Birth of Support Organizations

dentists turning to support organizations for administrative work

Support organizations are one of the most controversial topics of discussion in dentistry and healthcare today. But it’s important to talk about them.

Support organizations are byproducts of changes the dental industry is currently undergoing. And they’re giving rise to new models. So, how did they come about?

The Germs of Change

We’ve talked about this before, so we won’t spend too much time of on it—but dental support organizations (DSOs) arose out of a need for independent dentists to operate not only as dentists but also as small business owners.

Running a business isn’t easy. As a solo practitioner, you’ve got piles of work on your desk that have nothing to do with caring for patients in the chair.

Dental care is just the beginning. You also have to manage the business, your employees and the physical space your practice inhabits.

In other words, you have to be an accountant, a manager, a human resources expert, a payroll wizard and a hundred other things. Each one of these activities is a full-time job in itself, for a professional in that industry.

Not only that, but dentistry was becoming more competitive all the time.

More and more, solo practitioners are finding it difficult to operate as dentists and also business owners. This is the environment in which support organizations arose.

Heartland Dental

After graduating from dental school and starting his own practice, Dr. Rick Workman found himself in the same boat as the rest of his fellow solo practitioners.

Workman began to imagine an easier path, one in which dentists could somehow unburden themselves of the administrative tasks that were taking up so much of their time and energy.

He set out to create a support organization that would handle the management of dental practices.

By offering an array of non-clinical services such as human resources, payroll, information technology and marketing, he could enable dentists to focus on dental care rather than business management.

Over the following years, Workman hoped to make his vision a reality. By 1997, it was: Heartland Dental.

Along with administrative services, Heartland offered leadership training and continuing education.

Rise of Support Organizations

Today, Heartland Dental is the largest DSO in the U.S., with over 7,300 employees and 955 supported dentists in 625 offices throughout 28 states.

Starting out with a handful of supported offices 18 years ago, it has been amazing to see how far this organization has evolved.

– Workman

But Heartland Dental isn’t the only support organization out there for the dental industry.

Even if you question whether DSOs are good for the dental industry, there’s no question that they’re well established.

For good or bad, DSOs provide an option for small dental practices to contract out the administrative side of running a practice.

(Most people who oppose DSOs do so because of a belief that DSOs could or do infringe on the decisions made by dentists regarding care.

Regarding this, one thing to keep in mind is that, by law, dentists have complete control over every clinical aspect of their practice.

For some practices, DSOs make sense. For others, they don’t. Still others find that a solution in between flying solo and a DSO is the best for them.)

A New Model Emerges

The environment in which support organizations were born was (and still is) one of overburdened dentists trying to provide care for their patients while at the same time run a successful practice.

In this difficult environment, DSOs formed to help dentists with the business side of dentistry. Even if you question DSOs, there’s no question that they’ve opened up new options. From them, other models are emerging.


By Quinn Dufurrena, DDS