Hackensack, N.J.-based Max Surgical Specialty Management is leveraging its industry partnerships and surgeon network to continue growing its network and supporting members.
The oral surgery-focused MSO recently hit 25 practice locations after expanding its surgeon network by nearly 60% in 2024.
Co-CEO Mark Censoprano recently spoke with Becker's about the company's growth this year, its goals for 2025 and the challenges facing DSOs.
Editor's note: Responses were lightly edited for length and clarity.
Question: What would you say are the proudest accomplishments for the company in 2024?
Mark Censoprano: If you look at the quality of the surgeons who have joined the organization, [they are] absolutely unequivocally, best-in-class, top notch clinicians as well as human beings. We had our first-ever all surgeons meeting in October, and if you could have been a fly on the wall, you would have been amazed — folks who have never met each other before, the instant camaraderie they had and the instant relationships that were formed, and it's more than they're just in the same industry and practicing oral surgery. You can tell immediately that there are shared values, and that folks genuinely liked each other, and it was wonderful to see. So that's one of the points of pride. We now officially have 26 practices. We have 37 surgeons. We have north of 300 team members, and if you rewind [to] back in January before we started 2024, we've grown quite a bit since then.
Q: What kind of challenges did the company have to overcome this year to ensure its growth and success, and how did you overcome those?
MC: There are organizations that are 10 times our size that are out there. They've had more runway to build all of their support processes and systems. The nice thing about joining this organization when I did is that I'm early enough to be able to influence how important our mission, vision and values are to us. So that's one of the very first things we did. [It's] really important to set the direction for the organization in terms of what we stand for. Why are we here? Why do we get up every day? Why do we do what we do? If you read our mission, it's the passion that we support and serve our surgeons in their delivery of the optimal patient experience each and every time. That is absolutely and unequivocally the single most important guiding principle in the organization, and helping the organization to understand that and to live it every single day, that's one of those challenges over the past year that we've had, to make sure that's the guiding way. I've worked for two Fortune top 100 companies to work for. We're doing a mission, vision and values workshop next week. I'm using this at the workshop to tell people, trust me, it doesn't matter how big our family grows, you can still be a great and wonderful organization [and] have a really strong culture because I worked for two of them that have tens of thousands, if not hundreds of thousands of team members. It's just a dedication to that mission, vision and values every single minute of every single day that helps you to make sure you're walking the talk.
[The second challenge] is scaling. We're still a young and smaller organization. We have to build best practices. We have to build the strongest systems, and we talked to our surgeon partners about this all the time ... If you didn't want to join an organization that was still building, then feel free to join an organization [where] you're just another number, and you join and everything is up and running, but it's part of the fun right now to join an organization where our surgeons' voices matter. So, we are working together to build what best in class looks like, and it's been fun.
Q: What are the primary goals for the organization in 2025?
MC: Number one [is the] highest level of employee and surgeon engagement as always, and that stems back to, are we doing a great job living our mission, vision and values. Number two, we have to continue to passionately support and serve with our mission, and by passionately supporting and serving, allow our surgeons to be as productive as possible. They want to grow. We have to make sure we have the support systems in place that allow them to grow. Then, number three, can we find and partner with amazing new family members, new surgeons who can join the Max family, who would be wonderful cultural fits [and] wonderful fits from a level of eliteness of the surgery.
Q: What do you predict the greatest challenges to be for DSOs next year?
MC: I think [the biggest challenge] first and foremost will be talent acquisition and retention. There are a lot of options that the strong and talented surgeons have, so if you're not a winning proposition, it's a battle for talent. There aren't that many oral surgeons who are graduating from programs each year, and there are a lot of folks who would love to have them be a part of their team. So, you just have to be an organization that folks truly understand that that's a great choice for their career to join.
If you think about rising cost structure and the inflationary environment we're living in right now, if you are running your own business, if you're not thinking about how you're going to offset rising costs, it's going to eat away at your performance as an organization, and that's challenging. If you think about what's happening right now, whether you want to say that the inflationary environment is starting to subside, if you look at what costs are generally doing for occupancy, for utilities or labor rates or supplies, go down the list. All these costs are rising at unprecedented levels we haven't seen in a very long time as a country. If you don't have scale, if you don't have the support structure in place to be able to look at every one of these expense categories and figure out, if all of our supply costs are going up, how can we leverage our size and scale as an organization to offset that? At Max, we want people to partner with us who want to bet on us for the future and who are willing to help us to control those costs. Every one of our vendor partners, we go out to them — doesn't matter what the line is in the [profit and loss statement] — and we say, "Hey, we would love for you to truly be a partner of ours and figure out how to control these costs," and the folks who buy into what Max is doing and where we're heading will come forward and say, "We want to hook our wagon up to you," and we've had some amazing partners who have stepped forward and have done that for us. That's really helped us to manage our performance as an organization while costs are rising elsewhere.
Q: What trends are you following right now in dentistry?
MC: I think about [artificial intelligence] and its application to different parts of the business. The second is probably what will happen with recapitalizations in the DSO space moving forward because there have been a couple of organizations that have announced recapitalizations after a long drought. What's going to happen? Is the interest rate environment going to remain high, and are those exits going to be maybe at less than desirable multiples moving forward? We don't know. Will folks want to exit if the multiples are still not at the levels where the organizations expected them to be? We're all kind of hoping that the interest rate environment improves because if the cost of capital goes down, then the valuations of the companies go up, and multiples hopefully will start returning back to a place that everybody I think is rooting for.