Dentaltown October 2023 - 59

detriment to attracting new patients
and quality staff.
The alternative is a dentist/professional
design collaboration, which
involves working more closely with
dental-specific designers to optimize
your facility. This is a design process
we have promoted for years, sourcing
the dentist on the design of their
own facility. And we have witnessed
the impact the investment of time
in the design phase has had on their
ultimate practice growth; we recently
framed this as a contrast between a
facility designed to compete on price
versus one designed to compete on
experience.
A cheap start leads
to costly upgrades
We categorize the design-build
process as " competing on the price "
because the primary goal is to minimize
costs and design time so the
project can move into construction
relatively quickly. Typically, a general
Nearly 100% of start-up dental
facilities are design-build outcomes,
and current dental specialty lending
programs do not support soft costs
for professional designers outside the
design-build process. Yet, the No. 1
complaint of dentists designing and
constructing a startup facility, as
documented by those same dental
specialty lenders, is regretting not
investing more into the design of
the facility. A year or two into a new
design-build facility, dentists believe
the minimized aesthetic and disparate
function of their office is often a
contractor provides any additional
" design " that would be required to
take a dental supplier floor plan to a
permit set of drawings and advances
the project directly into construction.
As noted above, this is promoted as
saving the dentist money and time.
Competing on the price is a valid
approach for simple, less detailed types
of projects, such as big box stores like
Walmart. However, we'd argue that
it is not the best approach on a more
complicated type of project such as a
dental facility-and here's why.
What's not well understood or
explained to dentists is that " savings "
on the design phase typically
leads to a minimized aesthetic and
greatly increased cost risk during
OCTOBER 2023 | 59 | DENTALTOWN.COM
construction. Because in-depth
design discussions are truncated or
minimized, any desired aesthetic
details or technical specifics aren't
defined in the drawings-and anything
not defined in the drawings
becomes the general contractor's
prerogative (assumption) in the pricing
and construction of the project.
In the " competing on the price " model
of design-build, the allowances built
in the construction cost are typically
builder's-grade selections with
minimal appeal to dentists who want
to create a distinctive aesthetic, and
any upgrades or changes become a
change order or cost overrun (which
is a testament to statistics that show
most design-build dental offices have
cost overruns of 20% or more). Finalizing
your facility design during the
construction process is a costly and
ill-advised decision.
By contrast, a professional designer/
dentist design collaboration, working
with a dental-experienced general
contractor, is a " competing on the
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Dentaltown October 2023

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