Dr. Michael Durbin bought his first practice in 1990 with about $15,000 in student debt, from a faculty mentor. A resident today can finish owing more than $500,000, and many of the practices they'd want are already owned by OSOs and DSOs. The sitting president of the American Association of Orthodontists joins host Dr. Michael Jerkins with an unusually complete view of that shift: he has been an owner, an associate, and a corporate doctor, worked alongside pediatric and general dentists, and eventually sold his practice to his son and stayed on as an associate.

From there, it gets practical. Mentorship doesn't come standard, so ask for it by name before you sign. Startups are back on the table precisely because acquisitions often aren't. A practice running two days a week is a practice worth filling, not a gap to plug with associate work elsewhere, and that's the one thing he'd do differently. The new loan caps are the open question, and the person most exposed is the resident with dental school debt and no cosigner. AI, meanwhile, is already in the building: diagnosis, treatment planning, and the front desk. The AAO's rule is "human in command," meaning the software suggests, and the doctor decides. And the part nobody puts in the sales pitch is that a tool can move work rather than remove it.

Would he buy a practice again at today's valuations? Is corporate consolidation still climbing? Why should nine states requiring an in-person exam matter to a doctor practicing in the other forty-one, and what exactly is "vocation insurance"? Tune in for an honest look at what ownership asks of you now, from someone who has tried nearly every version of it.