Purpose, Passion, and Presence – The Keys to Building a Successful DSO

We get countless calls from single practitioners with already-successful solo practices or small partnered practices who want to build a DSO. Now that DSOs are the dot-com of the day, these dentists are gung-ho to develop and operate a DSO. What they fail to realize is that generating a successful DSO isn’t paintball — the existing DSOs, whatever their size, are playing with live rounds. These dentists would be competing head-to-head with corporate Goliaths and battle-tried warriors.

These wannabe DSO dentists who start the trek are already working incredibly hard. Most are doing the best they can. But as the effort to build a DSO increases, much more effort is required, and many eventually run out of steam and are forced to close up shop.

To build a successful DSO is arduous, demanding, and sometimes grueling. We ask three questions of potential clients who want to come on board with the Dentist Entrepreneur Organization so we can ascertain whether they have the right stuff. We can identify the dentists who we don’t think can make the jump — and we tell them they shouldn’t attempt it. Failure at this level costs too much time, money, and personal well-being, and puts a strain on relationships. Our cumulative 50-plus years of experience gives us the expertise to know what it takes for a dentist-entrepreneur to build and sustain a successful DSO.

Key Components to Building a Successful Dental Service Organization

Below are the three questions we ask. Each question is followed by additional questions about the same subject to ensure candidates’ answers are authentic, trustworthy, totally valid — and, most importantly, heartfelt.

  • Can you generate a true purpose?
  • Can you be unreservedly passionate about your purpose?
  • Can you operate in the present?

Those who are already running successful DSOs can answer “yes” to all three questions because their purpose, passion, and presence help them focus their attention, direct their actions, and persist in the face of adversity — and there is always plenty of adversity.

Let’s take a closer look at each of these elements.


If you are going to build a DSO, you need to figure out why your DSO will really matter. How will it make a real difference? Having a purpose leads directly to success because if you are doing something that has a positive impact on others, you are compelled to access much more of your power.

If you’re only in it for yourself, your staff and your patients will figure it out pretty quickly, and what follows is a loss of the energy needed to continuously generate the commitments and actions required for success.


Purpose alone isn’t enough. To be successful in the long term, you need to find that genuine purpose that makes your heart sing. Passion is a combination of love and enthusiasm, both of which are critical to overcoming challenges. 

You might fall 100 times on your path to success, but your commitment and passion pushes you to brush yourself off 101 times. Discovering your personal passion is as much about doing what’s important to you as it is about avoiding the unimportant. It starts with being crystal clear about what you want and why you want it.


There is no future, there is no past, there is only this moment. Successful entrepreneurs keep an eye on the future, but live in the present — because they know right now is where they can have the most influence. Presence is a byproduct of purpose and passion, and it is perfected through focus and continuous self-examination and self-awareness.


When I interview potential candidates for the DEO program, I need to know whether a dentist or executive possesses the capacity and willpower to develop a true and powerful purpose for their future DSO. Are they doing it for themselves? If they are, the odds of failure are sky-high.

I need to know whether that person has the guts to be passionate. Is he or she willing to be fully expressed — go beyond their comfort zone, speak from the heart, not their head, be captivated, entranced, and enchanted by their purpose? If, after my assessment, I don’t feel this person can be truly passionate about their purpose, in my eyes, the odds of them failing are quite high.

For me, it’s equally important that the person be able to operate in the now. Are they able to be in the moment in such a way that they can be totally engaged in what’s happening in the here and now? Why is being in the present so important? Because if you are not in the now, your ability to really listen to people is significantly reduced. When you don’t truly listen, you contribute to poor communication, which leads to ineffective action, which results in less-than-desirable results.

Do You Have What it Takes to Lead a DSO?

In my estimation, less than 20 percent of dentists with successful solo practices have the needed wherewithal and chutzpah to create a binding purpose, generate real passion for this purpose, and cultivate the ability to be in the present — all key components to the creation of a successful DSO.

Today, those who are leading successful DSOs have all three elements: purpose, passion, and presence. It should be no surprise that DSOs are growing at 20 percent per year, pushing solo practices out to the margins — and pushing some out of existence. Solo practices are now competing with real businesses that have made it because they have a powerful purpose, a deep-seated passion, and the ability to think and act in the present moment.


— Marc