The laws of design

July 1, 2009
One dentist's journey to the facility of his dreams

One dentist's journey to the facility of his dreams

by Doug Young, MBA

For more on this topic, go to and search using the following key words: office design, floor plan, technology, practice expansion, vision, Doug Young.

Do something long enough and you begin to see patterns emerge. After years of coaching dentists on office design projects, I can tell you that while every design is different, most successful projects play out over a familiar trajectory. “Practice Harmony: Design Your Practice, Design Your Life,” a workshop I teach with Imtiaz Manji at the Scottsdale Center for Dentistry, gives participants a clear line of sight for that ideal process.

As a result, graduates of the program are building the practices of their dreams free from the fear and uncertainty that can accompany this significant step in a dentist's career.

Dr. Jared Chisholm is a graduate of “Practice Harmony” and owner of a thriving general dentistry practice in Kamas, Utah. His story is just one example of how a design project done right — with a guiding vision, proper planning, and outstanding support team — can be a success strategy in any economy.

In 2001, Dr. Chisholm and his wife Becky settled in Kamas, a mountain valley community about 30 miles from Salt Lake City, and bought out the local dentist. The 900-square-foot, two-operatory facility was a good start for a young practitioner, but “quaint and cozy” soon became “outdated and cramped,” and Dr. Chisholm began to feel the limitations of his facility.

In August 2008, Dr. Chisholm moved into a brand new, 3,000-square-foot home on the ground floor of a building he built with three other medical professionals on land that they jointly own. The new office is a dream come true for the doctor, his wife, and their team. The story of their journey follows six basic laws of dental office design.

Law #1: Start with a vision

Dr. Chisholm's vision for his new facility began by inventorying everything that wasn't ideal with the old place.

“In the operatories, I was often up against a back wall, and it was too tight to get into position to work on patients,” he said. “So I would just get as close as I could and lean in. Sometimes my leg would go to sleep.”

With just two operatories, they were often unable to accommodate emergency patients. And while he did his best to keep current with equipment and technology, the lack of space limited his options for upgrades.

Out of this came a wish list — a vision of what an ideal facility should have — that became a running joke among the staff.

“We joked about having T-shirts made up that said ‘In the new office …,'” said Becky, who works in the practice as an administrator. “Every day we talked about what would be done differently in the new office.”

The Chisholms took the less-than-ideal circumstances of their old facility and turned them into a clear vision for their new one. From there, they began looking at floor plan ideas, brainstorming design options, and taking tours of dental offices to get inspiration.

Law #2: Get the right support

Prospering in today's chaotic business world is like navigating the rapids on a whitewater rafting expedition — so much depends on who is guiding your raft. Dr. Chisholm's expert guides for his office design project were his local territory representative and equipment specialist from Patterson Dental.

They not only helped him select the right equipment and technology, but they also consulted on floor plan ideas, recommended contractors, and organized a tour of several local offices.

“It was great to be able to go through other offices and say ‘I want this, I don't want that,' and to see these things in a real life setting,” said Dr. Chisholm.

That process also helped him select a design firm, because many of the offices he liked were created by the same regional firm specializing in dental offices. The Patterson team put him in touch with that company and helped coordinate the construction process.

“That was important, dealing with people who had done many dental offices,” he said. “They know what you're talking about when you talk about dental office considerations, and they're able to offer advice based on their experience.”

“We knew we needed a strong team behind us to do this,” Becky added. “Patterson was instrumental in putting us in touch with the right people and offering insights every step of the way.”

Law #3: Get educated

Dr. Chisholm's Patterson team also connected him to the “Practice Harmony” workshop at the Scottsdale Center for Dentistry.

“The workshop really got us thinking about our project in a comprehensive way,” he said. “We made some changes in our plans as a result of attending the program. When I got home, Becky and I went through the binder of materials and just pored over the ideas.”

“Practice Harmony” teaches dentists how to use their facility to enhance patient and practice value, increase profitability, prepare for a transition or retirement, and create a place where they love coming to work. Some participants are as much as two years away from beginning a new office project, while others, like Dr. Chisholm, attend after they have begun the design process. Either way, getting educated about the design process is key to a smooth and successful journey.

“It was reassuring to hear from all those experts in one place and confirm that I was on the right track,” said Dr. Chisholm. “It gave me the confidence that I would succeed with the right team around me.”

Law #4: Design around your value — and your values

Your facility communicates to patients much more than you could (or would) ever say to them chairside. Designing your ideal office, therefore, is as much about communicating your value — and your values — as it is about ergonomics and equipment.

For Dr. Chisholm this meant creating a place that exemplified his practice's mission.

“The new place has such a warm, bright feel, with the big windows in each room and the comfortable décor, and I think patients respond to that,” he said. “But beyond that there are all the tools I have to communicate our value — the big monitors, intraoral camera, digital radiography, patient education. There's definitely a ‘wow factor.'”

The result has been a noticeable change in case acceptance: “I've had patients with significant treatment plans come right out and say that in the old office they were reluctant to have all that work done, but this new environment has eased their mind and they've gone ahead.”

Law #5: Build for the future

Dr. Chisholm now enjoys the best technology of today — a paperless, high-tech, integrated office featuring digital technology, intraoral cameras, fully adjustable monitors, top-of-the-line chairs, and CEREC on the way. But he's also ready for the practice of tomorrow. He works out of four operatories, but has room to expand to seven.

And after years in an environment that limited his possibilities, Dr. Chisholm made sure that his new facility would be ready to grow with him — ready for a new associate when the time comes, and ready for new technology as it emerges.

“With technology developing the way it is,” said Dr. Chisholm, “you've got to plan for the future. In our operatories we've got conduits running everywhere — in the walls, the floors. We're not sure what it's going to be used for yet, but whatever new technologies are coming, we'll be ready.”

Law #6: Choose your economy

Every investment you make in your practice should generate a return that fits with your overall business plan and growth strategy. This is true no matter what the market is doing.

The key is recognizing the difference between the economy you have some control over — your practice — and the one we hear about on the evening news.

In fact, a down economy is often the best time to make practice improvements, because labor and construction costs are down. At “Practice Harmony” we go into detail about exactly the kind of return on investment you should be looking for in a facility project, and graduates come away with a clear picture of their individual situation.

Dr. Chisholm found himself moving into the new office just when the national economy began to sputter, but even in a community hit hard by the recession his practice is growing, with an 11% increase in production.

“There's probably never a time when it feels great to take on extra payments,” he said, “but this is something that needed to be done.”

Becky agrees: “With this new facility and the way we're better able to serve our patients, we're ready for when the upswing comes.”

Doug Young has dedicated his career to coaching and motivating people. As a consultant, coach, and professional speaker, he has impacted professionals in several industries and most recently joined Scottsdale Center for Dentistry to deliver the “Practice Harmony” workshop. Young can be reached at [email protected].

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