Page 29 - Bulletin Vol 27 No 2 - May - Aug. 2022 FINAL

Legal Article | DSO Contracts

Navigating a Dental Support Organization Contract

By: Amy Kulb, Esq. & Jill Kulb, Esq.

A Dental Support Organization (DSO) is an entity that provides non-clinical support for dental
practices by providing services such as human resources, payroll support, marketing, IT and other
practice administrative support. Essentially, a DSOs is a business concept that allows dentists with their
own practice to focus on clinical issues and their patients as opposed to the additional effort that
managerial and other such tasks require. In many cases, dentists wish to focus solely on clinical issues
and patient care and partnering with a DSO enables them to do just that while maintaining confidence

that the” business end” of the practice is being handled properly. DSOs vary in how they are structured,
how large they are, and how they are situated geographically.

Practices run or owned by DSOs are currently a very popular and fast-growing practice model.
Whether to partner with or sell your practice to a DSO requires a great deal of analysis and planning.
Non-clinical operations can be handled but not without certain concerns. Such a partnership can affect
dentists’ independence and autonomy because services and functions will be dictated by their program

and ultimately their goals. Related issues include control over the materials used, treatment plans
offered or recommended to patients and ultimately control over time spent and how it is allocated.

Often times, a DSO has two independent entities. In these cases, one entity can serve as a strictly
managerial entity that provides the support discussed above, while another entity acquires the clinical
aspect of a dental practice and employees the dental professionals. It is important to understand the
difference between these two types of entities when considering either selling your dental practice to a
DSO or being employed by one. As a Dentist selling a practice to a DSO or working for one, you will want

to make sure that you are selling certain assets and employed by the correct entity to avoid complex
legal issues. These can include fee splitting or ensuring that you are employed by an entity owned by a
license dentist.

When considering your options with regards to the above and, more specifically when reviewing any
proposed contracts with a DSO, there are several crucial components you will want to look out for. Some
key questions include:

• What type of entity will be charged with carrying out the specific components of your practice?

• What services will the DSO perform for your practice?

• What are your obligations to the DSO once employed?

Nassau County Dental Society ⬧ (516) 227-1112 | 29