Todd Cruse & Alayna Brent on Scaling a Specialty DSO Without Breaking Culture
February 19, 2026
Chord Specialty Dental Partners is redefining what it means to scale a DSO without losing the human touch. In this episode of The Dental Economist Show, host Mike Huffaker sits down with CEO Todd Cruse and COO Alayna Brent to explore their powerful leadership philosophy: take care of your team and patients first, and economics will follow. From ripping out three PMS systems simultaneously to implementing a 60-day integration playbook, Todd and Alayna share the real-world strategies behind building transparency, driving change, and creating a culture where doctors actually go home at 5 PM. This conversation is a masterclass in operational excellence, people-first leadership, and what it truly takes to grow a specialty DSO that providers want to join.
Chord Specialty Dental Partners is redefining what it means to scale a DSO without losing the human touch. In this episode of The Dental Economist Show, host Mike Huffaker sits down with CEO Todd Cruse and COO Alayna Brent to explore their powerful leadership philosophy: take care of your team and patients first, and economics will follow. From ripping out three PMS systems simultaneously to implementing a 60-day integration playbook, Todd and Alayna share the real-world strategies behind building transparency, driving change, and creating a culture where doctors actually go home at 5 PM. This conversation is a masterclass in operational excellence, people-first leadership, and what it truly takes to grow a specialty DSO that providers want to join.
#dentaleconomist #dsoleadership #specialtydentistry
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Chapters:
00:00 Introduction & Meeting Todd Cruse and Alayna Brent
02:12 Joining Chord: The Three-Month Road Show Strategy
06:04 Culture Building: From Siloed Practices to Unified Teams
08:46 Major Change Initiatives: Software Conversions & Same-Day Treatment
11:48 Leading with Data: How to Handle Difficult Conversations
14:13 Looking Ahead: AI, Automation, and the 60-Day Integration Playbook
19:26 Adding Specialty Service Lines & Building the Complete Flywheel
24:03 Open Book Management: Financial Transparency at the Practice Level
27:19 M&A Red Flags: Chart Audits, Deferred Maintenance & Cultural Fit
31:27 The 60-Day Integration Playbook: Payroll, Presence, and Quick Wins
36:16 Why Dentistry's Future Is Bright: Access, Evolution, and Impact
Connect with the team:
👉 Mike Huffaker on LinkedIn: https://linkedin.com/in/huffaker/
👉 Todd Cruse on LinkedIn: https://linkedin.com/in/todd-r-cruse-944a2155/
👉 Alayna Brent on LinkedIn: https://linkedin.com/in/alayna-brent-36ab1b171/
👉 Chord Specialty Dental Partners Website: https://chordsdp.com/
👉 Planet DDS Website: https://planetdds.com/
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👉 Fame Host: https://bit.ly/4aQNQ51
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