Why 2026 May Be the Year to Monetize

Dentists planning to monetize their practice value either in a traditional transition, or via an invisible dental support organization (IDSO) partnership in 2026, pay attention to patient stress levels. Values of all practices are dictated by collections growth rate. A growing practice will achieve the highest value; a shrinking practice may have a much lower or no value at all. The key to value is growth. If the consumer economy enters troubled times, your practice value will be impacted. Food, rent, car payments, and credit card bills often take priority over elective dental care. Are you prepared for a drop in collections and the impact on your practice value both now and in the future? Smart business owners and investors sell into rallies, not dips. Some recent statistics to consider regarding 2026 consumer stress:

• Gold, the Global Fear Gauge: Up 65% in 2025, YTD 2026: Up 16%
• Delinquency Rates on Consumer Debt: 4.8%, highest since 2017
• 90+ Day Delinquency on Credit Card Debt: 12.7%, highest since 2011
• Retail Sales in 2025: Flat with 2024, inflation adjusted
• Michigan Consumer Sentiment Index: Jan 2026, lowest level in 10 years
• American Dental Association Survey of Dentist Confidence: Declined 34.3% in 2025
• New Job Creation in 2025: 180,000 jobs, worst since 2003

Your practice is one of your largest investments and, as of today, the economy is not yet officially in a dip. Should you consider monetizing a part of your practice value today while you are still growing?

If collections in your practice decline in 2026, you become ineligible for a high-value IDSO partnership until you deliver at least two quarters of growth. IDSOs are the highest value monetization strategy for practices with at least $1.5+ million in collections. There will be no interest in your practice if it is shrinking. Conversely, if you are growing at double-digit rates, your value will increase.

In a traditional doctor-to-doctor transition, values are often about 70% of collections. In an IDSO partnership, values often exceed 200% of collections, and for some Large Practice Sales clients, over 300% of collections. Practice values in an IDSO partnership are based on profitability and growth rate.

In a traditional transition, the retiring doctor will stay for a short period of time. In an IDSO partnership, the highest values are achieved for doctors with a 5 year or longer horizon to continue leading their practice. Timing your IDSO partnership is critical for value. If dentists choose their IDSO partner wisely, they will have FULL autonomy and continue to make both the clinical and business decisions in their practice.

But choosing an IDSO partner wisely is becoming more difficult. There are more than 1,000 IDSOs in the US, some over 35 years old and a few with 800+ practice partners each. However, LPS considers only about 100 of them qualified to bid on clients. More IDSOs are under stress than ever before. Fortunately, several of the IDSOs have recently completed recapitalizations in which doctors experienced 500+% increases in the value of retained ownership in 5 years or less.

All dentists should honestly assess their growth risk for 2026 and become educated on the record values in an IDSO partnership today. The IDSOs are growing rapidly. You will ultimately partner with one, or compete with many. Their size gives them leverage on both costs and reimbursement rates that you cannot compete with over time. The Boy Scout motto says it all, “Be prepared”!

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From Decisions in Dentistry. February/March 2026;12(1):27.