Once upon a time, many years ago in the great land of Dentistry, there were a few good townspeople who dreamt of what “could be.” They came from very different backgrounds and very different places, but they all saw the future in a very similar way. None of them had wrinkles and gray hair as they do today. When the concept of Dental Service Organizations (DSOs) first came into existence, as is true of all successful ideas of this nature, many people had the same idea at the same time. It’s a phenomenological event: it’s extremely rare that ideas of this type happen in isolation. It’s the “hundredth monkey” phenomenon, only with fewer monkeys.
These few good and noble crusaders foresaw a future that would be possible if they built and operated DSOs. Although much risk and uncertainty lay ahead, these noble champions bravely stepped forward.
These valiant visionaries were leaders who had the courage, the chutzpah, and the fire in the belly to make their DSO idea a reality. Onward to battle they marched. But these champions were woefully outmanned and outgunned. Their opponents, the American Dental Association, State Societies, State Boards, Dental Schools, and the hordes of solo practices presented fierce resistance.
However, the enemy failed to realize that the noble knights-errant were fueled by a passion laced with obsession.
Joining Together
As they searched for answers, as they opened doors to places they had never been before, they kept on running into each other. They soon formed a band of brothers, and the DEO Roundtable was born.
Together, they found they could resist the disparagement and antagonism against DSOs, battle their enemies, and gain knowledge and insight if they united together as one.
These DSO crusaders avoided annihilation time and again and triumphed over their foes. Although each knight had distinctly different DSO models, they faced the same threats, trials, and challenges. Together, they became a force.
Working together as collaborative partners rather than competitors soon turned the tide of battle. Banding together had given them the support and strength to navigate and survive this uncharted path of the DSO. “Long live the DSO!” they cried. They walked arm and arm along their journey.
Their viability grew, and though their pace was at first slow and cautious, they grew stronger over time; they were not only sustained, but they became unstoppable. In battles where they had previously lost, they were victorious. The tide had begun to turn: Victory was now not just a pipe dream, but a realizable future.
Over the years, many others from the Kingdom of Dentistry and the foreign land of Investment Banking joined the Knights of the DSO Table. The warriors who began this journey had now become iconic commanders of much larger clans.
Today, the state of DSOs has placed these leaders and their clans — and all of DSO Land — in a position of vulnerability: the threat now is not a new or more powerful external force; their enemies are almost vanquished. Where the vulnerability lies is internal.
Will this fable have a happy ending — or will the DSOs ultimately be defeated from within? Only time will tell.
DSOs will be 20 percent of the dental delivery system soon; some call this the “tipping point.” At this tipping point, there is often a contextual shift from collegial partners and co-conspirators to heated competitors, and that shift would change everything.
The next episode in this fable will be determined by the DSOs, as they approach the coming fork in the road. One fork is DSOs sustaining a collegial, committed partner relationship with the growing numbers of tribe members. The other fork leads to DSOs turning into competitors. Both paths have benefits and costs. Both paths have irrevocable consequences.
But, as in any industry, sustaining collaborative partnerships is far more difficult when you cross the tipping point. As an industry gets more densely inhabited and some entities get larger, there is less space available in the field. As Sir Isaac Newton so wisely pointed out: Two things cannot occupy the same space at the same time. As soon as DSOs start to hit that point, competition will heat up. And competition will change the relationships DSOs have with one another.
The challenge then is this: Can the already-established entities and those now entering the Land of the DSO continue to relate with each other as members of a common crusade? Or, as is common in other realms, will they succumb to the natural tendency of voracious competition and damage themselves from within? If the veteran and newer DSO clans can sustain collaborative and supportive relationships, band together and fight as one on this crusade, the opportunity for growth and development will be available for many years. If the battle-cry of “one for all, and all for one,” can be deepened and continued, the crusade will be won. “Onward, DSO soldiers.”
