The business of dentistry is constantly changing. We see trends driven by consumer demands, OSHA standards, and state-of-the art equipment and services. Often mitigating these changes is the increase in the cost of doing business.
Office design is one important aspect of the business that factors into a practice’s success. Why?
While our office is our work space, it’s also one of the most important components of our marketing strategy: branding. With increasing competition in the business, it’s important to note patients can and will judge a book by its cover—and your facility is the first thing they see. Each patient has a phantom list used to compare you and your facility to his last doctor’s office. A great facility allows you to make a statement about the quality of dentistry and care he’ll receive. A well-thought-out design gives us a head start at creating a positive first impression. It can also increase your office’s productivity and make it ready to handle future growth.
Office design really has four key components: location, number of ops, layout and features, and budget. Under each of these are dozens of subcategories that also need to be considered for you to end up with the facility you want. You’ll need to partner with your real estate agent, attorney, CPA, architect and equipment supplier to be sure those details are taken into consideration. In this article, we’ll focus on the four major components.
Location
Determining where your office will be located should be your first consideration. I would spend time looking at locations and the demographics of those locations. You’d want your office to be located in a high-traffic area, and for it to be easily seen. Equally important is that the orientation of the building is conducive to good visibility, and the signage (allowed by the landlord or city sign ordinances) is also visible to traffic. Since women make 92% of purchasing decisions when it comes to dental care, it’s also a good idea to have it located near places women frequent, and have an overall design that appeals to a female’s eye.
Number of Operatories
Second, consider how much space you’ll need. The number of operatories you anticipate needing will help determine what the overall square footage of your office should be.
My suggestion is you consider about 325 square feet per operatory you want to have—not 325 square feet in each op. In other words, multiply the number of ops times 325 to give you the approximate total square footage for your facility. If it’s a 6-op office, you’d need about 1950 sq. ft. This will give you enough square footage to have a reception area, bathrooms, staff areas, a business office—everything.
I see doctors using a 500-1000 sq. ft. factor per op, only to find that they’ve created a huge overhead nut to crack each month without adding any productivity.
For strategic planning, you should consider the following:
- You’ll need 2 operatories and probably 1 swing room—or 3 ops—for each doctor.
- You also need 1 room per hygienist. You should strive for 2 hygienists per doctor, so that might add 2 more ops for a total of about 5-6 ops.
- An additional room for every 2-4 hygienists would take care of overflow or scheduling issues. (These don’t all have to be equipped initially.)
- You should anticipate a growth of about 15% a year. That will give you an idea of what you’ll need for the future.
- If you build in a doctor’s private office, I would plumb it for a future op. Leases for offices and expansion constraints in buildings you own are expensive and difficult to address, so be careful to plan for future growth.
Layout and Features
Every office should anticipate rapid changes in technology. How much room will you need for future equipment and technology integration? Also, what’s an ideal layout for my workspace, and what features should it have? These are additional things to think about when creating your ideal space.
Future Equipment, Workspace
I would plan for a location for a 3D cone beam. Scanned impressions—and the technology that goes with it—should also be a consideration. CAD/CAM generated crowns like E.Max have taken over the crown and bridge in most offices, and require space and access.
In addition, consider the increase in the number of general dentists doing work in what used to be considered specialist areas. Sedation, orthodontics, and endodontics require additional space, storage, and carts to do effectively.
Operatory Design
12 o’clock Positioning
Operatory design has actually settled on a modified Pride design with a power panel at the 12 o’clock position, creating a partial wall with an entrance on each side of the panel.
The x-ray unit is being mounted on the 12 o’clock position to make it equally accessible from the left or right-hand side of a chair. Many new offices we build are moving to a portable x-ray machine, allowing it to be moved to different operatories.
Also, the delivery unit (cart, arm, etc.) is often being placed in the power panel at a 12 o’clock position, making it possible to change from a left to right-hand operating position in seconds, while moving the cart or arm from one side to the other. Having the hand pieces in this position also allows you to remove instruments out of your patients’ line of sight.
Nitrous oxide, scalers, carpule warmers, headphones, CPU, and monitors can all be placed in the power panel within easy reach from either side.
This arrangement eliminates the excessive cost of cabinetry while maximizing ergonomic benefits of a 12 o’clock delivery system.
More Space, Better Organization
We’re also seeing fewer cabinets in operatories. Be wary of designs that include 2-3 huge cabinets built with drawer after drawer, creating clutter and holes where supplies and instruments are lost. Dental suppliers and their representatives’ idea of how operatories should look is often based on an antiquated design that maximizes the need to purchase more cabinets (and their profit motives).
There’s a long overdue movement toward creating a little more space in the sterilization area, a well-designed storage closet, and a tub and tray setup that moves all our instruments and setups in and out of an operatory. These features minimize turnover time, and make it easier to clean and maintain the office without having undue supplies spread about.
The advantage of a central supply area with setups for every procedure is that we can minimize the footprint of our operatories (lower cost and more profit), while making ops feel much larger without the clutter needed to maintain a clinically-clean setting.
Using barriers allows us to easily turn a room in couple of minutes.
Budget
Your budget should allocate 7-9% on overhead for your facility.
Supplies and equipment will be some of your costliest investments. It’s important you take time to shop for the best value and price. When I discuss planning new offices, costs, and budgets, I always suggest using the internet to research and purchase equipment and supplies from companies that undercut top-heavy, traditional national companies.
With companies limiting their presence to an online one to lower their costs, and the ease of researching online, we no longer need a middle man, and consequently to pay 30-40% above what things should cost. Going through a traditional national dental supply company nearly always ends with you paying thousands more than you should.
While there are other companies out there, I consistently use and refer my clients to TDA Perks Supplies. Wielding the purchasing power of the TDA membership, the company enables TDA members to save an average of 30% on dental supplies.
Dental equipment, service and planning at significantly discounted prices are also now available through TDA Perk Supplies, via a recent partnership with Archer Dental. For more information, visit tdaperksupplies.com, or call the company at 512-270-6999.
As you can see, many things have to come together to create a functional, attractive and affordable facility. Armed with knowledge, you’ll be able to create an office you can afford, grow into and be proud of.
By Michael Abernathy, DDS, is founder of a consulting and coaching-services company that teaches others how to duplicate his success. His work takes him to speaking engagements throughout the U.S. and Canada, and he has numerous published articles. Dr. Abernathy is a client of TDA Perks Supplies.