Last Updated: July 30, 2028 by happypractice

 I've been studying the DSO landscape extensively, and one thing is crystal clear: what keeps dental executives up at night isn't what you might expect.

Spoiler: It's rarely clinical challenges.

The Real Crisis in Dental Group Management

I interviewed a DSO founder who built a 22-location group over a decade of hard work. "We're hemorrhaging associates faster than we can recruit them," he shared. "And last year's harassment suit cost us nearly $200,000 – money that should have funded our expansion."
His story isn't unique. Across the industry, DSOs are facing a perfect storm:

Dental associate vacancy rates exceeding 15% in competitive markets
Legal defense fees running $175,000-$250,000 per harassment case going to trial
Production capacity sitting idle while recruitment drags on for months

But here's what fascinated me: The DSOs thriving despite these challenges share one common element that rarely makes it into industry conversations.

The highest-performing groups I work with have implemented Ombuds programs – independent, confidential resources where team members can discuss concerns before they escalate to formal complaints or resignation letters.
Think of it as an early warning system that catches issues while they're still small enough to fix with a conversation rather than a settlement check.

The ROI Math Is Surprisingly Simple
For mid-sized DSOs (15-30 practices), consider these numbers:

Cost of implementing an Ombuds program: $75,000-$150,000 annually
Cost of defending just ONE harassment lawsuit: $175,000-$250,000
Revenue lost from a 6-month associate vacancy: $300,000+ per position

When I walk leaders through this math, the question changes from Can we afford this? to How quickly can we start?

Beyond the Numbers: The Culture Advantage

The benefits extend far beyond litigation avoidance. DSOs with effective Ombuds programs create what psychologists call "psychological safety", an environment where professionals feel safe to speak up.

This translates directly to recruiting power. As one operations director told me, "We're not offering the highest compensation package, but candidates choose us because they hear about our supportive culture from current employees."

Three Immediate Benefits You'll See
When DSOs implement these programs, three things happen almost immediately:

Problems get solved at the conversation level instead of the legal level
Leadership gets invaluable insights about patterns across locations (without compromising confidentiality)
Top performers stay longer because they have pathways to address concerns

And yes, occasionally you'll learn things that make you cringe a little. But it's better to know now than later when things get messy.

Taking Action: Simpler Than You Might Think

Implementing an effective Ombuds rogram requires just a couple of elements:

>A qualified neutral who reports directly to the CEO 

>A commitment from leadership to support the program

>Clear communication about confidentiality and how the program works

>Anonymized reporting to inform about hidden issue or emerging trends

The DSOs seeing the greatest impact treat this as a leadership initiative rather than an HR function. When the CEO champions the program, adoption happens naturally.

Let's Connect
Is your organization facing retention challenges or concerned about increasing litigation risks in the dental space? I've helped dozens of DSOs implement these programs with remarkable results.

Drop me a message at hello@happypracticeconsulting.com or book at Strategy Call .

 I'd be happy to share more specific strategies for your situation or answer questions about implementation approaches that work best for different organizational structures.

After all, in today's dental marketplace, the question isn't whether you can afford these preventative measures – it's whether you can afford to be without them.