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Oral surgeons are sometimes referred to as the fighter pilots of dentistry because they are called upon to solve the most difficult challenges of facial pain. It’s also a relatively under-market industry, which led the Charlotte-based startup to focus on helping oral surgeons in the Southeast grow their businesses.
Flagship Specialty Partners launched in late 2021 after two large North Carolina practices signed on as initial partners. Charlotte-based Carolina Orofacial Surgery Center has 22 offices in the Carolinas, and Rockcliff Orofacial Surgery in Asheville has five offices. Since then, Flagship has signed on approximately 10 locations in the Southeast, employing more than 400 people, and plans to add two more locations each year over the next few years.
“There’s a lot of innovation going on in oral surgery,” says Jason Lockwood, who joined Flagship as CEO in September. “We meet real needs and help real people live better, healthier lives.”
Flagship acts as a managed services company that provides back-office functionality, allowing physicians to focus on their patients. These services include marketing, recruitment, financial IT, and facilities support. Flagship also assists medical practices by assisting in the correct billing and coding of medical services to ensure patients receive maximum insurance benefits. “This is a very important part of the service we provide,” Lockwood said.
The company is an alternative to the private equity firms that revolutionized U.S. health care by taking stakes in doctors’ practices over the past decade. This trend is controversial, as some studies suggest that prices often rise and quality of care declines after private equity investments.
A study from the University of California, Berkeley shows that private equity firms controlled more than two-thirds of the anesthesiology and gastroenterology market in 2021. The American Oral Surgery Management Company, based in Irving, Texas, has about 100 physicians and is a dominant force in the field. In the US, it is backed by Oak Hill Capital, a large PE group based in New York.
By contrast, Flagship is majority-owned by its physician affiliates, and the company derives its revenue from service contracts. The company does not accept outside investors, Lockwood said.
He joins the company after working as a senior executive at several healthcare companies. He most recently founded Clear Choice Implant Centers, a Denver-based company focused on supporting clinics that perform dental implants.
Many of Flagship’s 55 employees are medical industry veterans, including business development leaders Danny Ketola and Dee Dee Katopadis, who served as longtime executives at Carolina Orofacial Surgery Center. In mid-2023, Blair Primis, former director of marketing at Charlotte-based OrthoCarolina, joined Flagship to lead marketing. The company’s M&A director is Andrew Gibson, a former healthcare investment banker.
Primis said he was drawn to the opportunity to raise public awareness of the company’s physicians. “Many oral surgery practices are very small and don’t have extensive infrastructure,” he says. “This is a really interesting space and has a lot of potential.”
rapid growth. “
Training requirements are among the most demanding of any specialty, as oral surgeons must master both dentistry and surgery. Most are hospital-based training programs where he works for at least four years.This acts as a barrier to entry, but also requires patience given the high costs
of the School of Medicine. There are about 35,000 orthopedic surgeons in the United States, compared to about 7,500 oral surgeons, Primis points out.
About 10% of Flagship’s practice’s revenue comes from elective cosmetic surgery, but much of that is focused on pain management, such as jaw surgery and cleft palate conditions, Lockwood said.
“Oral surgeons can do amazing things,” Primis added. ■
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