"You've built the operating model.
So why isn't EBITDA moving?"
Where Clinical Leadership Meets EBITDA
Most DSOs & PE-backed DSOs don't have a strategy problem.
They have a translation problem.
The value creation plan is built. The operating model is in place. The reporting infrastructure exists. And the EBITDA still isn't moving — not the way the model said it would.
The gap isn't in the financials. It's in the eighteen inches between the boardroom and the operatory.
DSO Executives & PE operating partners are trained to read financial performance and identify operational inefficiency. Clinical leaders understand what drives provider behavior, patient retention, and team performance. But in most PE-backed DSOs, those two capabilities never fully connect — and the gap between them compounds quietly, quarter after quarter, in hygiene performance, in associate engagement, and in the kind of clinical culture that either supports a multiple or erodes it.
That translation gap is what I've spent 20 years learning to close.
“The EBITDA is already in your portfolio. The gap between the boardroom and the operatory is where it's being left.”
— Heidi Arndt
For PE Operating Partners
Your value creation plan has clinical KPIs. What it may not have is someone who can close the gap between those targets and the clinical behavior that delivers them.
I work with PE operating partners on the clinical execution layer — hygiene performance, associate retention, and the cultural alignment between financial goals and provider teams — specifically during the hold period, when that gap is most expensive.
For DSO CEOs
Same-store growth is stalling. Your operating model is sound. But hygiene is underperforming, associate turnover is higher than it should be, and clinical culture isn't translating into the production numbers the board is watching.
I've been in your seat — as a PE-backed CEO who took a platform through a successful transaction. I know what it takes to close the gap from both sides of the table.
For CFOs & COOs
You can see the gap in the numbers. Hygiene productivity is inconsistent. Associate production varies in ways that don't fully track to comp structure. The root cause isn't financial — and the fix isn't either.
I connect the numbers you're seeing to the clinical execution variables driving them, and build the systems to close it.
I work with a small number of DSO executives and PE operating partners at a time.
If your platform is built but your margins aren't moving — and you're ready to have a different kind of conversation about why — I'd like to hear what you're seeing.