Management Services Organizations, or MSOs, are helping physicians and specialists grow their practices without giving up ownership. They offer administrative support, financial guidance, staffing, and more.. allowing providers to focus on what they do best.
But as MSOs grow, they often face a silent but serious challenge. The bigger the organization becomes, the harder it is to maintain alignment across locations. The problem is not in the structure. It is in the execution. And it almost always shows up in communication.
Here are five major struggles MSOs are facing right now.
1. Every practice has a different identity
One of the strengths of the MSO model is that it allows each clinic to maintain its own culture and approach. But that also means no two locations operate the same way. What works in a suburban primary care office might not work in a downtown dermatology clinic. Rolling out new processes or systems becomes complicated when every clinic has its own set of values, workflows, and expectations.
2. Patients do not understand who is supporting them
Most patients have no idea what an MSO is, and they do not need to. What they do care about is how their experience feels. When an office is part of a larger system, it can sometimes lose the warmth and personal touch that makes patients feel at ease. If follow-up is late, staff seem rushed, or explanations are unclear, patients start to lose trust, even if the care itself is excellent.
3. Staff communication is not consistent
In many MSO-supported practices, staff handle most of the day-to-day communication with patients. That includes explaining procedures, answering financial questions, and following up after visits. When staff are undertrained or unsupported in this area, communication gaps form. These gaps lead to confusion, cancellations, and lost revenue.
4. Centralized marketing often misses the mark
Many MSOs invest in marketing at the corporate level. But these efforts are only effective if local clinics are equipped to continue the conversation. A patient might click on an ad and schedule an appointment, but if they show up and no one explains their care options clearly, that appointment may be their last.
5. Follow-up is fragmented
Some practices have great systems in place for post-visit communication. Others do not. Without a consistent approach to follow-up, patients fall through the cracks. This is especially problematic for elective or specialty procedures that require multiple touchpoints before a patient says yes.
So what can MSOs do about it?
The MSOs that are growing successfully today are not just thinking about efficiency. They are thinking about the patient journey.
That means helping every location build a communication system that works. One that makes it easy for staff to educate patients, answer questions, and provide follow-up without needing a script or constant reminders. It means giving patients clear, helpful information they can understand at their own pace.
When this happens, everything improves — patient satisfaction, staff morale, treatment rates, and revenue.
MSOs are already doing a lot right. But solving communication challenges at scale is the next big opportunity. And it will define which organizations are truly ready for the future of care.