ADSO Executive Director discusses the growth of the DSO industry, promoting oral healthcare and the next generation of dentists, and meeting the needs of today’s DSOs and their patients.
DSOPro talks with Andrew Smith, ADSO Executive Director, about its strategic initiatives: monitoring government regulations; promoting oral healthcare; gathering data on practice models, documenting oral healthcare shortages and access to care issues; and collaborating with the ADA, ADEA, DTA, and other professional dental organizations.
DSOPro: Describe the role and objectives of the ADSO
DSOs continue to come into the marketplace, are doing well, and are looking to scale and get to the next level. We have about a hundred DSO members that support roughly 11,000 supportive dentists, and are seeing about a 45% year-over-year growth in membership.
Another core focus for the ADSO is government affairs. We are active at the state level, and to some extent the federal level, monitoring regulations around dental practice acts and making sure the DSO model continues to be protected, as well as grow. We also are interacting with third-party payers. And we continue to work with other folks within the dental industry to help move oral healthcare front and center.
The ADSO is guided by several strategic initiatives. Our overarching goal is to promote oral healthcare, showcase the benefits of DSOs, and be strategic in elevating dentistry—highlighting it as an essential healthcare profession, promoting access to care and the DSO model within that lens. We emphasize the overall mouth-body connection, and act as a thought leader.
This is an exciting time for ADSO. We are undertaking a significant data-collection effort to create a “state of dentistry today.” Specifically, we will be looking at what type of practice model graduating dental students are entering, as well as highlighting the needs of dentists today and how DSOs can be a great option for their career. We also want to document where there are oral healthcare shortages in rural and urban settings and highlight how DSOs are helping fill that void. I think ADSO will be the aggregator of that data and the premier driver of proactive government relations strategies to drive the industry forward. This is a really important kind of a networking opportunity. We think convening the industry stakeholders, promoting and driving government relations, and being a collaborative force while letting the data be the driver is an important role for ADSO going forward.
DSOPro: Describe ADSO’s collaboration with other dental organizations
The American Dental Association (ADA) and ADSO are working in concert around several government relations opportunities. I think COVID really showed that dentistry wasn’t seen as essential healthcare and moving forward that’s an effort we are going to engage in jointly. We’re also really thinking through the future of dental insurance and exploring how dental providers can be unified, have a seat at the table, and talk about what’s best for the clinicians, the providers, and the patients.
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We are working with the American Dental Education Association (ADEA) to promote policy, education, and continuing education, and with student organizations such as the American Student Dental Association (ASDA), which is very involved in promoting the next generation of dental leaders. We are collaborating with them because that’s also a critical focus for us. We want to showcase the benefits and value of DSOs and the ADSO, so students understand the options they have when they graduate. We continue working with some of the specialty, hygiene, and other professional organizations. And we are collaborating with the Dental Trade Alliance.
Another area we’ve been working on with dental associations is teledentistry and how it can improve access to care. COVID showed the need for that. And we’re involved in helping find ways to provide greater access to care for underserved communities and the Medicaid population.
We are making a lot of connections and it’s exciting that the industry is becoming more unified and moving forward collaboratively.
DSOPro: Tell us about the 2022 ADSO Summit
The 2022 ADSO Summit, held March 29-April 1 in Austin, TX, was one of our most successful summits to date! More than 1,200 people attended, making this by far our largest event. We’re calling it “A new dawn for dentistry.” We focused on where DSOs are going, the role of technology, workforce development and retention, and healthcare integration. The first day was our “big ideas” day of looking at those issues. The second day was our “best practices” day, when members and their teams came for peer-to-peer networking. Our curriculum committee did a phenomenal job putting together content focusing on every aspect of dentistry, especially the business side and supporting dental offices. A lot of our industry partners, vendors, and exhibitors participated. We received very positive feedback and are working on next year’s event.
We were excited to have 12 dental school deans join us for networking and discussions about how DSOs and schools can continue to work together. We had great conversations with ADEA about how to attract a more diverse group of future dental leaders and how schools and DSOs can work together to help students better understand practice management and how to be more effective in a business setting. We will continue to explore opportunities for working with dental and hygiene schools and students.
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We are also talking about how to better support individual practices. We’re discussing how technology helps patients understand the types of treatments being offered and enables them to be more active in decision making, as well as how technology helps dentists be more comfortable in their treatment recommendations. On the insurance side, we’re looking at the impact of technology on decision making, and how technology helps insurers understand that it is better to treat patients earlier—when preventive dentistry and early restorative care can help. Technology really helps move the whole value chain forward. And it enables DSOs to provide best practices and a level of support that drives and elevates the standard of care.
DSOPro: Will DSOs and solo practitioners continue to work in parallel? Will they remain separate groups, or do you see a different future for dentistry?
The data and the trends show more dental students are joining DSOs. As of 2020, about 30% of dental school seniors were joining a DSO, which I believe is double since 2015. That said, ADSO and our member companies are very supportive of making sure students and dentists find their practice home, whether it is a solo practice or a DSO. We want to make sure more people are getting into dentistry, and that they know they have options in the profession.
Dentistry can be cost prohibitive between tuition and starting your own practice. There are various models and ways to work through these issues. I think we will continue to see thriving and successful solo practices. And I think DSOs will always want to work with private practices collaboratively to ensure the profession continues to grow and increase the number of patients who are getting the best care.
What we’ve seen over the past 25 years is that the market share of the oral healthcare space is growing. More people are going to a dentist, and more people are getting the healthcare they need. The overall consumer spend in the healthcare market continues to grow. More people are accepting dental treatment plans. Historically, if you had tooth decay or missing teeth, you’d probably get a root canal, a bridge, or dentures. Now, people are getting implants because they’re better for your mouth and your health. Yes, they’re more expensive, but now financing may be available, so more people are able to choose that type of care.
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For another example, look at the growth of clear aligners. Patients who have had braces or other types of treatments may later in life come back in to tweak some things. In addition, underserved groups like the adult or pediatric Medicaid populations that hadn’t seen a dentist are now more regularly seeking care.
I would argue that DSOs have filled the void for cost, care, and convenience when it comes to certain treatments. There are all these options for greater access to care, so the market continues to grow.
DSOPro: Any other trends in the DSO industry?
The big trends are the continued growth of DSO specialty practices, like endodontics, periodontics, oral surgery, etc. You’re going to start seeing more of that. It will be interesting to see how DSOs are growing and expanding what they are offering, for example, consolidating with other DSOs in a way that provides greater access to care. Recently, Aspen Dental partnered with ClearChoice, one of the leading dental implant DSOs, and now has that capability in addition to their Aspen platform.
Other DSOs are focused on systemic health. What’s the future of the mouth/body connection? Pacific Dental has co-located a medical and dental clinic. Other DSOs are recognizing the trend of healthcare moving together, promoting the idea that you can’t do one separate from the other. This is another area for growth and greater access to care. There are myriad opportunities on the horizon for DSOs.
| Andrew Smith brings a breadth of business experience to the ADSO. He has worked in Washington, DC, on state and federal campaigns; at a private practice law firm helping highly regulated businesses navigate Congress, federal agencies, the White House, and state governments and agencies; with a managed care client navigating the state and federal issues at Centers for Medicare & Medicaid Services; with pharmaceutical companies by promoting their research and development regarding new therapeutics, and the alcohol industry on trade issues, taxation, and the development of the dietary guidelines. As more states began to legalize medical cannabis as an alternative therapeutic, as a consultant Smith helped businesses obtain state licenses and set up regulatory structures. He eventually joined a medical cannabis company and helped build out its regulatory model and corporate development as the company grew. When COVID hit, Smith decided to rethink what he was doing. He had met some of the ADSO leadership and was intrigued by the entrepreneurial and innovative spirit of DSOs. He was also attracted to their executive committee makeup where, unlike many other trade associations, the executive committee were all CEOs. When the ADSO executive director position opened, Smith knew he could use his skill set and strategic thinking to help DSOs navigate a successful path within the healthcare industry. “We’re really excited about everything we’re doing within the space,” Smith says. “I think ADSO is really helping drive the narrative of the benefits of DSOs and how they can thrive within the oral healthcare landscape. It’s an exciting time.” |
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Andrew Smith is the Executive Director of the ADSO. He previously served as executive vice president of government relations and external affairs for Parallel (formerly Surterra Wellness) where he managed the state and federal government relations teams, served as the company’s chief advocate and spokesperson to policymakers and regulators, and led the company’s advocacy and communications goals in the public affairs space.
Prior to joining the private sector, Andrew spent a decade working in government, campaigns, and public policy. In particular, Andrew worked as finance director and senior advisor for Virginia Governor Terry McAuliffe where he oversaw the strategy, development, and implementation of a record-breaking $44 million fundraising operation.
Andrew is originally from Chicago and is a graduate of Georgetown University with a degree in government and history. He currently lives in Greenwich, Connecticut, with his wife Laura and their two children, Holden and Caroline.
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