Joel Idelson
CEO, Image Specialty Partners
I recently joined Image Specialty Partners as CEO—and like any new chapter, it gave me space to reflect.
Specifically, on how private equity’s involvement in a DSO can be a powerful engine for growth without sacrificing what makes each practice special. It pushed me to think deeper about how we scale while protecting culture, honoring clinical autonomy, and staying true to the reasons we acquire practices in the first place.
In the DSO world, the phrase you hear most often after an acquisition is: “Just don’t turn this into corporate dentistry.”
And I get it. That fear doesn’t come from nowhere. It usually stems from the idea that growth means losing identity, losing autonomy, or turning a thriving practice into a factory. But that doesn’t have to be the case. In fact, great platforms should protect the magic that made a practice worth acquiring in the first place.
At Image Specialty Partners, that’s the approach. Each practice keeps its name, its voice, its leadership, and its culture. But we also know that staying still is not an option. Just because a practice has been successful doesn’t mean it can’t evolve.
- Practices need to grow.
- They need to adapt.
- And yes—they need to be profitable.
That doesn’t make them “corporate.” That makes them sustainable.
Let’s be honest: when a doctor sells their practice to a platform, some things will change. They have to. And they should. That doesn’t mean we lose what made the practice special—it means we improve what can be better.
Oftentimes, the operational playbook a platform brings to the table is more efficient, more scalable, and more patient-focused than what a practice is used to. That doesn’t mean everything changes—but it does mean we need to be open to doing things better.
That’s not a threat to clinical care. That’s growth. That’s evolution. And as humans, we need to evolve. It keeps us young, vibrant, and curious. This applies to business as well.
Exceeding the standard of care should go without saying. But exceeding the standard of operations shouldn’t be taboo either.
If executed properly, operational excellence doesn’t mean red tape—it means support. It means simplifying workflows. It means giving our teams the tools to succeed and visibility into how they’re performing. It means getting the right data into the right hands so teams feel empowered—not micromanaged.
Here’s something else we don’t talk about enough: Doctors often want to focus only on clinical—and they should. But they also need to stay connected to the operations and financial health of the business. Office staff need to feel that same accountability. Everyone involved in the practice should be accountable for the success of the practice.
That’s why I believe so strongly in doctor partnership—whether at the practice level or the HoldCo level. When a provider is genuinely invested in the success of the business, emotionally or financially, their mindset shifts. They think long-term. They lean in. They care in a different way.
We have to stop acting like growth and culture are at odds. They’re not. The best platforms build both. They honor the past while pushing toward a smarter future. They don’t corporatize—they optimize.
If we’re not open to learning, changing, and evolving—then what’s the point?
Let’s lead. Let’s learn. Let’s grow. And let’s build DSOs that don’t just scale—but inspire.