
Rising Costs, Flat Fees, and Shaky DSOs
Dentistry isn’t going anywhere. When Casey’s crown popped off mid–Milk Dud, he never thought about the cost. He just wanted it fixed by a dentist he trusted. But building real wealth as a practice owner has never been harder. In this “State of the Union” episode, Casey Hiers and Jarrod Bridgeman cover the pressures every owner is feeling right now, and what to do besides complain about them: Rising costs, flat reimbursements: Supplies, rent, and wages keep climbing while PPO rates don’t. Most new clients’ fees come in 12–40% below the 80th percentile for their area. Staffing is a leadership issue: Why a new bonus structure won’t fix a toxic culture, and how good leaders recruit through their own team’s word of mouth. The DSO exit isn’t a sure thing: With PE-backed groups restructuring debt and creditors running the show, the 10x EBITDA “Hail Mary” is on shaky ground. Market saturation: Why some of the most profitable practices are in towns people don’t think to live in. The shiny tech trap: Before you buy, ask three questions: Does it make you money, save you money, or save you time? The industry won’t ease up on its own. The owners who go on offense now are the ones who set up their last 7 to 17 years of practicing. Upcoming Tour Dates: Go to our EVENTS page for info Facebook: Four Quadrants Advisory Instagram: @fourquadrantsadvisory LinkedIn: Four Quadrants Advisory





