The Dental Economist Show

What does it take to build a multi-practice dental organization that protects clinical independence, keeps doctors at the center of decision-making, and still delivers meaningful growth?

In this episode of The Dental Economist Show, host Mike Huffaker sits down with Dr. Adriatik Rama, Founder and CEO of American Dental Companies, to explore the doctor-led partnership model behind the organization’s growth across approximately 80 practices.

Dr. Rama shares why he founded American Dental Companies after seeing the broader healthcare market shift toward consolidation—and why he believed dentistry needed a model that could modernize operations without sacrificing doctor ownership, patient care, or clinical autonomy.

The conversation explores how American Dental Companies selects like-minded partners, integrates doctors into company leadership, and has historically achieved approximately 30% first-year growth for affiliated practices. Dr. Rama also explains the organization’s approach to transparent financials, clinical review, customized doctor development, and technology adoption.

Mike and Dr. Rama discuss the role of private equity in the company’s next phase of growth, the importance of maintaining a debt-free practice platform, and why clinical independence and doctor profit sharing are fundamental to building a durable dental organization.

Episode chapters:

00:00 From medicine to dentistry—and the appeal of independence

01:47 Why Dr. Rama founded American Dental Companies

03:41 The doctor-led model behind practice growth

07:21 Selecting partners who want to keep growing

09:11 Building community and shared decision-making among doctors

10:59 Why growth requires change, transparency, and shared systems

15:48 Bringing in private equity without taking on practice debt

21:12 How monthly clinical reviews drive excellence at scale

25:03 Helping doctors grow without working more days

31:59 Why Dr. Rama remains bullish on dentistry

Connect with the team:

👉 Mike Huffaker on LinkedIn: https://www.linkedin.com/in/huffaker/

👉 Planet DDS: https://planetdds.com/

👉 American Dental Companies: https://www.ameridentco.com/our-team/dr-adriatik-rama-dds

You can also listen to our podcast here:

👉 Apple Podcast: https://shorturl.at/ikORx

👉 Spotify: https://shorturl.at/SMInC

Want to be a guest on The Dental Economist Show?

If you’re a growth-focused leader in the dental business world or someone shaping its future through technology, consulting, or innovation, we’d love to hear from you.

Whether you’re leading a DSO, building the next generation of dental technology, or helping redefine patient care, The Dental Economist Show is where the industry’s leading voices come together to discuss what’s next.

How do you scale a dental organisation without losing the culture, trust, and people-first approach that made it successful in the first place?

In this episode of The Dental Economist Show, recorded live at Dental Forum in Fort Worth, host Mike Huffaker speaks with David Meece, founder and Executive Chairman of Pearl Street Dental Partners, and Ryan Torresan, Chief Operations and Marketing Officer at Mosaic Dental Collective, about leadership, influence, culture, and scaling change across growing DSOs.

David explains why Pearl Street has focused on managing through influence rather than directives, creating an environment where doctors voluntarily adopt new technology and initiatives because they understand the value behind them. He also shares why protecting culture starts long before an acquisition is completed, with careful partner selection and a clear understanding of shared values.

Ryan discusses Mosaic Dental Collective’s approach to change management as the organisation prepares to scale its technology and operations across more than 50 practices. He explains why leaders should “scale what works” rather than trying to scale individual opinions, using pilot programmes, operational standards, transparency, and data to build genuine buy-in.

The conversation also explores why culture cannot simply be dictated or installed, how data and trusted relationships make technology adoption easier, and why strong implementation matters just as much as choosing the right platform. David and Ryan also reflect on the next stage of growth for their organisations, building leadership teams around complementary strengths, and keeping patient care and people at the centre of growth.

Finally, they share how they continue to develop as leaders through learning, relationships, health, faith, and staying connected to the people around them.

Connect with the guests:

👉 David Meece on LinkedIn: https://www.linkedin.com/in/david-meece-b9201773/

👉 Ryan Torresan on LinkedIn: https://www.linkedin.com/in/ryantorresan/

Connect with the team:

👉 Mike Huffaker on LinkedIn: https://www.linkedin.com/in/huffaker/

👉 Planet DDS: https://planetdds.com/

You can also listen to our podcast here:

👉 Apple Podcast: https://shorturl.at/ikORx

👉 Spotify: https://shorturl.at/SMInC

Want to be a guest on The Dental Economist Show?

If you’re a growth-focused leader in the dental business world or someone shaping its future through technology, consulting, or innovation, we’d love to hear from you.

Whether you’re leading a DSO, building the next generation of dental technology, or helping redefine patient care, The Dental Economist Show is where the industry’s leading voices come together to discuss what’s next.

What does it take to build meaningful influence, lead high-performing teams, and create a career that does not come at the expense of fulfillment?

In this episode of The Dental Economist Show, host Mike Huffaker speaks with Julieanne O’Connor and Michael Keeter, co-founders of Influential Dental and the team behind Influence Elevée magazine, about mindset, leadership, culture, and the human side of success in dentistry.

Julieanne and Michael share the origin story behind their partnership and the mission that guides their work: elevating the people who elevate others. They discuss the common traits they see in high-achieving dental leaders, including authenticity, strong systems, curiosity, and a willingness to embrace change rather than fear it.

The conversation explores how leaders can sustain high performance without burning out, why achievement alone rarely creates lasting fulfillment, and the importance of focusing on the present instead of constantly chasing the next milestone. Julieanne also shares her approach to public speaking, while Michael explains why culture must be defined, lived, and connected to a purpose larger than numbers.

They also discuss the launch of Influence Elevée magazine, their commitment to spotlighting the people behind dentistry, and their new initiative, Influence for Kids, which supports foster youth through awareness, experiences, and opportunity.

Episode chapters

00:00 Introducing Influential Dental and Influence Elevée

04:54 The origin story behind Julieanne and Michael’s partnership

07:15 Elevating others and uncaging potential

08:16 The common traits of high-achieving dental leaders

14:22 Embracing change, AI, and sustainable high performance

21:01 Why the present moment matters more than the next achievement

27:44 Public speaking without the pressure to perform

31:43 Building a culture that people want to be part of

43:19 Why they launched a lifestyle and mindset magazine for dentistry

54:19 Influence for Kids and creating opportunity for foster youth

Connect with the team:

👉 Mike Huffaker on LinkedIn: https://www.linkedin.com/in/huffaker/

👉 Planet DDS: https://planetdds.com/

👉 Influential Dental: https://influentialdental.com/

👉Julieanna O’Connor on LinkedIn: https://www.linkedin.com/in/michaelkeeter66/

👉Michael Keeter on LinkedIn: https://www.linkedin.com/in/michaelkeeter66/

You can also listen to our podcast here:

👉 Apple Podcast: https://shorturl.at/ikORx

👉 Spotify: https://shorturl.at/SMInC

Want to be a guest on The Dental Economist Show?

If you’re a growth-focused leader in the dental business world or someone shaping its future through technology, consulting, or innovation, we’d love to hear from you.

Whether you’re leading a DSO, building the next generation of dental technology, or helping redefine patient care, The Dental Economist Show is where the industry’s leading voices come together to discuss what’s next.

Can your practice confidently explain where patient data goes after it is collected?

In this episode of The Dental Economist Show, host Mike Huffaker speaks with Thomas Terronez, CEO of Medix Dental, about the overlooked data supply chain behind modern dental technology.

Every new tool, from patient engagement and imaging platforms to payment systems, call recording, analytics, and AI, can introduce new pathways for protected health information. Thomas explains why cybersecurity is no longer just about securing the server inside a practice; it is about understanding every vendor, integration, backup, development environment, and third party that may touch patient data.

The conversation explores the security benefits of cloud-based practice management platforms, the risks associated with legacy on-premise systems, and why staff training remains one of the most important safeguards against ransomware. Thomas also shares why a signed BAA is not enough, what DSOs should ask vendors before connecting new technology, and how practices can begin building a clearer, more accountable view of their data ecosystem.

Episode chapters

00:00 The hidden data supply chain in dentistry

02:00 From computer enthusiast to dental IT leader

04:52 Why dentistry has been slow to embrace the cloud

07:33 The risks of on-premise servers and ransomware

10:29 How many vendors are touching your patient data?

12:20 Why a signed BAA is not enough

15:03 The data-governance gap in dental organizations

18:32 AI, patient data, and the startup landscape

22:28 What responsible technology adoption looks like

28:49 The questions every DSO should ask a new vendor

Connect with the team:

👉 Mike Huffaker on LinkedIn: https://www.linkedin.com/in/huffaker/

👉 Planet DDS: https://planetdds.com/

👉 Thomas Terronez:  https://www.linkedin.com/in/thomas-terronez-9371104/

You can also listen to our podcast here:

👉 Apple Podcast: https://shorturl.at/ikORx

👉 Spotify: https://shorturl.at/SMInC

Want to be a guest on The Dental Economist Show?

If you’re a growth-focused leader in the dental business world or someone shaping its future through technology, consulting, or innovation, we’d love to hear from you.

Whether you’re leading a DSO, building the next generation of dental technology, or helping redefine patient care, The Dental Economist Show is where the industry’s leading voices come together to discuss what’s next.

Why DSO Operators Are Being Blamed for a Problem They Didn't Create

Why has the DSO deal market stalled even as demand for dental care remains strong?

In this episode of The Dental Economist Show, host Mike Huffaker speaks with Kyle Welch, Associate Professor of Accountancy at the George Washington University School of Business, about the capital-market forces shaping private equity, DSO valuations, and the path to liquidity for dental entrepreneurs.

Kyle explains his central thesis: the current slowdown is not simply an operator-performance issue or a reflection of what is happening in the dental chair. It begins higher up the chain with how private equity is valued, how institutional investors allocate capital, and how rising rates have changed the economics behind acquisitions and exits.

Drawing on his experience at the Stanford University endowment and his research into private equity reporting, Kyle explores why private-market valuations can appear smoother than public markets, why secondary-market discounts matter, and why the capital that once fueled DSO consolidation has become more constrained.

The conversation also examines what comes next. Kyle and Mike discuss the pressure created by extended hold periods, the importance of retaining doctor partners, refinancing and debt restructuring, and why combining platforms and pursuing public-market liquidity may offer a more durable path forward for some dental organizations.

Episode chapters

00:00 The capital-markets problem behind the DSO slowdown

02:09 Kyle’s path from institutional investing to academia

03:32 Why private equity’s challenges matter to dentistry

06:49 The accounting “smoothing” effect in private equity

12:36 Secondary markets and the gap between reported and market value

15:13 Why this is a private-equity issue—not just a dental issue

20:00 Capital constraints, dry powder, and the liquidity freeze

26:50 The two priorities for DSOs: debt coverage and doctor retention

33:19 Restructuring debt and working with lenders

39:56 A potential path forward: consolidation and public-market exits

Connect with the team:

👉 Mike Huffaker on LinkedIn: https://www.linkedin.com/in/huffaker/

👉 Planet DDS: https://planetdds.com/

👉 Kyle Welch on LinkedIn: https://www.linkedin.com/in/ktwelch/

You can also listen to our podcast here:

👉 Apple Podcast: https://shorturl.at/ikORx

👉 Spotify: https://shorturl.at/SMInC

Want to be a guest on The Dental Economist Show?

If you’re a growth-focused leader in the dental business world or someone shaping its future through technology, consulting, or innovation, we’d love to hear from you.

Whether you’re leading a DSO, building the next generation of dental technology, or helping redefine patient care, The Dental Economist Show is where the industry’s leading voices come together to discuss what’s next.

What does it take to help clinicians deliver more consistent care, build confidence in the chair, and grow into effective leaders?

In this episode of The Dental Economist Show, host Mike Huffaker speaks with Dr. Shilpi Priyadarshini, Chief Dental Officer at the Dentist Entrepreneur Organization (DEO), about the clinical systems, mentorship, and communication practices that help dental organizations improve care at scale.

Dr. Shilpi reflects on her journey from practicing dentist to regional leader at Jefferson Dental and now clinical coach at DEO. She explains why dentistry does not have a standard-of-care problem as much as it has a systems problem—and why clear processes, mentorship, and regular clinical audits can help clinicians make better decisions for patients.

The conversation explores how radiographic AI can support more consistent diagnosis and patient communication, the importance of separating treatment planning from insurance benefits, and the role empathy plays in case acceptance. Dr. Shilpi also shares her “LIGER” framework for clinicians, practical approaches to coaching providers based on their strengths, and how better systems can reduce decision-making fatigue and burnout.

Episode chapters

00:00 From the chair to clinical leadership
08:33 Why dentistry has a systems problem
12:12 Repetitions, mentorship, and building clinical confidence
14:15 How radiographic AI improves patient communication
18:05 Creating a better patient experience from the first conversation
21:26 Treatment planning beyond insurance benefits
26:30 Coaching dentists and building customized mentorship pathways
33:07 The clinical systems leaders often miss
41:03 Decision-making fatigue, burnout, and operational clarity
43:59 AI as a tool—not a magic solution

Connect with the team:

👉 Mike Huffaker on LinkedIn: https://www.linkedin.com/in/huffaker/
👉 Planet DDS: https://planetdds.com/
👉  Dr. Shilpi Priyadarshini on LinkedIn: https://www.linkedin.com/in/shilpi-priyadarshini-8137831a8/
👉 DEO: The Dentist Entrepreneur Organization: http://www.deodentalgroup.com

You can also listen to our podcast here:

👉 Apple Podcast: https://shorturl.at/ikORx
👉 Spotify: https://shorturl.at/SMInC

Want to be a guest on The Dental Economist Show?

If you’re a growth-focused leader in the dental business world or someone shaping its future through technology, consulting, or innovation, we’d love to hear from you.

Whether you’re leading a DSO, building the next generation of dental technology, or helping redefine patient care, The Dental Economist Show is where the industry’s leading voices come together to discuss what’s next.

What does it take to build a dental organization that expands access for millions of patients while creating lasting opportunity for providers and teams?

In this episode of The Dental Economist Show, host Mike Huffaker speaks with Bob Fontana, Founder, Chairman and CEO of The Aspen Group, about the principles that have shaped Aspen Dental from a single practice in East Syracuse into a multi-brand consumer healthcare platform.

Bob shares the founding idea behind Aspen Dental: becoming a “yes” organization in a market where patients too often encounter barriers around cost, access, convenience, insurance, scheduling and financing. He explains why a deep understanding of the consumer—particularly working-class and middle-America patients—must inform everything from location strategy and affordability to the patient journey and on-site capabilities.

The conversation also explores the operating model behind long-term scale. Bob discusses why a national brand creates both patient demand and accountability, why provider alignment and practice ownership have been fundamental to Aspen’s success, and why learning and development cannot be treated as an HR add-on. He also reflects on the evolution of his own leadership, the role of culture in helping thousands of people make good decisions at scale, the synergies across TAG’s healthcare brands, and why the next generation of DSOs must add real value for patients and providers.

Episode chapters

00:00 Building a “yes” organization

04:17 The barriers to dental care: cost, access and convenience

08:32 Why a national dental brand matters

12:36 Provider alignment and the practice ownership model

18:21 TAG University and investing in people

27:18 Evolving as a leader while the organization scales

31:15 Culture as a distributed decision-making system

32:11 The multi-brand consumer healthcare platform

37:57 The founder-led advantage and passionate discontent

43:13 Building better DSOs and giving back to dentistry

Connect with the team:

👉 Mike Huffaker on LinkedIn: https://www.linkedin.com/in/huffaker/

👉 Planet DDS: https://planetdds.com/

👉 Bob Fontana on LinkedIn: https://www.linkedin.com/in/bob-fontana/

👉 The Aspen Groupl: https://www.teamtag.com/

You can also listen to our podcast here:

👉 Apple Podcast: https://shorturl.at/ikORx

👉 Spotify: https://shorturl.at/SMInC

Want to be a guest on The Dental Economist Show?

If you’re a growth-focused leader in the dental business world or someone shaping its future through technology, consulting, or innovation, we’d love to hear from you.

Whether you’re leading a DSO, building the next generation of dental technology, or helping redefine patient care, The Dental Economist Show is where the industry’s leading voices come together to discuss what’s next.

What will separate the next generation of winning DSOs from the roll-up models of the past?

In this episode of The Dental Economist Show, host Mike Huffaker speaks with Chris Moxon, Managing Director and Partner at Boston Consulting Group, about the future of the dental market, DSO consolidation, and the operational foundations required for sustainable growth.

Chris shares BCG’s data-led perspective on why dentistry remains a compelling market: resilient underlying demand, a significant number of patients still outside the care system, and growing recognition of the connection between oral and overall health. He explains how preventative care, salivary diagnostics, and better patient communication can improve treatment acceptance while creating better outcomes.

The conversation also explores the realities of consolidation. Chris explains why dental is unlikely to consolidate like pharmacy, why de novo growth depends on more than capital and real estate, and why strategic acquisitions need a clear clinical and operational rationale. He also discusses lender-controlled platforms, specialty growth, clinician incentives, and why the doctors with the greatest clinical autonomy may be working inside the best-run DSOs.

Episode chapters

00:00 Clinical autonomy inside well-run DSOs

00:17 Introduction

08:03 The case for growth in dentistry

15:10 The future of DSO consolidation and de novo growth

22:06 Strategic acquisitions, specialty, and lender-controlled platforms

35:02 The platform playbook: operations, incentives, and clinical autonomy

42:24 AI, treatment acceptance, and the connected patient journey

Connect with the team:

👉 Mike Huffaker on LinkedIn: https://www.linkedin.com/in/huffaker/

👉 Planet DDS: https://planetdds.com/

👉Chris Moxon on LinkedIn: https://www.linkedin.com/in/moxon/

👉 Boston Consulting Group: https://www.bcg.com/

You can also listen to our podcast here:

👉 Apple Podcast: https://shorturl.at/ikORx

👉 Spotify: https://shorturl.at/SMInC

Want to be a guest on The Dental Economist Show?

If you’re a growth-focused leader in the dental business world or someone shaping its future through technology, consulting, or innovation, we’d love to hear from you.

Whether you’re leading a DSO, building the next generation of dental technology, or helping redefine patient care, The Dental Economist Show is where the industry’s leading voices come together to discuss what’s next.

What separates a DSO that is ready for a successful capital event from one that is not?

In this episode of The Dental Economist Show, host Mike Huffaker speaks with David Murphy, Managing Director at Moelis & Company, about the M&A market, capital strategy, and what dental operators should be building today to maximize their options tomorrow.

David explains the role of an investment bank, when DSO leaders should begin building advisor relationships, and how to evaluate the right banking partner. He breaks down the trade-offs between debt and equity financing, why the dental M&A market is beginning to recover after a challenging period, and how higher—but more predictable—costs of capital are changing deal structures.

The conversation also explores what buyers look for in diligence: durable organic growth, clinician retention, accurate financial reporting, integrated technology, disciplined de novo performance, and high-quality EBITDA. David shares why well-integrated businesses with strong operational performance are positioned to take market share, why specialty platforms continue to command a premium, and how AI could become a major growth and margin opportunity for dental organizations.

Connect with the team:

👉 Mike Huffaker on LinkedIn: https://www.linkedin.com/in/huffaker/
👉 Planet DDS: https://planetdds.com/

👉 David Murphy on LinkedIn https://www.linkedin.com/in/david-murphy-a7841462/
👉 Moelis & Company: https://www.moelis.com/

You can also listen to our podcast here:

👉 Apple Podcast: https://shorturl.at/ikORx
👉 Spotify: https://shorturl.at/SMInC

Want to be a guest on The Dental Economist Show?

If you’re a growth-focused leader in the dental business world or someone shaping its future through technology, consulting, or innovation, we’d love to hear from you.

Whether you’re leading a DSO, building the next generation of dental technology, or helping redefine patient care, The Dental Economist Show is where the industry’s leading voices come together to discuss what’s next.

What happens when a state dental board introduces rules that could fundamentally change how DSOs support dental practices?

In this special breaking-news episode of The Dental Economist Show, host Mike Huffaker speaks with Andrew Smith, CEO of the Association of Dental Support Organizations (ADSO), and Steve Bilt, Co-Founder and CEO of Smile Brands, about Colorado’s newly adopted dental-board rules and the ADSO’s legal challenge.

The conversation explores the practical effect of restrictions on DSO-held leases and clinical equipment, as well as the potential disciplinary exposure for dentists whose arrangements are deemed noncompliant. Andrew and Steve explain why they believe the rules exceed the dental board’s authority and could create serious financial burdens for dentists already operating under established support arrangements.

They also discuss the wider implications for patient access, affordability, Medicaid participation, clinical autonomy, capital investment, and the future of the DSO model nationwide. With the rules scheduled to take effect in January 2027, the episode examines the legal and legislative paths ahead—and why every DSO operator should be paying attention.

Connect with the team:

👉 Mike Huffaker on LinkedIn: https://www.linkedin.com/in/huffaker/
👉 Planet DDS: https://planetdds.com/

👉 Andrew Smith on LinkedIn: https://www.linkedin.com/in/andrewmulherinsmith/
👉 Association of Dental Support Organizations: https://theadso.org/

👉 Steve Bilt on LinkedIn: https://www.linkedin.com/in/steve-bilt-782835b/
👉 Smile Brands: https://www.smilebrands.com/

Want to be a guest on The Dental Economist Show?

If you’re a growth-focused leader in the dental business world or someone shaping its future through technology, consulting, or innovation, we’d love to hear from you.

Whether you’re leading a DSO, building the next generation of dental technology, or helping redefine patient care, The Dental Economist Show is where the industry’s leading voices come together to discuss what’s next.