The DSO Reckoning – What Every Doctor Needs to Know Before Selling Their Practice – Brannon Moncrief: Ep# 564

The dental marketplace is recalibrating under the weight of rising interest rates, over-leveraged DSOs, and the wake of a gold-rush era that rewarded speed instead of discipline. In this razor-sharp conversation, Brannon Moncrief exposes zombie companies pretending to be buyers, duct-taped roll-ups doomed before they start, and deal structures designed to trap doctors in equity with no path to liquidity. He breaks down how the smartest operators survived the downturn, why valuations have reset, and what separates premium practices from those stuck on the sidelines.

But this episode is far more than market analysis. It’s a blueprint for autonomy, optionality, and protecting decades of work from a single bad decision. Brannon and David rip apart the myths around DSOs, clarify when a private sale is actually the wiser move, and reveal the real meaning of alignment in a deal: culture, clarity, control, and contract terms that won’t turn into nightmares two years later. If you’re even thinking about an exit in the next decade, this is the most honest, unfiltered conversation you’ll hear all year.

Minute Markers:

00:00 – Intro
04:32 – The Interest-Rate Shock That Shook DSOs
07:55 – Why So Many DSOs Are Stuck or Failing
11:24 – How to Identify a Truly Strong DSO Operator
14:50 – “Zombie DSOs”: What They Are and Why They Matter
18:10 – Easy Money Is Gone: DSO Operators Must Actually Operate
25:08 – Red Flags in Conversations, Term Sheets, and Contracts
29:18 – Which Practices Should NOT Sell to a DSO
33:13 – The Truth About Earnouts, Hold Backs, and Risk
36:10 – How to Choose a Partner Without Regretting It
38:06 – The Emotional Roadblock to Exit Planning
40:03 – Reverse-Engineering a 5–7 Year Exit
43:13 – David’s Riff: Why Last-Minute Exits Fall Apart
48:45 – Equity Rollovers vs Recaps: The Real Difference
52:20 – Incentives: How Every Player Shapes the Deal

If you like this episode, here are more episodes we think you’ll enjoy:

Ep #538 – Scaling Smart: Navigating Growth, Profitability, and Dental Exit Strategies with Jake Conway
Ep #499 – You Are More Than a Number – Selling Your Practice and Leaving Dentistry with David Porritt

Links Featured on the Show:

Download the Exit Strategy Playbook
Brannon’s website: Dental Transitions
Text Brannon for a 30-min discovery call at 512-660-8505 Or
Email Brannon directly at brannon@dentaltransitions.com
Schedule your Freedom Founders discovery call

#DentalPracticeSale #DentalTransitions #DSODeals #PrivateEquityDental #DentistryBusiness #DentalEconomics #PracticeOwnership #DentalExitStrategy

Watch full-length Interviews on video!

Watch full length interviews on David’s YouTube channel by going to www.DentistFreedomBlueprint.com/YouTube. Don’t forget to subscribe to David’s YouTube Channel for more content on maximizing your business, wealth, and creating a financial blueprint to reach your Freedom faster!

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P.S. Whenever you’re ready, here are some other ways I can help fast track you to your Freedom goal (you’re closer than you think):

1. Schedule a Call with My Team:

If you’re tired of running on the hamster wheel, and are looking for a proven blueprint to create more freedom and reduce dependency on your practice income, schedule a call with my team to learn more.

2. Get Your Dentist Retirement Survival Guide:

The winds of economic change are here, and now is the time to move to higher ground. This guide gives you the steps to protect your retirement, your family, and your peace of mind. Get the 25-point checklist here.

3. Get Your Free Retirement Scorecard:

Benchmark your retirement and wealth-building against hundreds of other practice professionals, and get personalized feedback on your biggest opportunities and leverage points. Click here to take the 3 minute assessment and get your scorecard.

Want to know more about David and schedule him as a speaker or podcast guest? Go to doctorphelps.com to book David now.

Power Concepts:

[Tweet “Long-term satisfaction in a DSO deal isn’t about the valuation; it’s about the partner. — Brannon Moncrief“]

Start early, plan well, and you’ll have options most doctors never get. – Brannon Moncrief

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