Group practice facilities - Part 1

Nov. 1, 2011
In our opinion, the most challenging and often most rewarding project option is a group practice facility in which multiple doctors collaborate ...

Jeff Carter, DDS, and Pat Carter, IIDA

For more on this topic, go to and search using the following key words: group practice facilities, design vision, budget, Dr. Jeff Carter, Pat Carter.

In our opinion, the most challenging and often most rewarding project option is a group practice facility in which multiple doctors collaborate in designing, financing, and constructing a new or extensively remodeled facility.

The primary challenge to completing group practice projects successfully (vs. single doctor practice facilities) is the breakdown of collaboration/communication between doctors with differing design visions and budget expectations.

For those of you able to resolve your differing project expectations, the rewards can be significant. These include:

♦ Larger and impressive facilities with reduced overall costs per square foot due to economy of scale
♦ Reduced equipment costs through sharing of major equipment/technology components
♦ Reduced building system costs through sharing of HVAC/mechanical, electrical, and plumbing infrastructure
♦ Standardized treatment/operatory configurations and ergonomics attractive to most operators
♦ Broad appeal design esthetic outcomes

While the legal business entity of your group practice can be varied, nuanced, and unique in structure, from a design perspective group practice facilities fall into two categories.

Category ONE: A general or specialty practice owned by more than one doctor operating as a single business entity. The most likely scenario of a category one group practice facility is a senior doctor with an established practice and a recently acquired junior partner or associate that has maximized the current facility and created a need to expand.

Another new project scenario in category one is multiple doctors of approximately the same age and practice experience sharing a facility they have outgrown after practicing together for a number of years. Functional expansion goals for category one doctors may include:

♦ increasing the number of operatories
♦ improving operatory ergonomics through new equipment and principled design solutions
♦ securing adequate parking
♦ securing adequate waiting area seating
♦ redesigning front desk areas to alleviate bottlenecks in patient check-in and check-out protocols
♦ adding staff support areas, including kitchenette, lockers, changing rooms, laundry, and training/huddle spaces
♦ adding a dedicated bulk storage space with inventory control oversight
♦ upgrading technology, including digital radiography/computed tomography and CAD/CAM
♦ adding patient consultation spaces
♦ adding a private restroom for doctors and individual doctor offices
♦ dedicating separate areas for sterilization and lab

Esthetic and quality of practice life goals that are more subjective in nature may include: creating spaces with more access to natural light, updating and modernizing the look of the facility, increasing curb appeal and signage exposure, moving to a better location, adding patient amenities, and creating a positive patient experience

In category one, you and your partner(s) must agree to a majority of the design and esthetic/quality of practice goals or it is unlikely you will proceed with a new project.

Category TWO: Multiple separate practices form a collective real estate/business entity to design, finance, and construct a new or remodeled facility building shell/site to house each practice in a separate interior space with shared common areas.

The most likely scenario of category two is a group of specialists (from different disciplines) that want the benefits of sharing a larger facility, including teaming with each other on multidisciplinary cases to offer referral doctors and patients a unique one-stop treatment option. Each individual specialty practice would seek to fulfill the functional and esthetic/quality of life goals listed for category one projects.

Also, it is unlikely and probably ill advised for multiple specialists to share a building shell with one general practitioner. Referral doctors are typically leery of sending patients to specialists that appear to have a business relationship with an in-house general practitioner.

A less likely category two scenario is a group of general practitioners collaborating on a single building project due to their inherent competition for similar patient types and treatment opportunities.

Next month we will describe how to assign roles and responsibilities for each doctor collaborating in a group practice project to ensure a successful outcome.

Jeff Carter, DDS, and Pat Carter, IIDA, are owners of PDG- Practice Design Group. Located in Buda, Texas, PDG offers a full range of design and consulting services to dentists nationwide. For information, call (800) 511-7110 or visit

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