Scribd Logo
Upload

Welcome to Scribd!

  • 3K views

    DSO Organizational Chart - by Michael W. Davis, DDS

    Uploaded by

    Dentist The Menace
    Private equity firms establish dental service organizations and nominee dentist owners to manage and control dental clinics while distancing themselves from liability. The private equity firm controls the dental service organization board of directors and selects its managers. The dental service organization then manages all non-clinical and some clinical aspects of the dental practices through management service agreements, including production quotas, finances, staffing, and supplies. Nominee dentist owners and associate dentists have little power and are fully subordinate to the dental service organization. Patients are often unaware of this organizational structure and the conflicts of interest it creates between patient care and corporate profits.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    DSO Organizational Chart - by Michael W. Davis, DDS

    Uploaded by

    Dentist The Menace
    3K views1 page
    Private equity firms establish dental service organizations and nominee dentist owners to manage and control dental clinics while distancing themselves from liability. The private equity firm controls the dental service organization board of directors and selects its managers. The dental service organization then manages all non-clinical and some clinical aspects of the dental practices through management service agreements, including production quotas, finances, staffing, and supplies. Nominee dentist owners and associate dentists have little power and are fully subordinate to the dental service organization. Patients are often unaware of this organizational structure and the conflicts of interest it creates between patient care and corporate profits.

    Original Description:

    How corporate dental chains are structured

    Original Title

    DSO Organizational Chart- By Michael W. Davis, DDS

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Private equity firms establish dental service organizations and nominee dentist owners to manage and control dental clinics while distancing themselves from liability. The private equity firm controls the dental service organization board of directors and selects its managers. The dental service organization then manages all non-clinical and some clinical aspects of the dental practices through management service agreements, including production quotas, finances, staffing, and supplies. Nominee dentist owners and associate dentists have little power and are fully subordinate to the dental service organization. Patients are often unaware of this organizational structure and the conflicts of interest it creates between patient care and corporate profits.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    3K views1 page

    DSO Organizational Chart - by Michael W. Davis, DDS

    Uploaded by

    Dentist The Menace
    Private equity firms establish dental service organizations and nominee dentist owners to manage and control dental clinics while distancing themselves from liability. The private equity firm controls the dental service organization board of directors and selects its managers. The dental service organization then manages all non-clinical and some clinical aspects of the dental practices through management service agreements, including production quotas, finances, staffing, and supplies. Nominee dentist owners and associate dentists have little power and are fully subordinate to the dental service organization. Patients are often unaware of this organizational structure and the conflicts of interest it creates between patient care and corporate profits.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Basic Organizational Chart of Chain Dental Clinics in the US

    by Michael W. Davis, DDS

    Private Equity Firm


    (Beneficial Owner of Dental Clinics)
    PE firms are established as first lien creditor or mezzanine financier for accounting purposes &
    not owner, to shelter profits from lawful taxation. Their directors and managers are
    responsible for every aspect of the dental clinics, which they beneficially own. They control
    the board of directors of the DSO. They ultimately select the DSO managers.

    DSO (Dental Service Organization)


    A DSO is initially the beneficial owner of dental practices, prior to sale to PE firm. This entity
    allegedly only manages the non-clinical aspects of the dental practices via Management
    Service Agreements (MSA). Yet, they oversee clinical production quotas and bonuses, control
    clinic bank accounts, control clinic staffing, control nominee dental clinic owners on who the
    Nominee Dentist may buy & sell the dental practice, dictate clinic hours & staffing, and
    establish & control patient supplies, equipment, scheduling, clinical protocols and
    laboratories. Once purchased by a PE firm, they become a subordinate management arm to
    the PE firm. Office Managers, employees of the DSO oversee the clinic operations for the DSO.

    Nominee Dentist Owner

    Employee Associate Dentists

    (This is a sham or figurehead dentist owner)


    This position is often required to circumvent state statutes on
    dental clinic ownership. These doctors are retained for potential
    dental clinic liability damages (administrative, civil, or criminal
    law). Yet, they wield no real power or control. They may not
    freely sell what is alleged to be their asset; the dental practice.
    They have no control over what is alleged to be their clinics
    finances. They are contractually obligated (via the MSA) to
    retain the services of the DSO into perpetuity. They are fully
    subordinate as employees or shell entities, to the DSO and
    receive a management fee for each clinic for which they claim
    ownership.

    These are doctor employees fully subordinate


    to DSO managers, who are often unlicensed to
    practice dentistry. This may or may not include
    subordination to a nominee dentist owner, who
    is also an employee & subordinate of the DSO.
    They generally have little contact with the
    ultimate Private Equity Firms directors. Thus,
    the PE firm is afforded layers of liability
    protection, although they are the ultimate shotcallers.)

    Patients
    Because of patients lack of expert information and training in the dental
    profession, they are highly vulnerable. In the doctor/patient relationship (a
    lawful contract) doctors are ethically and legally required to place patient
    interests above all others, inclusive of undisclosed third parties (interests of
    DSOs). Patients are generally fully unaware of their doctors conflict of
    interest. A lack of full and open disclosures, layers of conflicts of interests,
    and a series of misrepresentations further compromise the patients standing
    in the doctor/patient contract.

    You might also like