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Unifying Clinical Excellence with Business Strategy: The Pivotal Role of Doctor Leaders in Dental Service Organizations

Former DSO CEO Heidi Arndt explains how connecting clinical excellence with strategic business objectives drives organizational growth, sustainability, and operational effectiveness.


Navigating the dental service organizations (DSOs) and integrating clinical excellence with strategic business objectives have become critical determinants of success. My journey from clinician to CEO within the DSO industry has afforded me a unique perspective on the indispensability of connecting these two domains. This connection enhances patient care and drives organizational growth and sustainability. Delving into examples from my own experiences, we’ll explore the pivotal role of clinical leadership within leading DSOs in bridging the gap between frontline providers and executive decision-making. This discussion will underscore its critical importance in areas such as recruitment, staff retention, standardization of procedures, fostering organic growth, and strategic planning, particularly in setting achievable goals and outlining performance plans.

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Bridging the Gap: The Role of Clinical Leadership

The journey begins with acknowledging the often-disconnected realms of clinical practice and business strategy within DSOs. Initially, as a clinician, the broader organizational objectives seemed distant, a sentiment likely shared by many in similar positions. However, ascending through various leadership roles, including my CEO role, illuminated the necessity for a cohesive approach aligning clinical goals with the DSO’s strategic vision.

The integration of a Doctor Leader or Chief Clinical Officer (CCO) within a DSO’s structure is recognized for its potential to synergize clinical excellence and business acumen. However, many organizations face challenges in actualizing this integration, stemming from concerns over revenue impact, the expense of the roll, and the leadership training needs of transitioning clinicians. Addressing these challenges requires an understanding of the role and potential of clinical leaders in shaping the strategic direction and operational effectiveness of DSOs.

Revolutionizing Recruitment and Retention

A mid-market DSO’s experience with recruitment and retention underscores the transformative potential of clinical leadership. Faced with difficulties in hiring and retaining associates, the organization identified a need for greater clinical presence in its recruitment process. Incorporating the CCO in interviews, onboarding, and ongoing mentorship resonated with dental professionals’ desire for clinical guidance and community. This strategic shift not only improved the recruitment pipeline but also significantly enhanced retention rates, demonstrating the value of clinical leadership in creating a supportive and cohesive and rewarding work environment.

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Standardizing Success Across Multiple Locations

The challenge of standardization across a Midwest DSO’s 50 locations highlights another dimension of clinical leadership’s impact. The absence of consistent protocols and processes across these geographically dispersed practices presented a significant obstacle to organic growth. The CCO’s initiative to implement standardized patient care and workflow processes across all locations exemplified the clinical leader’s role in driving operational excellence and efficiency. Within a year, this initiative yielded a remarkable ~20% increase in organic revenue, illustrating the critical role of standardization in achieving scalable growth.

The Chief Clinical Officer’s Role in Goal Setting and Performance Planning

During the annual planning sessions, the DSO leadership, including the CCO, convened to set the organization’s revenue objectives and distill these goals down to the provider level. This process involved analyzing hours worked, daily production, and annual revenue projections for each provider. The CCO played a crucial role in ensuring that the goals set for each provider were realistic and attainable yet challenging enough to encourage skill and efficiency improvement.

The responsibility of the CCO extended to individual discussions with the doctors, explaining the revenue goals and strategizing on how to meet them. These conversations, rooted in a clinician-to-clinician understanding, focused on work assessment, key performance indicators (KPIs), and personalized plans to achieve set targets. The clinical leader’s unique perspective was instrumental in these discussions, emphasizing the value of clinical leadership in areas beyond traditional business management.

Post-goal setting, the CCO engaged in quarterly reviews with each provider to evaluate performance, offer recommendations, and devise strategies for ongoing improvement. This structured approach to performance planning and feedback demonstrates the indispensable role of clinical leaders in fostering a culture of continuous growth and excellence within DSOs.

Strategic Planning and Program Expansion

CCOs are deeply involved in the strategic planning process. They bring a clinical perspective to the boardroom, ensuring the strategic plan and goals align with clinical excellence. Their insights into the nuances of dental care delivery enable them to identify opportunities for enhancing service quality and expanding revenue through the mix of services offered. By participating in these discussions, clinical leaders ensure that the organization’s strategic objectives are not only financially aligned but also clinically sound and patient-centric.

Clinical leaders play a critical role in assessing the need for new clinical programs and services in terms of program expansion. They evaluate market trends, patient needs, and the latest dental technology and practice advancements. This evaluation process helps identify key areas where the DSO can expand its clinical offerings to meet emerging patient needs, improve care outcomes, and capture new market segments. For instance, introducing medical/dental integration and specialized services such as orthodontics, periodontics, or cosmetic dentistry can help a DSO differentiate itself in a competitive market and attract a broader patient base.

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Join the Movement: The Evolving Group Dentistry Conference

As we recognize the profound impact of clinical leadership across various facets of DSO operations, it’s clear that a collaborative effort is required to further this agenda. The Evolving Group Dentistry Conference embodies this movement, aiming to bridge the gap between clinical excellence and business strategy, from the boardroom to the front line and back. This event serves as a pivotal platform for DSO professionals to engage in discussions, shared insights, and sharing strategies to enhance both patient care and organizational growth.

We are at a juncture where the convergence of clinical leadership and strategic business management is not just an ideal but a necessity for the future of dentistry. The Evolving Group Dentistry Conference provides an unparalleled opportunity to be part of this transformative movement. Attendees will gain valuable insights into creating environments where team members feel valued, patients receive exceptional care, and DSOs achieve unprecedented success.

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About Heidi Arndt  

2024 headshot Heidi 3

Heidi Arndt if the Founder and CEO of Evolve Dental Advisors. She is a highly skilled DSO strategist, advisor, doctor/clinical leadership champion, and thought leader specializing in developing and managing multi-location dental groups. With an impressive track record spanning over two decades, Heidi offers her expertise to emerging and mid-market DSOs, providing invaluable support to clinicians, owners, and investors in aligning clinical outcomes with overall business success.

Previously, Heidi was CEO at Strive Dental Management, a private equity-backed DSO headquartered in Austin, Texas. During her tenure, she led the company to achieve remarkable growth, with same-store sales increasing by an impressive >18% over 2 years. In July 2021, Heidi successfully guided the company through an equity sale transaction, demonstrating her adeptness at navigating complex business transactions.

Before her role at Strive Dental, Heidi founded two renowned consulting and training firms: Enhanced Hygiene and Enhanced Practice. These boutique firms catered specifically to DSOs across the United States, providing comprehensive guidance and support. In early 2019, Heidi successfully sold and exited both companies, a testament to her entrepreneurial acumen and ability to deliver exceptional value to her clients.

Heidi’s journey in the dental industry began as a clinical dental hygienist at prominent dental groups such as Mayo Clinic in Rochester, Minnesota, and American Dental Partners in Wakefield, Massachusetts. Her commitment and expertise eventually led her to assume the position of National Director of Dental Hygiene at American Dental Partners. Heidi holds a Bachelor of Science in Dental Hygiene from the University of Minnesota.

Evolve Dental Advisors 

Evolve Dental Advisors specializes in aligning clinical expertise with business acumen for dental groups and dental service organizations. We empower executive teams to drive organizational transformations by creating a synergy between clinical objectives and business strategy. Our comprehensive services include strategic alignment, leadership development, performance and revenue optimization, cultivating a balanced culture, and change management expertise. In addition, we provide guidance, training, and mentorship to clinical leaders within these organizations to enhance their skills and effectiveness in leading their teams and driving clinical excellence and strong financial results. Through a unique perspective on both clinical and business aspects of dental operations positions Evolve Dental Advisors is an ideal partner for achieving organizational excellence.


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