How do dental practice owners separate empty corporate promises from stable, long-term growth? In this episode of The Dental Economist Show, host Mike Huffaker sits down with Keith Miller, President and COO of Partnerships for Dentists (P4D), to unpack the operational discipline required to build a truly sustainable DSO model. Drawing on his extensive background in high-stakes retail operations at Aldi, Keith explains why transparency and structural consistency are essential for long-term clinical and financial success. The conversation dives deep into the realities of modern DSO integration, detailing how P4D achieves an impressive average EBITDA increase of 30% in year one through non-invasive yet disciplined cost management. Keith sheds light on the hidden pitfalls of over-leveraged acquisitions, why dental practice buyers must look directly at a partner's financial health, and how to effectively navigate internal resistance when transitioning to automated client systems. This episode provides an invaluable framework for any dentist looking to navigate dental support organizations without compromising their clinical autonomy. #dentaleconomist #dsoleadership #dentaloperations If you enjoyed this episode, make sure to subscribe, like, and comment📱