Designing Your New Office

By Dr. Mark Tholen

Clothes Makes the Man—or Woman

How superficial. Clothes make the man; the saying implies that image is very important. Although the phrase may not be completely true, first impressions are very important. In fact, psychologists have found that an individual will assess a new acquaintance or environment within 30 seconds to one minute (revealed in the book, Blink), and an overwhelming amount of contradictory information is required to change the originally-formed opinion.

What is your patients’ perception of your practice? You might be surprised to learn their actual assessment because we judge ourselves based on our intentions, but others (that is, patients) judge us on our performance. And since not many of your patients are dentists(!), they judge your clinical skills on the condition of your office and the sophistication of your equipment and technology. Worn out dental equipment and outdated technology yields a perception of compromised quality of care—and this perception becomes reality in the mind of the patient.

The Moment of Truth

The state of your technology is especially evident to the patient in the case presentation. For example, are you using current radiographic technology such as Cone Beam Computed Tomography (CBCT) in your implant case presentations? Are you conducting your case presentations in a consult room or the operatory? Utilizing state-of-the-art technology in a nonthreatening consult room (yes, the operatory is threatening to the patient) allows your patient to hear you, focus on the quality of the technology being presented, and most importantly, trust you. In order for your patients to accept the care you are proposing to them, they must first trust you. Ergo, you must give them a reason to trust. And since they don’t understand the clinical aspects of the case presentation, you must speak to them in a language they understand: the sophistication of your employed technology such as CBCT and the room in which you present the case. The design and elegance of the consultation room must match the level of care you are presenting to the patient (Fig.1).  If you observe this design principle, your case acceptance rate will soar. The average case acceptance rate in the US is approximately 45%, but offices with technology and consultation environments consistent with the level of care proposed have acceptance rates greater than 80%. The reason is simple; patients have been given a reason to trust the doctor.

In order for your patients to accept the care you are proposing to them, they must first trust you.

A Picture Is Worth a Thousand Words

Working with a three-dimensional radiograph (CBCT) of the patient’s maxilla, mandible, or dentition in a case presentation delivers a clear message to the patient that you use state-of-the-art diagnostics and deliver a high standard of care (Fig. 2). They don’t need to understand anything about dentistry to receive that message loud and clear. You are allowing the patient to trust you—and accept the treatment plan.

The Clinical Benefits of CBCT and i-CAT Are Well-Known

The quantum leap in diagnostic and treatment planning value of CBCT makes the purchase of the technology a true value proposition. The added data points create a three-dimensional image, thus making your mental interpolation of multiple two-dimensional views unnecessary, and the analytical software used to examine the radiograph will reveal pathology that even the most trained radiologist will not be able to discern with conventional radiography (Fig 3). The radiograph is composed of 256 shades of gray from absolute white to black, but the human eye is capable of detecting only 12 to 14 shades of gray. A tremendous amount of information is present but not detected by the human eye. Diagnostic software can shift the gray scale range of the entire image and also stretch the gray scale of the image on the monitor so that the pathology “enters” the gray scale range of the human eye. The course of hair-line fractures, root and canal anatomy, quantitative determination of a structure’s density, metabolic disorders manifested in hard tissue, and many other diagnostic functions can be employed. i-CAT goes beyond that with color 3D renderings. The point is that CBCT and i-CAT transform radiography from a diagnostic aid to a pathopneumonic diagnostic tool. That said, you do need CBCT technology that best serves and supports your practice. The i-CAT suits the needs of general and specialty practices that offer orthodontic, TMJ, airway, implant, and other surgical procedures.

Office Design Considerations With i-CAT

If you are planning a new office, I would urge you to plan on adding space for CBCT and i-CAT even if you are not initially installing the unit in the new construction. As CBCT trends toward the standard of care, you may want to incorporate i-CAT in the practice in the future. Of course, it will be necessary to comply with your state’s radiation safety board code, but generally the i-CAT has the same foot print as a pan machine (Fig.4). The alcove should be located in the clinical zone, i.e., grouped with the operatories, lab, and sterilization (Fig.5). However, rather than occupying your time with these details, request that your Henry Schein Equipment Specialist partner with the i-CAT certified pro-physicist to conduct a site analysis to determine the specific radiographic and space requirements for your existing or new office.

Also, when considering which CBCT to employ, remember that your equipment selection must be able to adapt to future advances in hardware and software applications. The average practice will occupy a facility for 17.5 years, so the CBCT unit must be expandable and adaptable as technology races forward; i-CAT is particularly suited to upgrades.

Feature i-CAT as a Practice-Building Element Without Saying a Word

Illuminate your i-CAT (Fig. 6) in the alcove in which it is housed! This will draw the patient’s eye to the technology and speak volumes to them about the quality of the practice. Lighting in an office delivers the biggest bang for the design dollar as it truly delivers the “wow” factor, and you can capitalize  on your “cutting- edge technology” image with purposeful illumination of your i-CAT.

The Economic Advantage of Moving Now

There have been some tectonic economic shifts in the past few years, and we need to be positioned to take advantage of the movement created by these shifts: inflation, depressed construction costs, and depreciation schedules. The answer to inflation (It is occurring, no matter what the Fed says. Gasoline is up by 83% and food by 21% over the past several years.) is taking on debt and repaying the debt with inflated dollars. As dentists, we have an almost unique opportunity of (1) investing in an asset (office and equipment) that (2) earns money that (3) we use and manage. This combination allows us to maximize the return on our investment and keep pace with inflation.

Depressed construction costs are seemingly paradoxical when describing an inflationary environment. But because the housing industry is in the doldrums, labor costs are down about 15% compared to 4 years ago.

Finally, there is a significant tax advantage to building a new office and buying new equipment such as the i-CAT. Section 179 of the tax code continues to allow accelerated depreciation of dental equipment; in 2011, the maximum amount that can be depreciated 100% in the year the equipment is placed in service is $500,000. I would urge you to speak with your Henry Schein Sales Consultant to obtain the details and other tips in navigating the funding process.

Every journey begins with the first step, so take the step of contacting your Henry Schein Sales Consultant and investigating the clinical and financial opportunities of adding CBCT and i-CAT to your new or existing office.