Office Renovation-Are All Required Expenses Accounted For?

Recently a client asked me for help in renovating a dental office. Whenever people think of renovating they do so prompted by the desire to add a new gadget, more staff, or a new procedure in order to increase revenues. The thinking goes that if we can offer more effective diagnostics, add a specialist, or refocus the practice, then the patients/clients will benefit and the practice will be more profitable. Good thinking! Excited at the prospects of growth, we tend to neglect to notice the inter-dependence of the basic components involved: changing the space to support the new addition, its financial impact and the people factor. Are all the required expenses accounted for? 

Financial matters tend to show what we value most and surface quickly. Discussions surrounding the space renovations became stalled when the price tag appeared to be higher than my client expected. The doctor asserted that the practice was in need of a very expensive and “much-needed, even crucial, newest and greatest” dental machine. However, they could not possibly afford the financial commitment of both! We need this superb diagnostic! Space designer, what do we do? Can we scale down the redesign? If so, how do we manage to add this BIG new machine within an existing constricted and awkward configuration? Designer, you can make miracles, don’t you?

The need to create room for a big piece of equipment not only means disruptions to the work, and a financial commitment; it also implies that changes are coming. These may be painful. Something must be removed to make room for the addition if no additional space is available. Space, like a body is an entity. We cannot continue to stuff an already full digestive system without introducing a new regimen—exercise, good & qualitative food and practices, eating less, meal planning…You get it, space does not stretch and this space is tight!

In this project, insufficient storage was but one of the problems. An outmoded and bulky filing system was compounded by single-use office equipment and the apparent lack of time for organizing the office. The front office was the one in most need of help. The first diagnosis: clean and clear as much as possible and combine office equipment. Staff time allocation for this procedure was strenuous; for when an office is crowded, people feel that they can never accomplish enough.  New multi-function equipment was installed and much de-cluttering ensued. Yet space and staff continued to be problematic.

The front office staff works in a narrow, very cramped space directly in line with the front door. They have breaks in an open and tiny space housing a microwave, a refrigerator and random storage above their heads; all within a narrow corridor shared with operatories, the sterilization center and the lab. Being in direct line with the front door makes them feel that they “are always on”. The lack of space to take a meaningful respite within the work day creates restlessness and feeling disrespected or uncared for. Continued neglect of staff needs eventually may show up in staff morale, disgruntled patients and a tired CEO. Can we afford to renovate with these people?

The diagnosis was to carve appropriate space for their efficient functioning. This was the designer’s job. The clarity achieved in cleaning, de-cluttering and re-allocating inspired a space reallocation.  Great! Yet funding the new space design must also prompt some serious thinking. Improperly addressing money issues may create unwanted personal side effects on the management side. These are not only monetary. The need to maintain the pace of work to support growth may lead not only to working additional hours, but to a diminished quality of life. This was the doctor’s conundrum!

Fortunately, being in a healing environment, we looked to necessary procedures for proper treatment. Doctors know that the basic procedures are not priorities. They are just that; basics of equal weight. Just like doctors prepare patients for a healing treatment, space planners must prepare (design) the space for the new practices/equipment to be incorporated while considering the work flow and its needs (staff ) and the entire financial aspects. Failure to consider any of these basic components, like patients, the new treatment (space & new equipment) may fail (financial & people losses).

An optimal renovation means that staff will work in a space that supports them in assimilating the new and incorporating what exists. An office needs appropriate storage for efficient workflow and effective movement within the work area in addition to effective work practices.  A space that restricts movement cannot produce at any level; let alone increase productivity. People simply survive. It is hard for doctors or management to feel this because they are busy treating patients or taking care of “important matters”.

Yet, when the front office really produces, all will notice a remarkable surge in their ability to serve the needs of the patients/clients and their own comfort level. That is how dependent we are on our staff’s efficiency! Staff also needs room to take a meaningful break. When we provide for this basic need, it says we appreciate them. When we don’t, we express that we only care for the bottom line. When you feel uncared, it makes it quite difficult to care for others. The front office is the mouth of the practice and vital.

Dentists know the importance of discussing with their patients about what enters the mouth, a vital body part, and how it affects the rest of the body’s functioning; front office staff  are the first encounter with your business.  Overworked, tired and unable-to-concentrate greeters cannot be as cheerful as they need to be. Just like the space, their thinking becomes narrow, stagnant and constricted. They are unable to grow. If they accommodate, then they get in time, depleted.

Properly preparing to renovate the space means analyzing all the parts and their interaction. It is the only balanced move toward a practice that is healthy, happy and that keeps on growing. Developing the layout and pricing it is as important as getting the specs for the new equipment and pricing it, and as important as projecting for additional staff and planning for revenues and outlays.

At the present moment, we are still planning on renovating the space, keeping an eye on training staff for the new procedures and planning to purchase the amazing machine when the time is right. We all keep an eye on the basics and keep smiling. The doctor and I are still smiling 🙂


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