CLIENT
DSO · SOUTHEAST · PARTNER-EQUITY
NAME · ██████████████
ADMITTED
13 JAN 2023
DISCHARGED
08 NOV 2025
ATTENDING
Admen partners
RECORD № 0214 — UNSEALED
Partner-equity roll-out, 24 to 42 locations
Partner-equity, six regions, nine owners — so the programme covered the sixteen locations whose partners bought in, not the ones we would have picked, which is the constraint partner-equity roll-ups impose on every programme run inside them. 24 → 42 locations. Same-store new patients 34 → 41 a month over thirty-four months; all-in 34 → 37, because eighteen of the forty-two were immature at discharge. Cost per new patient improved same-store and rose all-in, and collections per new patient fell.
Exhibit A · The record, in motion
Five plates · 2:01 · every figure below is on the record
Locations at admission
24locations
Presenting complaint
34
New patients · per location · per month
Industry average is 39. This group arrived at 34, and stalled.
Where 34 actually sits
Planet DDS 2026 · n = 8,500+ practices · monthly new patients per practice
Two-fifths of the market books fewer than twenty a month. The distance from 34 to 41 is one band on a published curve — not a transformation.
SOURCE. Planet DDS — 2026 Dental Industry Outlook: Deep Dive, n = 8,500+ practices. Henry Schein One — 2026 Catalyst Index: industry average 39, "strong" band 45–65, top decile 82.
RECORD № 0214 · PLATE I
ADMITTED 13 JAN 2023
Locations inside the acquisition programme
Each circle is one location · 42 total at discharge
16 / 42
There is no head office that can order a media budget into a region. Sixteen of forty-two is not a scope we set — it is the number of partners who said yes.
two of the three who declined were right —
already at chair capacity
NOT A CORPORATE CHAIN. Nine partners hold equity across six regions; each region carries its own P&L. Intake instrumentation and reporting went company-wide — measurement is a shared cost line. Media money is regional, and regional money votes.
RECORD № 0214 · PLATE II
16 OF 42 · ADOPTION
No percentage is published for the ranking problem, because no honest one exists. This one we measured — two calls, per location, per month.
2 × 24 locations × 12 months = 576
576 × $887 = $510,912
SOURCE. AHRQ MEPS — Statistical Brief #555: mean annual dental expenditure per person with a dental expense, $887. Unbooked calls counted at call level on the group’s own instrumentation, across the 24 locations held at admission.
RECORD № 0214 · PLATE III
$510,912 / YEAR
Same staffing. Same chairs. A 7.1× spread in production between the best pod and the worst. MGMA publishes the analogue across 141 multispecialty groups: $250K–$1.8M revenue per FTE physician at comparable staffing.
Programme cohort · 16 locations
7.1× → 4.2×
All 42 locations
7.1× → 5.2×
The new sites stayed outliers. They had to.
SOURCE. MGMA DataDive — Financials & Operations, 141 multispecialty groups: revenue per FTE physician $250K–$1.8M at comparable staffing, ≈7×. A published analogue for the 7.1× measured here — not the same measure.
RECORD № 0214 · PLATE IV
7.1× → 4.2× / 5.2×
Programme cohort
34 → 41 +20.6%
All locations, blended
34 → 37 +8.8%
Eighteen of forty-two were immature at discharge. Twelve de novo.
Against us
Client: ██████████████ — names stay sealed, and so do voices. What is published is the arithmetic, and the source under every figure.
Admen '25
NO ACQUISITION-COST BENCHMARK EXISTS for general dentistry. Cost per new patient is the group’s own instrumented spend over its own counted new patients, and is compared to nothing published.
RECORD № 0214 · PLATE V
DISCHARGED 08 NOV 2025
Transcript · the narration, in full
I · Intake
24 locations, 34 new patients per location per month. The industry average is 39. On the published curve, two fifths of the market books fewer than 20 a month. So 34 is not a disaster. It's a stall.
II · The vote
This was not a corporate chain. Nine partners held equity across six regions, and every region carried its own P&L. There is no head office that can order a media budget into a region. Three regions bought in, 16 of 42 locations. That is an adoption number, not a scope we chose. And two of the regions that declined were right to.
III · The leak
What we could measure, we measured. Two qualified new patient calls per location per month died unbooked. Two times 24 locations times 12 months. 576 patients a year. At the federal mean of $887 a head. About $511,000 walking back out the front door.
IV · Dispersion
The finding that mattered wasn't marketing. Identically staffed pods produced at a 7.1 times spread. In the cohort, we closed it to 4.2. Across all 42, only to 5.2. The new sites stayed outliers. They had to.
V · Discharge
34 to 41 in the programme cohort, 34 to 37 blended because 18 of the 42 were immature at discharge. Against us, cost per new patient rose all-in and collections per new patient fell 6.6%. Both are true, and the gap is the story. The name stays sealed. The arithmetic doesn't.
NATURE OF THE ENGAGEMENT
What the group came to us with
T he group came to us at 24 locations and stalled: 34 new patients per location per month, against an industry average of 39. What follows took thirty-four months, and the headline movement is a 21% same-store gain — real, and roughly what this work produces when it goes well. It is not a doubling. Groups that double new-patient volume in a year exist and we have seen a handful; in every case the constraint that broke was chair capacity, not marketing, and the practice had the operatories to absorb it. This one did not, and pretending otherwise would misdescribe both the engagement and the trade. They finished at 42 locations, and eighteen of those forty-two were opened during the engagement — twelve of them de novo, six in towns where the brand had never traded. Nor was the same work done everywhere, and the reason is ownership rather than clinical judgement. This is not a corporate chain. It is partner-equity: nine partners holding equity across six regions, each region carrying its own P&L. There is no head office that can order a media budget into a region. There is only a case you make to nine people who each own their own outcome, and who each get to say no. So the sixteen of forty-two locations in the acquisition programme is not a scope we set. It is an adoption number — three regions bought in at the start, covering sixteen locations, and the others watched. Reporting that as though we had chosen the sites would flatter us and misdescribe the engagement. Two of the regions that declined were right to decline: several of their sites were already running at or near chair capacity, where additional spend buys demand the schedule cannot absorb and the only result is a worse cost per patient. What the holding company could mandate, it did — intake instrumentation and reporting went company-wide, because measurement is a shared service on a shared cost line while media is regional money. That split is the governance story in one sentence, and it decided more about this engagement than any campaign did. Two markets ran as tests for eleven weeks before anything was rolled outward. So the figures below carry two different populations, and mixing them would be the easiest way to overstate this engagement. That segmentation matters more than anything else on this page, so it is stated first rather than buried: every blended per-location figure below is dragged down by immature sites, and that drag is mechanical, not a failure. National Vision, which files its ramp publicly, targets a new store at 55% of year-five sales in its first full year and reaches profitability in year two. A group that adds eighteen locations in thirty-four months and shows no blended decline is describing something that does not happen. How far underwater the twelve de novo sites finish is not something this record will state, because we do not know it and we have not seen a number worth printing from anyone who claims to. It depends on things that vary far more than the average does: catchment density, the operator running the site, whether the region carried any brand recognition before the doors opened, how consolidated the local competition already was, and what media cost in that market in the month it launched. The filed National Vision curve is the only external anchor we will put near it, and that describes a chain of optical stores rather than a dental practice — it bounds the shape of the ramp, not its depth. Anyone who quotes a single de novo payback figure across markets is quoting an average that no individual site will actually experience.
OBJECTIVE — INTAKE
What we found
Their hub domain was outranking its own location pages on the queries that mattered — we never put a percentage on that, because no honest one exists. The front-desk leak we did measure. Roughly two qualified new-patient calls per location per month died unbooked; 2 × 24 locations × 12 months = 576 patients a year, valued at the $887 MEPS mean annual dental expenditure per person with a dental expense. About $511,000, and the arithmetic is the whole claim.
THE OPERATION
What we changed, and in what order
We spent six weeks inside their ops. We rebuilt the location template, instrumented intake to the call rather than the form, and mapped paid pressure to local demand curves market by market. We didn't change their brand. We didn't have to. The finding that paid for the engagement was dispersion: a 7.1× production spread between pods running identical staffing — the same pathology MGMA measures across 141 multispecialty groups, where total medical revenue per FTE physician runs from $250K to $1.8M at comparable staffing levels.
POST-OP VITALS
What moved, and how it was measured
By month 30 new patients per location had reached 41 a month — above the 39 industry average on Henry Schein One's scale, still short of the 45 where its strong band begins, and a long way short of the 82 that marks the top decile. Cost per new patient is their own instrumented number, their spend over their own counted new patients: general dentistry publishes no acquisition-cost benchmark at all, and we do not pretend otherwise. It read $268 at intake and $235 at exit same-store, against $292 all-in. The banker was engaged in month 31.
AGAINST US
What did not work, or moved the wrong way
What did not improve: cost per new patient rose all-in, $268 to $292. Same-store it fell only to $235. Nor did collections per new patient across the first twelve months, which fell 6.6% from $1,040 to $971 — the volume that arrived was less established and carried more payer discount than the base it joined, and that is the standing cost of buying growth rather than the exception to it. Both are true and the gap is the story — twelve de novo markets with no brand equity cost more to enter than an established catchment does to defend, and they were entered across thirty-four months of rising media prices. Case acceptance improved less than the same-store new-patient gain would suggest — 44% to 47%, not the 53%-plus a 21% volume gain might imply — and for a reason worth naming: a larger share of first visits were unestablished patients, and unestablished patients accept less treatment. Volume and acceptance pull against each other, and any record showing both rising in lockstep is not reporting from a practice management system. Production variance closed to 4.2× among the mature pods and only to 5.2× across all forty-two, because the new sites are now the outliers the mature ones used to be. The market mattered too. This was not an open catchment: it is a Sun Belt corridor with active DSO and PE-backed consolidation, and holding position there costs more than the same work would cost in a market without sophisticated competitors.
LIMITS OF THE RECORD
What this record does not prove
No client is quoted on this page, or on any case record. Names stay sealed and so do voices. What is published instead is the arithmetic, and the source under every figure.
VITALS — INTAKE vs DISCHARGE
| MEASURE | DAY 0 | DAY 1030 | Δ |
|---|---|---|---|
| Locations | 24 | 42 | +75.0% |
| Ownership | 9 partners · 6 regions | 9 partners · 6 regions | partner-equity |
| Regions that bought into the programme | — | 3 of 6 | adoption |
| In the acquisition programme | — | 16 of 42 | adoption, not scope |
| Opened during engagement — de novo | — | 12 of 18 | ramp drag |
| New patients / loc / mo — programme cohort | 34 | 41 | +20.6% |
| New patients / loc / mo — all locations | 34 | 37 | +8.8% |
| Case acceptance — group-wide | 44% | 47% | +3.0 pts |
| New-patient wait, days | 21 | 18 | −14.3% |
| Patient retention, 8+ loc | 57% | 61% | +4.0 pts |
| Production variance — programme cohort | 7.1× | 4.2× | −40.8% |
| Production variance — all locations | 7.1× | 5.2× | −26.8% |
| Cost / new patient — programme cohort | $268 | $235 | −12.3% |
| Cost / new patient — all-in AGAINST US | $268 | $292 | +9.0% |
| Collections per new patient, first 12 mo AGAINST US | $1,040 | $971 | −6.6% |
| EBITDA multiple, modelled | 8.4× | 8.7× | +3.6% |
Client retained Admen on quarterly review post-exit. Two follow-up engagements with sister portfolio companies referred since.
SOURCES — REFERENCE DISTRIBUTIONS
- 1. Henry Schein One — 2026 Catalyst Index — New patients/location/month: industry average 39, top 10% 82 (45–65 = "strong"). Case acceptance 45% average / 75% top 10%. Retention, 8+ locations, 58% average / 90% top 10%. Appointment lead time 23 days average / ~7 days top performers.
- 2. Planet DDS — 2026 Dental Industry Outlook: Deep Dive (n = 8,500+ practices) — Distribution of monthly new patients per practice — 0–19: 38.8% · 20–39: 19.0% · 40–59: 14.9% · 60–79: 9.5% · 80+: 17.7%. An intake of 34 and an outcome of 41 sit inside the same published curve, one band apart — 20–39 to 40–59.
- 3. ADA Health Policy Institute — 2026 Survey of Dental Practice, Table 22 — Average wait for an initial appointment, new patient, general practitioners: 16.0 days (2025).
- 4. AHRQ MEPS — Statistical Brief #555 — Mean annual dental expenditure per person with a dental expense: $887. The only federal per-patient dental spend series, and the input to the $511,000 front-desk figure above.
- 5. MGMA DataDive — Financials & Operations (141 multispecialty groups) — Total medical revenue per FTE physician ranges $250K–$1.8M at comparable staffing — a ~7× spread, the published analogue for the 7.1× pod dispersion measured here.
- 6. Brian Colao, Dykema DSO Industry Group — via Group Dentistry Now — Two bands are published and only two: individual practices and add-ons at 5–6× EBITDA, and larger DSO platforms at 9–10×, down from 13–16× at the peak. No band is published for a group of this size, which sits between them — so the modelled 8.7× exit is placed at the conservative edge of the platform range and is a model, not a comparable.
- 7. No acquisition-cost benchmark exists for general dentistry — ADA HPI Table 13 aggregates all practice expenses and never breaks out advertising. The cost-per-new-patient row above is this client's own instrumented figure — their spend over their own counted new patients — and is not comparable to any published industry number, because there is none.
FILED BY
Admen '25