Group practice facilities — Part 2

Feb. 1, 2012
In our Nov. 2011 article, Group Practice Facilities — Part I, we addressed the challenges and rewards of a group practice facility ...

Jeff Carter, DDS, and Pat Carter, IIDA

In our Nov. 2011 article, Group Practice Facilities — Part I, we addressed the challenges and rewards of a group practice facility in which multiple doctors collaborate in designing, financing, and constructing a new or extensively remodeled facility.

Group practices are defined as either single practice entities owned by more than one doctor, or multiple separate practices creating new individual facilities within a shared building shell and building core.

In this article we will describe how to define and assign roles and responsibilities for each doctor collaborating in a group practice project to reduce project stress and promote a collaborative and successful outcome.

Project roles

In group practice projects, obviously all partners should be asked for their input as the project progresses. Assigning roles to specific partners most capable of and/or willing to manage key project components requires examining the options, and empowers that partner to shape and present those options to the group for efficient decision making.

If your group is comprised of two or three doctors, each doctor will take on multiple roles and responsibilities, unlike large group practices with more delegation flexibility.

Role 1 — Design visionary

In our experience, there is typically one doctor who initially conceives of and drives the group practice facility concept and rationale. Even where multiple practices come together to share a building shell, a single visionary individual most likely provided the impetus to organize and advance the project.

If you are the design visionary, you hold a specific vision for the project outcome based on how it will look and feel, and the benefits the new facility will produce for the practice(s). A design visionary will speculate much more about what is possible and consistent with the practice goals than the other partners in the group.


  • Define the size and scope of the project and rationale for doing so
  • Define the subjective/emotional drivers of the project
  • Define the look and feel of the project
  • Create buy-in for the project concept from the other partners
  • Role 2 — Budgeting and financing manager

All the partners should be equally concerned about the financial implications of a new project to the practice. Nonetheless, one partner should take the lead on managing the project finances. This role is often the most challenging.


  • Define the budget or budget range for the project based on current practice dynamics and future needs
  • Research and select lender(s) to finance the project
  • Provide necessary documentation to lender(s) to qualify for loan(s)
  • Define a strategy, with help of consultants if need be, to justify total project cost and monthly debt service required to support project
  • Build consensus with other partners on worthiness of investment

Role 3 — Equipment and technology manager

Who in your group is most interested in the latest equipment and technology? The best doctor for this role often lobbies the other partners to upgrade equipment and test the latest technology.


  • Inventory and assess existing facility equipment
  • Research potential new equipment upgrades
  • Strategize and oversee the purchase of new equipment vs. reusing existing equipment
  • Interview dental equipment dealers and select project equipment supplier
  • Evaluate current office technology integration
  • Create strategy to upgrade technology in new facility and select technology subcontractor

Role 4 — Esthetics developer

Often the design visionary takes on the job of overseeing esthetic development. In our experience, male doctors assuming this role are very comfortable selecting exterior building materials, and often have strong preferences for types of roofing systems and masonry options in new construction.

Remarkably, when presented with finish options for flooring, wall coverings, upholstery, and interior paint colors, these same confident male doctors often become overwhelmed and indecisive. If you have concerns and assume this role, you may want to ask a spouse or even a staff member to assist you.


  • Inform design team of group’s preference for traditional, transitional, or contemporary esthetic development for the facility
  • Approve selections of exterior and interior finish materials
  • Approve selection of furniture, accessories, and artwork

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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