DSO or Stay Independent? Non-Competes, Recaps & Growing Your Own Dental Group | Samantha Strain

Should you sell to a DSO, stay independent, or build your own group? Sam Strain and her business partner Brendan advise dental groups on deals and growth, and they explain what's really happening in the DSO market. They cover why many DSO deals were worth less than they looked, the recapitalizations now asking doctors for 10-year non-competes, and the three kinds of dentists now building their own groups. They also cover the technology an emerging group needs and whether DSOs should be funding dental schools.

In this episode:
- Why an 8x offer can be worth much less once rolled equity is counted
- Emerging groups: dentists banding together, gunners, and dentists leaving DSOs after their work-back
- When a DSO non-compete may not hold up
- Recapitalizations, missing equity and 10-year non-competes
- "DSO 2.0": the technology an emerging group needs, and cutting through the noise
- Why they named Curve for multi-site groups
- Should DSOs fund dental schools? High Point and business training for dental students
- Know your options: growing without selling, and business process organizations

📰 Plus dental news: the new HIPAA privacy notice due February 16, the EPA's fluoride review, HR1's proposed caps on dental student loans, Florida passing dental therapy, and dentist Tara Peterson curling at the Olympics.

Samantha (Sam) Strain is the co-founder and chief development officer of Healthstream, a dental-focused investment banking and advisory firm that helps everyone from single-practice dentists to multi-state DSOs with deals and growth. She was chief development officer of American Dental Partners, which sold to Heartland in 2021. She also co-founded Doublemint Ventures, a go-to-market advisory firm for dental technology companies, and Kara Capital, a venture fund of funds. She serves on DSO advisory boards and is an angel investor. A Vanderbilt graduate, Sam lives in Charlotte, North Carolina with her husband, a former US Marine, and their three sons. Brendan is Healthstream's managing partner.

🙌 Special shout out to Curve Dental, our educational partner, for making this episode possible!
Learn more about Curve: https://fanflet.com/dinks/curvedinks

Chapters:
0:00 Intro
1:07 Welcome, and thanks to Curve
1:47 Midwinter is one week away
5:15 JB's full-mouth reconstruction day
5:44 How a high-doc, low-doc schedule works
8:15 News
8:27 News: new HIPAA privacy notice due Feb 16
9:18 News: the EPA reviews fluoride
10:23 News: HR1 caps on dental student loans
12:03 News: Florida passes dental therapy
13:41 News: dentist Tara Peterson curls at the Olympics
17:06 Meet Sam Strain
20:50 Why Brendan joined the show
22:24 How Healthstream started
24:06 Sam's background on the buy side
25:06 Why many DSO deals were worth less than they looked
26:08 Helping 3 or 4 locations grow to 10
27:39 Why dentists want community
28:03 Who's forming groups now
31:06 The gunner who wants to be the next Heartland
32:35 Dentists leaving DSOs after their work-back
33:24 Do DSO non-competes hold up?
35:04 Recapitalizations and 10-year non-competes
37:03 Advising dental technology startups
38:32 DSO 2.0 and "the Sphere"
39:45 Too much noise in dental tech
41:32 When the business and clinical sides work together
42:16 Why they named Curve for multi-site groups
43:03 Their dental technology report
46:44 Partnering with innovative companies
47:43 Let's stop calling it PMS
49:46 Should DSOs fund dental schools?
54:06 Business training in dental school
55:11 Why dental school lags behind real practice
57:12 High Point: Epic and practices near the school
59:29 Parting advice: know your options
1:00:27 Growing without selling
1:02:08 Closing: clinician and business person

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