Podcast Episode #564: The DSO Reckoning – What Every Doctor Needs to Know Before Selling Their Practice – Brannon Moncrief
Episode #564: Dentist Freedom Blueprint Podcast
The DSO Reckoning – What Every Doctor Needs to Know Before Selling Their Practice – Brannon Moncrief
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
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
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) :
In this episode, we finish up the second part of my interview with Rob Swanson and his eight rules of investing. (If you haven’t listened to part 1, be sure to go back and give that a listen before jumping into this one.) Today, we pick up where we left off, covering rules four through eight and talking about everything from decision-making to cash flow and risk reduction.
Listen in as Rob shares his incredible insight and experience in real estate and investing to give us a few rules that help make our decisions and investments more solid. You will hear about the importance of looking at margins before buying and what boxes need to be checked when it comes to predicting a solid income stream. Rob also discusses how to define and mitigate the different risks involved so that you can come out on top.
Alastair MacDonald is a private advisor to established entrepreneurs, investors, and business owners, as well as a TEDx speaker who lectures on economic, social, and financial forecasts. Join me today to hear part two of our conversation at the Freedom Founders Mastermind, where we dive into the concept of certainty, how to hedge against a volatile economy, and why the abdication model is no longer one that works.
Listen in to learn the reasons why Alastair is not worried about consumer price inflation (and what he’s really worried about instead) and why the 401(k) is not always the investment that it is made out to be. You’ll learn why he is most concerned about the issue of division and polarity in the Western world, why your business is your best asset in a volatile economy, and how you can maintain its viability to weather the most intense economic storm.
1. 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. Go to www.FreedomFounders.com/Scorecard to take the 3 minute assessment and get your scorecard.
2. Attend A Workshop:
If you’re committed to Freedom, but still building a practice, paying down school debt, or growing investment capital, our hands-on Freedom Blueprint Workshops are your entrance ramp onto the fast track! Visit www.freedomfounders.com/workshop to claim your seat!
3. Apply To Visit The Mastermind:
If you’d like to join dozens of dentists, docs, and practice professionals on the fast track to Freedom (5-7 years max), visit www.freedomfounders.com/step-1 to apply for a seat.
4. Want to Work Directly with Me?
If you’d like to work directly with me and a small group of my closest investment colleagues, with direct access to the dealmakers and asset classes that I invest in, just send a message to my Executive Assistant (Lindsey@FreedomFounders.com), and put “Fast Access” in the subject line. Or, call (972) 203-6960 Ext 144 and leave a brief voicemail for Lindsey. Let her know you’re interested in the Fast Access program – we’ll set up a time with you to talk, find out about your goals, and see if there is a fit.