The Disruptors, the Disrupted, and the Consumer
October 21, 2024
The cycle is inevitable. When Sears rolled into town, small hardware stores faltered. When Bed Bath & Beyond expanded, mom-and-pop shops couldn’t keep up. But then, Sears? Gone. Bed Bath & Beyond? Also gone. So where do customers go now? The internet?
Rite Aid, Walgreens, and CVS crushed nearly all the family-owned pharmacies. Rite Aid just filed for Chapter 11 in October 2023. Walgreens? They’re closing 1,200 stores. CVS plans to shut down 900 more. They chased away the competition—now what happens when they disappear?
Enter Mark Cuban. In 2022, he saw this coming and launched an alternative: Cost Plus Drugs, offering transparent pricing and a real choice. Smart move.
Dentistry is on the same path, and the storm has already begun. Private equity and venture capital are buying up dental practices, wielding leverage that small practices can’t match. They get higher reimbursements and lower supply costs. Small practices? They either sell or fade away.
But what happens when the corporate model fails? Walmart already closed 51 clinics. More will follow.
Patients may turn to online DIY options. But here’s the thing: dentistry isn’t a virtual experience. You can’t fill a cavity through Zoom or AI. Hands-on care still matters. Dentistry, as much as some would like to make it, is not a commodity. It’s a service.
Still, some have tried, like Smile Direct Club and Complete Sleep to provide direct to consumer solutions. SDC has already failed and so will DIY sleep appliance programs as the inevitable side effects will have the lawyers circling, waiting to pounce.
So where do patients turn next?
This is why smaller, independent dental practices are vital. They’re the lifeline when the corporate giants falter. And they will.
How does a small practice survive and thrive amid this DSO (Dental Service Organization) takeover? I know because I did it. I built a fee-for-service practice in Midtown Manhattan, one of the toughest markets in the world, and repeated it across the river in Bergen County, where people said it couldn’t be done. It wasn’t easy, but it’s possible. The secret is in differentiation—creating a practice that attracts patients who value personal care, not just a corporate experience.
In the coming weeks, I’ll share the strategies you can use to survive—unless, of course, selling to a DSO is part of your plan. That’s a path I’ve also helped clients with. I’m not against the DSO movement. They serve a purpose. My concern is what happens at the end of the cycle. Will there be dentists and practices that know how to deliver the kind of care the supports a fee for service, personalized practice?
Every disruption creates an opportunity. What’s yours? What legacy do you want to leave?
Stay tuned.
— Michael
Practice Success Insights

Dr. Michael Goldberg is one of the leading educators on dental practice management in the United States.
Michael ran and sold a prestigious group practice in Manhattan and has been on Faculty at Columbia University and New York-Presbyterian Medical Center for 30 years including Director of the GPR program and Director of the course on Practice Management.
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