GuidesThe Ultimate Business Guide For Orthodontists

Chapter 23: Beware of Selling to a DSO

Marketing Implosion: Why DSOs Fail at Advertising

Marketing Implosion: Why DSOs Fail at Advertising

One of the biggest disasters of selling to a DSO is how they handle marketing. DSOs tend to centralize marketing with a small team that manages hundreds of offices at once. This results in:

1. A One-Size-Fits-All Approach

Most DSOs apply the same marketing strategies across all locations, regardless of differences in demographics, income levels, or local competition.

  • What works in New York or Los Angeles won’t work in a smaller market like Ohio or Nebraska.

  • Instead of customizing strategies for each location, they push generic campaigns that fail to produce results.

  • 2. Major Billing & Payment Issues

    Many DSOs don’t properly manage ad spend or even pay for marketing services on time.

  • I’ve personally seen DSOs fail to pay their credit card bills for months, leading to their social media ads getting shut off.

  • When 80% of your new starts come from paid social ads, this is a massive wake-up call.

  • No marketing means fewer leads, fewer starts, and a serious decline in revenue—but the DSO still expects you to hit growth targets.

  • DSOs cut corners in marketing to save money, but in reality, this short-sighted approach cripples their ability to drive new patient flow.