How to Scale and Add Locations with Dr. Hendrik Lai
Weave
As DSOs scale from mid-market to regional entities with 50 or more practices, operational excellence and same-store growth have become critical drivers of success.
But growth isn’t without challenges. Reduced insurance reimbursements, increased competition from large-scale acquisitions, and a higher cost of capital have shifted the landscape. Where once EBITDA aggregators relied on endless acquisitions, today the path forward is sustainable same-store sales growth within existing portfolios.
📈 Key challenges for scaling DSOs:
-Reduced payments from insurance companies
-Competition from large DSOs acquiring smaller groups
-Rising cost of capital limiting acquisition-based growth
-Greater need for operational efficiency at scale
-Focus on driving same-store sales growth
💬 “The only way to really grow now is through same-store sales growth within the portfolio of companies.”
For DSOs, scaling in today’s environment means sharpening operations, optimizing existing practices, and creating efficiency that fuels long-term, sustainable growth.
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VideoSeptember 2025





