Consolidation, Integration & Enterprise Value for DSOs
The dental industry is consolidating, but market shifts are changing the rules for those rolling up practices looking to package and exit.
Consolidation now requires integration across a portfolio to drive the enterprise value needed to move that portfolio to a private equity sponsor.
Five years ago, an operator could get away with packaging up 25–50 practices and turning them over to PE to integrate and optimize. As is typically the case, PE learns that EBITDA growth is in the operations, and operations is hard, therefore shifting the onus to the operator to create value in the portfolio before entertaining the transaction.
Now, dental operators must be adept at integration across people, process, and technology. No small feat—but to make investors whole, it’s the only way.
As an institutional investor in B2B vertical SaaS, I see the dental industry going through a common tech consolidation cycle.
Core systems lead the charge, in this case, Practice Management Software (PMS) becomes the technology backbone of the practice. Then smaller tech solutions flood the market to fill the gaps in the core solution. The stack starts to bloat, raising costs and complexity.
As in other industries, the tech leaders in the space do a great job of influencing process in the form of “best practices.” The best of them build armies of raving fans (power users) who become the mouthpiece in the practice for the adoption of new solutions. That’s great for the software company—but not always for the business. When an operator decides to roll up practices, this problem compounds, as you now have conflicting opinions about the right solution moving forward.
The next phase is tech consolidation, which typically looks like a series of M&A transactions led by the system-of-record tech (PMS), trying to roll up smaller solutions into their platform to acquire customers, transition them to their core, and generate the perception of a fully integrated solution. There are varying degrees of success here. But the reality is, most companies are not going to acquire the best-of-breed solutions—those are expensive transactions. And just like the DSOs rolling up practices, tech companies are building enterprise value for their investors. The result is often a half-baked solution that isn’t much more than a customer grab.
So, what’s the solution?
First, look at best-of-breed solutions focused on delivering tangible ROI for your portfolio, those that facilitate the consolidation of people and process through a seamless technology experience.
Second, examine their partner ecosystem. The best companies create deep partnerships that bring together the best of the best across specialized use cases. These partnerships go beyond tech integration. They extend into go-to-market strategy, deploying a value-based model that highlights the levers they can pull in your portfolio, the outcomes of pulling them, and the roadmap to get there. These partnerships often lead to M&A transactions that create outsized outcomes for both stakeholders and customers.
DSOs are at a crossroads when it comes to delivering enterprise value to their investment partners. The only path forward is an integrated portfolio, built on solutions that drive revenue, production, and efficiency across the enterprise—setting the standard for people, process, and technology.
As an investor and operator in Peerlogic, our charge is to serve 1 million patients through our AI-first solutions and deliver $1 billion in incremental revenue for dental practices. We do this through a truly integrated, value-first solution—one focused on meeting the DSO market where they are: building integrated portfolios that deliver enterprise value at the next turn.
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AI gets blamed for stealing jobs. But in reality, it’s stealing something else , the tedium.
And that might be the best thing to ever happen to patient care.
Why Empathy Is a Workflow Problem
Front desk teams don’t lack compassion; they lack time. Between insurance questions, scheduling chaos, and non-stop phones, they’re managing a dozen demands at once. When people are stretched thin, empathy becomes a luxury.
A 2025 Healthcare Experience Study found that front-office staff spend nearly 40% of their day on repetitive administrative tasks. That’s almost half of their emotional bandwidth gone before they even speak to a patient.
Efficiency Isn’t the Enemy of Empathy
The irony is that technology, when used right, doesn’t erase empathy , it restores it.
When you remove the noise (manual follow-ups, double entry, transcribing voicemails), you give people back the mental space to be human.
Patients notice. According to the same study, patients who describe their interactions as “personal” or “caring” are 3.6x more likely to remain loyal to their provider, even if wait times are longer or costs are higher.
Empathy is measurable, and it pays.
The Shift from “More Calls” to “Better Conversations”
For decades, practices have focused on volume: more calls, more bookings, more marketing.
But quantity isn’t scalable. Quality is.
The practices thriving today are the ones tracking conversation quality metrics: tone, response time, and follow-up rate.
The real competitive edge? Protecting staff capacity to care.
How to Build Empathy Capacity
You can’t “teach” empathy in a training session , but you can design for it.
Start small:
- Reduce friction: Simplify how staff log and retrieve patient information.
- Delegate the repetitive: Offload low-emotion tasks like reminders or callbacks.
- Protect focus: Give staff uninterrupted time for live patient interactions.
This isn’t just culture work , it’s operational design.
The real AI revolution won’t be measured in efficiency. It’ll be measured in empathy.
The best practices in 2026 won’t be the ones that adopted the most technology , they’ll be the ones that used it to make their people feel more human.
Try this:
Ask your team: “What part of your day makes you feel least connected to patients?” Their answer is where your automation journey should begin.
If every business line told the truth, the voicemail box would have a meltdown.
It works around the clock, never takes a break, and yet somehow loses you more money than any marketing campaign ever could.
Most practices think their marketing isn’t working. But the truth is, the leads are there , they’re just getting lost before anyone picks up.
The Hidden Cost of “I’ll Call Them Back”
Across healthcare and dental practices, 25–40% of inbound calls never reach a human. That’s not just an inconvenience , that’s a lost relationship.
When the average new-patient visit is worth $300–$500, even ten missed calls a week can quietly erase $150,000+ in annual revenue. But the real problem isn’t the missed call. It’s what happens next , or doesn’t.
Only 8% of businesses respond to missed calls within the first hour, when a potential patient is still actively looking. After two hours, that number drops below 2%. By the next day, you might as well be calling a stranger.
The Follow-Up Gap
This isn’t a staffing issue. It’s a systems issue.
In most practices, the front desk is juggling check-ins, insurance questions, cancellations, and walk-ins , all while the phone keeps ringing. There’s no process to triage or follow up efficiently.
Here’s what typically happens:
- A new patient calls during peak hours.
- They leave a voicemail or hang up.
- The message gets lost in the rush.
- By the time someone calls back, they’ve already booked elsewhere.
If this feels familiar, you’re not alone. Responsiveness is the most common , and least measured , gap in healthcare operations.
How to Measure Responsiveness (and Fix It)
If you want to find the leak, start by tracking three simple metrics for one week:
- Missed call rate: Number of calls that never reach a staff member.
- Follow-up time: Average time between a missed call and a callback.
- Conversion rate: Percentage of callbacks that lead to booked appointments.
You don’t need new software to start , just track it manually for seven days. The pattern will reveal itself quickly.
Practices that reduce their follow-up time to under 30 minutes see, on average, a 35% higher appointment conversion rate. It’s the easiest performance improvement you’ll ever make without hiring anyone new or spending another dollar on ads.
If your marketing feels “flat,” start with your phones.
Your next growth opportunity isn’t on social media , it’s already sitting in your call log.
Your voicemail box is doing its best. But maybe it’s time to give it a little help.
Try this:
Audit your calls for one week. Track how many voicemails turn into appointments. That one exercise will tell you more about your marketing ROI than any dashboard.
Why Appointment Types Matter
The average dental office loses thousands of dollars a month in inefficiencies tied to poor scheduling: patients booking the wrong visit, missed calls, or confusion between cleanings and exams.
Your dental office phone system and online scheduling tools should work together to make the process clear, simple, and accurate. That means defining your Aimee Bookable Appointment Types strategically and using data to fine-tune them over time.
AI Bookable Appointment Types
Our customizable AI, Aimee supports a full range of appointment types to fit nearly every workflow in a modern practice.
General & Consultation
- Bridge
- Bridge Consultation
- Consultation
- Cosmetic Consultation
- Crown
- Crown Consultation
- Denture
- Denture Consultation
- Emergency
Existing Patients
- Existing Patient Cleaning
- Existing Patient Cleaning and Exam
- Existing Patient Exam
- Existing Pediatric Patient Cleaning
- Existing Pediatric Patient Cleaning and Exam
- Existing Pediatric Patient Exam
Procedures
- Extraction
- Extraction Consultation
- Filling
- Filling Consultation
- Fluoride Treatment
- Implant
- Implant Consultation
- Invisalign Consultation
New Patients
- New Patient Cleaning
- New Patient Cleaning and Exam
- New Patient Exam
- New Pediatric Patient Cleaning
- New Pediatric Patient Cleaning and Exam
- New Pediatric Patient Exam
Specialty & Advanced Care
- Orthodontic Consultation
- Periodontal Consultation
- Periodontal Maintenance
- Prosthodontist Consultation
- Root Canal Consultation
- Scaling and Root Planing
- TMJ/TMD Consultation
- Veneer
- Veneer Consultation
- Whitening
Each of these can be customized to match your practice’s workflow and managed directly through your workspace.
1. Start with Data
Before adjusting your booking options, use dental analytics and call tracking for dentists to identify where things break down:
- Which appointment types are most frequently booked incorrectly?
- Which calls are missed entirely?
- How often are new patients calling about cleanings instead of exams?
The data from your dental phone system and dental call tracking platform provides the roadmap for smarter scheduling.
2. Align Appointment Types with Your Day
Your setup should reflect the reality of your care process.
If a consultation is always required before a treatment, don’t let patients skip ahead online.
Action steps:
- Only make the consultation bookable online.
- Let your front office schedule follow-up treatments internally.
- Review dental analytics monthly to confirm the flow is working.
This simple change reduces cancellations, wasted chair time, and frustrated patients.
3. New vs. Existing Patients
Mixing new and existing patients in the same time blocks leads to chaos.
Do this instead:
- Create separate appointment types for new patient exams.
- Add clear naming conventions: “New Patient Exam (First Visit Only).”
- Configure your dental office phone system or AI assistant to recognize new patient calls and route them appropriately.
Your call tracking for dentists reports will confirm whether patients are being routed to the right visit the first time.
4. Simplify the Experience
Patients don’t speak in dental codes, they speak in symptoms. Conversational AI bridges that gap by interpreting natural language like “I chipped my tooth” or “I need a cleaning” and booking the correct appointment automatically.
Try this:
- Review dental call tracking transcripts to see how patients actually describe their needs.
- Update your appointment names to use patient-friendly language (e.g., “Tooth Pain / Emergency Visit”).
- Use your dental phone system to provide short explanations (“Includes X-rays and exam”).
When in doubt, keep it simple and clear.
5. What about Multi-Step Treatments?
For treatments like implants, crowns, or orthodontics, don’t let patients self-book every step.
Best practice:
- Only make the first appointment (consultation) public.
- Have your team schedule follow-ups.
- Track reschedules using dental analytics to measure workflow efficiency.
The goal is to give patients flexibility without losing operational control.
6. Consistent Labeling
Appointment confusion often comes from duplicate or unclear naming conventions.
Actionable steps:
- Limit each treatment to one appointment type.
- Use clear, specific names (“Filling Consultation” vs. “Consultation”).
- Mirror those labels in your dental office phone system menus, AI chat, and web booking.
Unified language builds trust and prevents errors.
7. Continuous Improvement
Scheduling optimization isn’t a one-time task, it’s ongoing.
Set a review cadence:
- Monthly: Check dental analytics for appointment types with high reschedules or no-shows.
- Quarterly: Review call tracking for dentists insights to see where confusion persists.
- Annually: Audit your dental office phone system setup to align with new treatments or team changes.
Even minor refinements can create measurable gains in patient satisfaction and booked revenue.
8. The Right Balance
Technology doesn’t replace your front office team, it supports them.
Use conversational AI to automate repetitive scheduling tasks and recover missed calls, while your staff focuses on relationship-building.
With dental analytics, your leaders gain a clearer view of call volume, conversion rates, and appointment flow trends.
And with an integrated dental phone system, every call, text, and appointment connects into one streamlined experience.
Building a Smarter Scheduling Ecosystem for Your Office
Modern practices that thrive are the ones that merge insight with empathy.
By uniting conversational AI, dental analytics, and dental call tracking, you’ll:
Reduce scheduling errors and double bookings
Give patients more clarity and confidence when booking
Free up front office time for high-value work
Build visibility into your phone and appointment data
Your dental office phone system isn’t just a communication tool; it’s a growth engine when used strategically.
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