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| The following is a reprint of an article
that was featured in "Dental Economics"
March 2002 issue- entitled, "Dental Office
Design and Productivity for the Rest of Us"
by Dr. David J. Ahearn. |
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DENTAL OFFICE DESIGN AND PRODUCTIVITY FOR THE REST OF
US.
In every practitioner's life there comes a time when it
is clear that a physical office change must occur. For
some doctors, this happens early in practice; for others,
a reawakening occurs later in the practice life that makes
this transition desirable. Nevertheless, it is a point
through which every dedicated caregiver crosses at some
time.
Because office redesign is such a rare event, we do not
gain enough knowledge or experience to do justice to this
critical task. For example, we place composites every
day, and, as a result, our trade journals have hundreds
of articles about them each month. Our knowledge is great
in such areas - not so regarding future office planning.
Dental supply companies frequently will supply you with
a floor plan at no up-front cost. Unfortunately, they
can't be expected to spend a great deal of time on productivity
enhancements that only an actual practitioner would understand,
nor can they be expected to labor long and hard to save
you money. These plans tend to be simple to draw and very
expensive to equip. It isn't the supplier's fault. Everything
costs money and there is no such thing as a free lunch.
This is a reasonable choice for practices that are relocating
but not expanding, or for offices that are simply purchasing
new equipment to replace outdated hardware rather than
re-engineering or re-invigorating their practices.
High-end office designers offer great service and have
the benefit of prior dental practice experience. They
are noted for creating "image" practices for
those dentists who desire them. Design costs alone for
such offices can run into the tens of thousands of dollars
as each step in the design process is individually handled.
Moreover, due to the one-of-a-kind nature of the design,
it is common for a project to take up to two years to
complete.
A larger number of practices are actually designed by
local architects rather than by high-end dental designers
for two reasons. First, doctors often hire professional
architects who they are familiar with (through patient
contact or social activity). Secondly, doctors often feel
that they must use a local professional because of what
might be unique code requirements in their geographical
area. Unfortunately, in most situations, this is the least-desirable
method of office design. Perhaps one practice in 25 should
pursue this design alternative.
We find that it is virtually impossible for an architect
without vast knowledge and experience in dentistry to
lead you beyond your existing vantage point. Even architects
who have successfully worked out the physical requirements
(plumbing, etc.) have little actual knowledge regarding
what makes a practice highly productive. It would be like
designing tomorrow's most advanced car without having
a driver's license! All dental offices today must comply
with national standards such as the Building Officials
and Code Administrators (BOCA) and the International Mechanical
Code (IMC). While it may be possible to get something
accepted by a local building inspector at a lower local
standard, it seems rather shortsighted to risk potential
liabilities associated with the Americans with Disabilities
Act, which holds the owner liable for oversights despite
the issuance of local building permits. Figure 1 shows
the pros and cons of each choice of office design supplier.
| Figure
1: Office Design Choices |
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I won't go into further detail here about these choices.
This series is about dental office design for the rest
of us. It's about taking charge of the process - about
establishing a method for going where you have never been
before in a safe, sure, and successful manner - and only
spending those dollars that provide a significant return
on your investment. As we progress in these discussions,
you should become able to specify a design plan in a straightforward
manner. This will allow you to save a significant amount
of time and expense, and often permit the purchase of
a pre-engineered office plan or even the acquisition of
an entire prefabricated office that is the practice of
your dreams (see Figure 2).
To take your practice into the future with maximum success
and minimal risk, we first should establish some conceptual
foundations to build upon and accept some of the constraints
within which we must work. Conceptual vs. physical design
Let's break your design endeavor down into two major categories:
1. The physical aspects - the design, construction,
equipment, lighting, etc.
2. The conceptual aspects - the sort of technology
people will want in the future, what staffing may
be like in five years, how a dental office should
feel to a new patient, etc.
Most dentists hate to think about the intangible elements
of office design and, as a result, will do anything they
can to rush into the physical aspects of the project.
Please don't do that! You should build your physical infrastructure
around your carefully evaluated plans.
Figure 3 outlines the conceptual aspects of office planning.
Note that not all of these items will relate to your specific
goals. Clearly, how you rank the importance of these trends
will have a strong influence on where and how you create
your new practice - how the design becomes uniquely yours.
| Figure 3: The Conceptual
Aspects of Office Planning |
A. Factual foundations for the future
of dental practice:
• Increase demand for elective cosmetic services
• Increase need for periodontal and hygiene
services
• Advances in technology are a trend, not
a fad
• New or upgraded offices have increased
productivity
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B. Physical limitations in the future
of dentistry:
• A declining pool of skilled auxiliaries
• Decreasing number of available doctors
• Difficulty in finding adequate space for
the ideal practice
• Increasing procedure complexity
• Decreasing sale prices of existing practices
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C. Things we've been told are important
that probably aren't
• Where the handpieces go in your office
design
• How big your operatories are
• How much you spend on each treatment room
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Practices that plan to focus on perio/hygiene need to
make a strong commitment to more treatment rooms. Practices
developing a cosmetic future must plan space for an optimal
consultation area and create a scheduling system that
permits privacy. For practices that are suffering from
manpower shortages, a design that enables uncompromising
two-handed function is requisite.
You need to clearly outline what you want your practice
to be long before committing to a design. You should have
a good sense of how your specific objectives will influence
your design, and then carefully communicate them to your
designer. This will allow you to assess the ability of
your designer more accurately. If he or she is unable
to quickly translate your conceptual needs into an outline
for your future, it is best to extend your search for
help, perhaps to another category of designer.
The future is in your hands. The practice of your dreams
does not have to become a nightmare of overbudget or overtime
woes. Clear, written design goals are the first step in
creating that future.
In subsequent articles, we will discuss essential elements
of office and operatory design, as well as specific features
such as lighting, noise abatement, and the elements of
a productive treatment room. Later on, we will cover the
necessary details of a great design and more. I look forward
to sharing this process with you. These principles will
enable you to take control of your office improvement
project - large or small - and will assure your success.
D/E |
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