Oral surgeons are sometimes called the fighter pilots of the dental industry because they are called in to solve the most difficult challenges of facial pain. It’s also not the most well-marketed industry, prompting a Charlotte-based startup to focus on assisting Southeast oral surgeons expand their businesses.
Flagship Specialty Partners started in late 2021 after two large North Carolina practices signed on as initial partners. Charlotte-based Carolinas Center for Oral and Facial Surgery has 22 offices in the Carolinas, while Asheville’s Rockcliff Oral and Facial Surgery has five. Since then, Flagship has signed on about 10 practices in the Southeast, employing more than 400 people, with plans to add a couple more annually in coming years.
“There’s a lot of innovation going in oral surgery,” says Jason Lockwood, who joined Flagship as CEO in September. “We’re treating real needs and helping real people live better, healthier lives.”
Flagship acts as a management services company that provides the back-office functions, freeing physicians to focus on their patients. Those services include marketing, recruiting, finance IT and facility support. Flagship also aids the practices by helping them bill and code medical services correctly so that patients receive maximum insurance benefits. “It’s a super important part of the services we provide,” Lockwood says.
The company is an alternative to private-equity companies, which have revolutionized U.S. medical care by taking stakes in physician practices over the past decade. It’s a controversial trend because some research suggests that prices often increase and the quality of care declines after the private-equity investment.
Studies at the University of California-Berkeley show private-equity firms controlled more than two-thirds of the market for anesthesiology and gastroenterology in 2021. Irving, Texas-based U.S. Oral Surgery Management is a dominant force in its sector with about 100 physician practices in the U.S. It is backed by New York-based Oak Hill Capital, a large PE group.
In contrast, Flagship is majority owned by their partner physicians, with the company’s revenue coming from its service agreements. It hasn’t taken on outside investors, Lockwood says.
He joined the company after working as a senior executive at some medical-oriented companies, most recently Denver-based Clear Choice Implant Centers, which focused on aiding practices that performed dental implants.
Many of Flagship’s 55 employees are medical-industry veterans, including business-development leaders Danny Ketola and DeeDee Katopadis, who were longtime executives of the Carolinas Center for Oral and Facial Surgery. In mid-2023, Blair Primis, the former marketing director of Charlotte-based OrthoCarolina, joined Flagship to lead marketing. The company’s mergers and acquisitions director is Andrew Gibson, a former healthcare investment banker.
Primis says he was drawn by the opportunity to raise public awareness of the company’s physicians. “A lot of oral surgery practices are pretty small and don’t have massive infrastructure,” he says. “It’s a really interesting space that is ready for more
rapid growth.”
Because oral surgeons have to be masters of both dentistry and surgery, the training requirements are among the most demanding of any medical specialty. Most serve at least four years in hospital-based residency programs. That serves as a barrier to entry, but also requires patience given the high cost
of medical school. There are about 7,500 oral surgeons in the U.S., compared with about 35,000 orthopedic physicians, Primis notes.
Elective cosmetic surgery makes up about 10% of the revenue of Flagship’s practices, but most of the emphasis is on pain management, including jaw surgery and cleft palates, Lockwood says.
“Oral surgeons can do amazing things,” Primis adds. ■
