Exit planning
Selling a dental practice: your two real options
Most owners hear about one path: sell to a DSO or a private equity backed platform. There is a second one. You can transfer ownership to your own associates and employees through a doctor-owned ESOP, keep full clinical autonomy, and take no outside shareholders. This page lays the two side by side so you can tell which one fits before you respond to an offer.
DSO sale vs doctor-owned ESOP
Who owns the practice afterward
A corporate platform, usually backed by private equity and outside shareholders.
Your associates and employees, through a doctor-owned ESOP. No outside shareholders.
Clinical autonomy
Clinical decisions are shaped over time by production quotas and platform standards.
You keep the chair, the team, and your standard of care.
Timeline
Set by the buyer's fund cycle, often with a multi-year employment commitment.
Set by you, with a transition plan built around when you actually want to step back.
Who advises you
The buyer's team runs the process, models the numbers, and drafts the LOI.
You work with the Alliance and your own advisors before anything is signed.
Your team
Staffing, benefits, and comp are re-set by the platform after closing.
Your team becomes the owner group, which is the point of the structure.
Why the second option exists
Private equity spent a decade rolling up dental practices with financial engineering and aggressive leverage. Many of those platforms now carry heavy debt and thin margins, and the quotas that follow quietly reshape clinical decisions. The Alliance built Master DDS One as the alternative: a doctor-owned ESOP platform that uses bank debt and tax strategy instead of outside equity, so the practice stays doctor owned, doctor led, and doctor controlled.
Before you sign anything
- Know your own numbers. Run the free Practice Report Card so you are not evaluating an offer using only the buyer's model.
- Read what buyers are actually paying. Our DSO Watch reporting tracks consolidation activity in dentistry.
- Compare structures, not just headline price. Multiple, earn-out, employment term, and who controls clinical decisions matter more than the number on page one of the LOI.
- Talk to someone who is not the buyer. Request a confidential call with the Alliance.
Common questions
- What is an ESOP in dentistry?
- An employee stock ownership plan transfers ownership of the practice to the people who work in it. In the Alliance model, ownership moves to your associates and employees through Master DDS One rather than to a corporate buyer, using bank debt and tax strategy rather than outside equity.
- Do I have to sell my whole practice at once?
- No. The transition is planned around your timeline, which is one of the main differences from a DSO sale where the closing date and the post-close employment period are set by the buyer.
- What should I do before responding to an offer?
- Understand your own numbers first. The free Practice Report Card scores your practice across production, overhead, team, and transition readiness so you are not evaluating an offer using only the buyer's model.
- Is any of this a commitment?
- No. A confidential call is a conversation about your situation. Nothing is signed and nothing is listed.
Not ready to talk yet?
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This page is educational and is not legal, tax, or financial advice. Any transition should be reviewed with your own advisors.