Site Selection and Council Approvals

We work with many dentists who are taking the leap into owning their own practice. It’s an exciting time but also can be very stressful. Most of the practitioners that we deal with are very proficient health care professionals but are cautious first-timers when it comes to the logistical and financial challenge of setting up a functioning, profitable health care facility.

Selection of a location is one of the fundamental first steps and can mean the difference between success and failure. From our experience, small shopping centres or shops immediately nearbyare the best choice for start-up practices. Pedestrian traffic, parking and exposure are the key elements. The increased rent charged for premises in shopping centres is more than offset by increases in traffic flow and these sites often cater for needs such as parking, and potentially expensive requirements such as disabled access and amenities, fire provisions and compliance with NSW Health infection control policies.

A shopping centre that contains a medical centre, a pharmacy or some other related health care professional provides a definite advantage. Don’t even be scared if there is already a dentist there. Multiple facilities quickly create the presence of a ‘dental destination’ that draws patients from surrounding areas.

Other public amenities that have been seen to make a marked difference in practice success are train stations and schools, and we have also noted a great benefit from commercial office blocks.

It is very common for a surgery to start with one treatment room with space to add another chair once the practice gets up and running. 70-85m2 is a good size that can be fitted out well with one chair, OPG, sterilization room, reception and waiting area, and possibly an administration office and bathroom. A second treatment room is left empty or as storage until the practice patient base justifies fitting it out and using it.

If the premises has existing rooms that are about 3.2m x 3.5m these are a good size for a surgery room, but in most cases we suggest removing existing internal partitioning and re-designing. The cost of new internal wall fittings is more than offset by the improved use of space once the practice is open. We have achieved very comfortable,  ergonomic and profitable layouts in very pokey spaces.

The other point of stress for dentists setting up for the first time is council approvals. Development Applications are very daunting and many don’t know where to start. Council approvals can be painful, time consuming and expensive. From our experience, if you are a dentist you are better off attending to patients and getting someone to do the council approval for you. You can search for a planner near you or ask your specialist medical fitout company to handle it for you.

We found that over the years we became familiar with the regulations and the idiosyncrasies of different councils in the Sydney area. We also found that sticking with one principal certifier helped us enormously. The whole process involves a lot of waiting on hold, and waiting for replies from many different parties like real estate agents, building managers and council or heritage officers. A great deal of the work requires compliance certificates to be issued by the relevant tradespeople so make sure you use trades that are licenced and know their responsibilities under the Building Code of Australia and associated Australian Standards. Developing relationships with some of the parties like certifiers, fire engineers and councils has, in recent times, allowed us to get results much more quickly and at reduced expense for our clients. Provided your premises is already zoned correctly it is often possible to certify a surgery as a Complying Development, negating the need for a full Development Application. This can save you many months and many thousands of dollars of council fees and other costs.

The preliminary site selection and approval process can be daunting but once it’s taken care of you can quickly move into construction and the grand opening of your new practice!

We are always happy to have a chat about any stage of your project. We are happy to provide friendly advice to anyone.

For more information on medical or dental clinic location selection and council approval, please contact us today.

8 Ways To Save Money Setting Up Your New Surgery

Here are a few ways to save money when building a new dental surgery:

1.       Flooring – Spend a bit more for higher quality. Good flooring products will stand the test of time. Strip flooring is very durable and can be repaired easily in panels. Ensure slip rating of R9 or R10.

2.       Joinery –  Use laminates. Modern laminates are available in a huge range of colours and high gloss finishes. There is no reason for stone or glass splashbacks in a commercial workspace. Install dental specific joinery that has been designed accordingly to make best use of the space and maximise ergonomics while working.

3.       Lighting – LED lights are beautiful and eye catching in the reception area, but traditional fluorescent lighting is less expensive throughout the surgery rooms and provides perfectly adequate light. Life spans of fluorescent tubes are very good and in some cases running costs are less expensive than LEDs.

4.       Ceilings – Acoustic grid ceilings are quiet, flexible and affordable. They are easy to keep looking new and allow for additional cabling when required.

5.       Read the Scope of Works carefully and order additional items ahead of time. It is much cheaper to add items before the builder starts than after he has started.

6.       Beware of Fire Provisions – Make sure you know what is required in terms of Fire Provisions. The requirements are often determined by what is already in the building and they are sometimes quite expensive.

7.       Choose your equipment and your equipment supplier before work commences – The surgery needs to be set up for your specific equipment. Plumbing, mounting points and electrical connections all need to be installed near the beginning of the fitout. If you make changes to your equipment half way through the project it will cost you more.

8.       Lock your builder into a time frame – Time is money. If your project runs late it will cost you significant money. Make sure your builder commits to a timeframe and hold them to it.

For more information on saving money on your surgery please contact us today.

Building a Surgery to Last

When you invest in a new surgery fitout, one of the main considerations is longevity. Often we see expensive surgery fit outs that are beautifully designed and look very glamorous when the surgery opens, only to deteriorate quickly over the next 2 years. We also see dentists outgrow their new surgery in relatively short timeframes.

Most new surgeries open with one or two chairs, and a plan to expand as their customer base grows over the next 12 months. It is important to know where money can be saved, and where a relatively small expense at the time of building can save many thousands at a later date.

Ensure you design and build all IT infrastructure to allow expansion later. Grid ceilings are inexpensive and allow low cost increase of power and cabling at a later date. Running conduits under the floor to cabinetry locations is very inexpensive and facilitates low cost connections to extra equipment when required.

In contrast, chairs and joinery for additional treatment rooms can be ordered and installed later with little additional expense, provided that provision has been made for connections.

There is always a temptation to design eye-catching, ‘wow-factor’ waiting and reception areas. Recent research shows that friendly reception staff and familiar surroundings are higher contributing factors to acceptance of the treatment plan and overall patient satisfaction. Classic designs withstand the test of time and will look professional for years, maybe decades, to come. Whites and earth tones are the best choice with perhaps a small feature that can be updated at little cost in due course. It’s important to distinguish between a workspace that maximises patient comfort and overall profitability, and an architectural work of art. The most successful dentists seem to have functional practices, but save breathtaking architecture for their homes.

Dental cabinetry is a significant expense in the fitout process. Good cabinetry is an investment that can possibly last your whole working life. Check for construction with water resistant plinths and modules. A dental specific cable management system should also be incorporated within the cabinets to allow for easy installation of IT and electrical services both now and in the future. Laminate finishes for doors and benchtops are cost effective and last many years without deteriorating. The modern selection of finishes is almost unlimited and includes high gloss, metallic, satin, woodgrain and many others.

Don’t cut costs on flooring. Spend your money on the right flooring the first time. Ensure you have a slip rating of R9 or R10. This gives you sufficient grip for patient safety whilst enabling easy cleaning and maintenance. Again, choose classic colours that match other elements to make sure you don’t need to change the colour of the floor in a few years’ time. It is vital to double check with your supplier that the floor is commercial use rated and can withstand the high heels of your female patients without damage.  Replacement of flooring is particularly expensive, requiring removal and reinstatement of chairs and electrical connections, normally on a weekend.

Consider staff amenities and parking when planning for expansion. As your practice grows, additional dentists will need additional assistants and perhaps another receptionist. The small lunchroom that was perfect for a staff of 3 can become uncomfortable for a staff of 8. Good staff facilities are vital for attracting and retaining quality staff, so err on the side of caution when designing the room sizes for the fitout. It is not uncommon for new surgery DA’s to show a ‘storeroom’ on the plans, which later becomes a treatment room. This strategy navigates a path through the Council’s parking requirements per practitioner (sometimes up to 3 spaces). However, ultimately a smooth parking experience for patients is very important. Lack of safe, convenient parking spaces can easily drive mothers and other patients to another dentist. Again, plan ahead and plan to succeed.

If you ever need or wish to sell your practice, it will almost invariably be sold to a practitioner who is planning to grow. Practices that are bursting at the seams are less attractive than practices that are ‘pre-wired’ for expansion and increased turnover. In most cases, money that you spend on good foundations within the surgery is more than recovered in the event of a sale.

Some practical advice from an experienced specialist at the time of installation will see you in fine stead to maximise your returns well into the future.

Where Do Great Surgeries Come From?

Have you ever stopped to wonder how a surgery gets there in the first place? We walk into great medical workspaces all the time. Many with magnificent design features, expensive equipment and efficient layouts. But how does it all happen, and is it easy to produce a great surgery?

Project management is a crucial element of building your surgery. Designing and constructing a surgery requires coordination of three competing elements: scope, time and cost. Constraints and requirements of each element, affect the others. To be able to deliver a surgery of the required scope and quality, on time and at the budgeted cost is no mean feat. The project manager is required to consult with the dentist, the designer and tradespeople. The good project manager is almost an interpreter between the dentist who has a vision of how the practice will look eventually but often doesn’t know how to build it, the designer,  who has created something magnificent but doesn’t have to work in it, and the team of tradesmen who are skilful but require clear instructions in builders language. Many tradespeople don’t like changes and are often busy and unsympathetic to the fact that the dentist is building a surgery for the first time. The experienced project manager has found his core team of tradespeople that are professional, experienced, considerate and clean.

Other parties and factors that require considerate management include councils, certifiers, centre management, equipment suppliers and installers, neighbours, the dreaded body corporate, security, parking issues, access issues, noise, dust, fire alarms… the list goes on and on. The good project manager is on site at 4am to supervise noisy concrete drilling for chair plumbing. All to maintain good relationships with the dentists new neighbours.

Imagine taking responsibility for the work of up to 20 different tradespeople and as many apprentices, along with supervising the installation of dental specific cabinetry and expensive equipment. The ‘cardiovascular’ system of a dental practice comprises hundreds of connections for power, plumbing, radiation devices, sterile areas, security systems and more. The good project manager has a hawk-like eye for detail. He visits the site daily and scours the area for any errors in skill, communication or judgement. There is a delicate balance in finding tradespeople that are price competitive and also have specific dental surgery experience. Location and time-line for installations and knowledge of the various equipment brands is crucial and only comes with experience and manufacturer training.

Many dentists get a shock when they visit their site halfway through construction. They see what looks, to the uninitiated, to be a bomb site. Hundreds of wires and pipes, wall partitions, ceilings, floors, windows all being worked on in a chaotic beehive. Upon closer inspection, however, there is order and discipline amongst the activity. Everything following a particular sequence, in a time-efficient, cost-effective manner under the watchful eye of the project manager.

The bottom line for any project manager is customer satisfaction. In the end, the project manager has but one master, and focusing on this fact often provides a compass to steer by in the busy on-site world. A good project manager will go into bat for their customer in order to get a good result. Sometimes it’s a late change to the plan, sometimes it’s an extra push over the weekend to make up for an unavoidable delay. Sometimes it’s just old fashioned patience. Almost all clients start to see and think of new ideas as the project rises in front of them. As much as we would like every selection and decision to me made before the first hammer is raised, it’s just unrealistic, and good project managers know it. The good project manager uses their experience and established systems to assist in decision making as early as possible but still have a flexible cooperative attitude along the way.

The next time you walk into a dental practice, have a good look around and imagine the work that went into creating it. Imagine what was there before the project manager arrived. Was it a derelict hardware store? Was it a chicken shop? The good project manager produces beautiful ergonomic spaces on time and on budget from any beginnings. If he’s good at it he will have pushed, strained, coerced and back-flipped to make it all happen, but he won’t show it.