim Larson: Short and powerful rather than long and light.

Bill Neumann: Yep. And, you know, again, could talk about this for hours, is more like anything specialized specific. Yeah, we have these conversations with a lot of vendors out there. We’re going to talk about 2025 and kind of what to expect with meetings in a second here. And in fact, I think right now, if I look at this list that I have, We’re going to move on to 2025 and kind of what to expect in 2025. So one thing, if you don’t mind me mentioning a little bit about, we hear a lot about technology. I mean, you help create a ton of content and a lot of our vendor partners or advertisers or technology companies. And I will say that from the DSO’s perspective, They are inundated with technology companies, technology solutions, platforms, so many different opportunities. I think it’s overwhelming, number one. I think that this gets back to your how to message to DSOs. You have to have a concise message, which again, if you want to find out about marketing to DSOs, Kim’s on LinkedIn, you need to reach out to her. But I mean, from what I hear from DSOs is a lot of great solutions out there don’t have the time to evaluate them all. So you’ve got to figure out a way to kind of stand head and above, right? Heads above the crowd. And also, I think it’s a matter of the support and the education for companies that are going to bring on this technology because you just can’t just necessarily plug in a technology. You need that support, the onboarding, the training, which seems to be lost on so many companies. So, you know, that’s what I would just say is we’re going to see more and more in 2025 technologies coming more and maybe in different categories, more options in the same categories. It’s overwhelming. So just keep that in mind if you are a technology company looking to reach DSOs.

Kim Larson: kind of extending on that a little bit. One of the biggest issues that dental groups and DSOs have is recruitment of clinicians. And the younger clinicians obviously are going to be very interested in technology for a variety of reasons. So perhaps technology is a great way to provide services to a DSO to help them differentiate themselves from other groups in the hiring process. So technology is really key, I think, to the future. And having that twist on it in terms of how to make it appealing for recruitment is important. So if you’re a technology company, keep that in mind. What do they call them? Native users or something? These people were born with a computer in their hands. So this is what they like. This is what they want. They want the coolest gadgets. the newest and greatest stuff, so there are technology companies out there who can provide that, but like Bill said, it’s very difficult to get that. And sometimes, this is something, in other private conversations, this is DSO declassified. I think sometimes people wanna get in when they’re breaking into the market, they wanna get in with an Aspen or a Heartland, and that’s great, fabulous. But do you really want that and need that coming into the market? Or would you be better off going, making your entry into the market in like a 10 or 20 group location where you could sort of get your feet wet and understand how you’re going to scale and help them scale and have a success story come out of it?

Bill Neumann: No, totally. I mean, we talk about it all the time. You think you’re ready to support somebody that has 1,800 locations. But are you? But I mean, are you really able to do that? So yeah, to your point, it will be a lot easier to work with some of the smaller groups. get some case studies built, build out your onboarding, build out your training and education before you. And these larger DSOs know this. They are going to make sure that you are ready, even if you think you are. I mean, you really need to be prepared because there is a lot of service and education, ongoing support for sure. Let’s talk about a couple meetings that are coming up in early 2025. We’ve got Yankee. They’re doing multi-site again. That is the end of January. This will be their third year. They are doing Yankee now on the exhibit floor. So it’s not in the back. It’s not in the center.

Kim Larson: Near where the classrooms are.

Bill Neumann: Yep, yep. And so that’s great. So I’m really excited for that. And I don’t think they’re charging a special entrance fee for that particular… I think there might be separate registration, but I don’t know if there’s any different fee.

Kim Larson: There needs to be a separate charge to go upstairs to the multi-site. So we’ll see how it’s received there.

Bill Neumann: Yeah, I’m excited. And I think we looked at, you know, the topics and the speakers and, you know, we’ll be there. We support the meeting. And I think it’s great. I mean, they are the only traditional dental trade show, traditional dental meeting that actually embraces the DSO model. Well, yeah, right, and private group practice for the doctor-owned, doctor-led, so it’s not just DSO, it’s the smaller as well. Of course. And yeah, I think that they’ve, and they’ve taken a little bit of flack for it. Very much so. I don’t think it’s justified at all. I think that, you know, it’s needed. I believe their members, a lot of their members are private group practices. Some of their members are with the SOs. So, you know, this is the model and it’s changing. After that is AADGP. That’s early February. They have really reinvented themselves as an organization. And this is more of, you know, going, you know, more of a, like a mastermind. It’s like a workshop. Yeah. Everything’s workshop based. So I’m super excited about that. That is in Orlando, February 6th through the 8th.

Kim Larson: What’s the next one?

Bill Neumann: And then just some predictions. I was gonna try and wrap things up here. So what are you grateful for first? I am grateful for having the best co-founder and COO in the DSO space. Thanks to Kim, I mean, a million, 100,000 impressions on LinkedIn. I won’t even tell anybody mine because they’re not even, I don’t have anything to say. 10 minutes a day. I spend more than that. Obviously, I’m not doing it right. Sue, can I take that marketing to DSS class? Jeez. So I’m very grateful to have a partner like Kim and makes my job easier.

Kim Larson: Make you shine.

Bill Neumann: Yes, that’s her job and about seven other things. So, yeah, I think so. Just some things I would say that that’s what I’m grateful for. How about you?

Kim Larson: I am grateful for, this is kind of, well, you of course, and my children.

Bill Neumann: She had to say that after what I said.

Kim Larson: Our children. But honestly, this year, for me personally, I have come to grown really fond of small businesses. I never really thought about it before. I would just buy something wherever. Small businesses are so important, not only to the lifestyle that I like to live, But just to our community, so by small business, like local businesses for us, it’s really become, it was nothing. Now we go to farmer, well not in, of course it’s snowing, I’ll tell you right now, but in the summer we’d like to go to the farmer’s market. I, like for Christmas, tried to buy a lot of gifts from smaller businesses because they are, you know, the heartbeat of America. Does that sound too corny? But it’s actually the truth and possibly keeps the, you know, until they sell out to larger corporations, I will support them. Some of our favorite brands have done that this year, so that’s kind of sad.

Bill Neumann: And some might see some irony in this supporting small businesses, but when you really look at the DSO space, it is made up, the majority of multi-sites are private group practices, so they are owned by doctors. And I would say there is a trend with the larger DSOs to have doctor partnerships, where the doctors have ownership, they retain ownership, you know, or they earn in from an associate level. So, I mean, when we say this, we love the industry. And I just think that that ownership component for the larger DSOs, the dental, in a partnership model. Right, no, I understand, but it does tie into, we have to tie everything back to DSOs.

Kim Larson: Well, I will say that when we speak to people, this podcast has been going on a long time, but I’ll just say, when we speak to people who are outside of the DSO space or in the dental space, You know, they think the DSF space are just the large DSOs, the ones that have over, you know, six, seven, eight hundred practices, but that’s not really how we look at the space. We like the emerging groups to watch awards, for example. That’s really the heart of the industry. Yes, there are these wonderful big DSOs that can That was originally why we started the company was because we wanted to increase, or at least for me personally, to increase access to care for all, not just for certain people. And those larger DSOs can do that. They can go into the rural and urban areas that other solar practitioners who have Thousands and thousands and thousands of dollars of debt cannot do. As a matter of fact, I just wrote an article about that a few weeks ago, about the dental school debt and how it’s actually growing the DSO space. Because how can you pay back that ridiculous debt unless you’re going to go for DSO, plus they offer the mentorship and everything else that you’re not going to get on your own. So, I mean, I could talk about this for hours.

Bill Neumann: We almost have been. So predictions, just kind of, I’ll wrap this up. You add anything that I may forget. I would say deal flow is going to increase in 2025. We’re going to see some big deals get done. It’s not going to happen, I think, in Q1. I could be proven wrong, but I think it’s going to take a little bit of time.

Kim Larson: Just like it feels like to me, like, you know when the horses, you’re at a horse race, I’ve never been to a horse race, but, you know, on television, you’re at a horse race and the horses, they just want to run, right? They just want to get out of the gate. It almost feels like that right now, that the horses are in the gate and they’re just waiting for the gates to be opened.

Bill Neumann: I like that. It’s a nice analogy. So again, deal flow, picking up Q3, Q4 is really when I think it’s going to get from, you know, again, talking to the experts. I would say we’re going to still continue to see layoffs. I don’t think the layoffs in the industry are over yet. The other thing that I did forget to mention is if you are on the industry side, Some of those skills translate to the DSO side of things. So kind of think about that. It’s like, you know, maybe I want to be on the other side of things.

Kim Larson: And vendors move into the DSO space. But we have seen DSO people move into the vendor space because the skill set that they’ve acquired is very usable in the other space.

Bill Neumann: And I’d say look for us to continue to grow, to continue to be involved in the industry.

Kim Larson: I mean, we’ve had some partnerships. Yep. Yep. 2025 is shaping up personally for group dentistry now to be by far, by far, thankfully, gratefully, by far our best year ever. I think 2021 was also one of those years for us coming out of COVID.

Bill Neumann: Yeah, where we, you know, where we have just, just incredibly, and we’ve got some things in the works that if one of them works out, it’ll, it’ll be a big year for us.

Kim Larson: We should talk about the Learning Hub real quick. Sorry. Sure.

Bill Neumann: Learning Hub. Speaking of partnerships.

Kim Larson: Yeah, speaking of partnerships, we do have a partnership, a learning hub, and we have people, DSOs coming to us, gosh, maybe once a week or so. They need education and we have, we partnered with Dentlogix to provide customizable white label education.

Bill Neumann: Yeah, I mean it’s funny. I was talking to somebody at lunch two days ago, a marketing company works with a bunch of private group practices and I would see even emerging groups and I was telling him a little bit about the platform and he connected us with several of his clients. There’s a need for it. It’s something to definitely check out. It’s on our website. We’ll drop a link in the show notes. Kim, if people want to find out more about marketing to DSOs or want to follow you and for some crazy reason they’re not connected to you, follow you.

Kim Larson: Follow me. We might not be able to connect. maxed out with that but Please just follow me and in with LinkedIn Oh, here’s just words of wisdom and don’t get disheartened if people are not liking or commenting on your posts There are this is not Facebook and you’re not posting a picture of your brand new puppy and everybody wants to like it There are a multitude of reasons why people don’t like and comment. That’s 100% fine. They’re still seeing it

Bill Neumann: And I think, well, with that, you can find me on LinkedIn as well. Kim Larson on LinkedIn.

Kim Larson: GroupDentistryNow, most importantly, GroupDentistryNow. And if you’re not subscribed to our newsletter, you can stop by our website, groupdentistrynow.com. In the top right-hand corner, there’s a subscribe button.

Bill Neumann: No spam, we promise.

Kim Larson: No spam. We only shoot out one email a week. That’s it. We don’t sell your information. We don’t sell your list. We try to keep it clean and we respect your privacy.

Bill Neumann: That’s it. We’ll check in soon with everybody, but that was pretty comprehensive. So again, Merry Christmas. See you in 2025.