A Large Office with a Smaller Feel

May 1, 2001
Profile Fairview Dental, the winner of the best multi-practitioner practice and/or multi-purpose facility in the 2001 Dental Office Design Competition.

By Kevin Henry, Editor

Photos courtesy of Fairview Dental

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Editor's Note: This "Office Spot-light" profile Fairview Dental, the winner of the best multi-practitioner practice and/or multi-purpose facility in the 2001 Dental Office Design Competition, sponsored by Dental Economics and The Matsco Companies. Fairview Dental is located in Aurora, Ill., one of the western suburbs of Chicago.

Following is a question-and-answer session with the four doctors who comprise Fairview Dental — Dr. Gary L. Ahasic, Dr. Michele Bruno, Dr. Laurence A. Sexton, and Dr. Brian R. Tonner.

What makes your office design unique? What were the major influences that affected your design decisions?
"The challenge in our office design — and what makes our office design unique — is the ability to take something large and make it seem smaller. We have a large group practice that can have as many as 150 people a day come through our front door. It was important to us that each person has a warm personal experience when visiting us. We steered away from designs that looked like a sterile clinic. Instead, we designed a space where we can focus on individuals in a group setting.

"Here's a word picture of our office: The exterior of the building is in harmony with the neighborhood. The roof lines and the exterior elevation fit in well with the other professional buildings in the area. The large columns support porticos on both the street and main entrance elevations. The lightposts in the parking lot add an 'Old World' flavor. The garden is full of blooming perennials with a stone path which invites patients to walk through.

"Above the garden is a trellis supported by more columns that is home to different color varieties of clematis, trumpet vine, and wisteria that put on a splendid show in late summer. The trellis was designed for both the esthetic beauty and to reduce the direct sunlight into the treatment rooms facing west. This Romanesque theme is picked up in the interior design, both in the column theme and the use of arches to connect the treatment rooms. There are 36 paintings or custom prints spread throughout the office, which also reflect the same theme.

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"As you enter our foyer, you will notice the classic hanging light fixture, much as one would see in a villa in Tuscany. Entering the large, spacious reception room, one notices the high ceiling with a suspended soffit that provides indirect lighting. Halogen accent lighting is used extensively to bring attention to areas such as the artwork and front desk. One also notices the detail used in selecting the materials and textures by mixing woods and fabrics to achieve a rich effect.

"Once a patient enters the reception area, he or she can find an area that feels the most comfortable. There is an area that is designed like a reading room in a luxury hotel. There is a different area with a couch and a children's activity table so Mom and the kids can stay together in a 'family room' environment. Both areas are tied together with similar decorating patterns and original artwork so that, even with a large number of patients in the waiting room, you don't feel like you're at a bus station.

"The reception desk is one of the features that presents a real 'wow!' The fine woods are inlayed, so their grains make a harlequin diamond pattern that is repeated throughout the office. The style of wood in the reception desk is carried throughout the business area. The crown jewels of our office design are the glass-enclosed consultation rooms. These rooms are eye-catchers due to the deep, rich, cherry furniture, crown molding, floor-to-ceiling glass walls, and the hand-painted light fixtures.

"Our treatment rooms are designed to optimize efficiency. They are richly appointed and all 16 are designed and stocked alike so that a doctor or hygienist can easily switch rooms. There are two rooms at the corners that have doors, which come in handy for those patients who may be a bit troublesome to treat! The utility wall is situated behind the patient and continues the use of wood, which is richer than a standard wall of wallpaper or formica. The patient sees the wood trim and the wood soffit which contains recessed lighting.

"Patients marvel at the technology they see in each treatment room. Because the equipment was designed to fit into each room, they feel comfortable, rather than overwhelmed, by the sight of cables, monitors, or equipment. All treatment rooms were designed to be only a few steps away from a tray preparation area. The three radiograph developers are placed so that they are close to the treatment rooms. These two design elements keep us from getting in each other's way.

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"The doctor's office has some unique design features that we have found most helpful. All four doctors share the same office with each doctor having his or her own desk, phone, and computer. In the middle of the office is a large round table which we use for doctor meetings, staff reviews, and presentations. This sharing of space lets us minimize our office square footage by avoiding separate private offices. It also allows us to easily communicate with each other in a private environment. In a group practice, it is vital that we all communicate with each other. For most day-to-day functions, we have our own individual workstations but, when we have common issues to discuss, we spin our chairs around and the center table changes the office into a board room. This center table is a metaphor of the group practice and we have found that most of our important decisions are made here.

"Our design has the unique ability to make a large, impersonal space seem warm and comfortable."

How have you integrated technology, or plan to integrate technology, into your dental office? How has its implementation benefitted, or will benefit, your practice?"Technology is very important to our office and was a very big part of the planning of the office. Our computer systems are all integrated. We use PracticeWorks dental software. This allows us to schedule from any computer, look up patient information from any computer, and have up-to-the-minute schedule changes throughout the whole office. Our recall system is also computerized, which makes our hygiene coordinator very efficient. Reminder postcards are printed at the touch of the key. Welcome letters, patient labels, excuse letters, and postoperative instructions are all available within minutes of the patient leaving the dental chair. Much of the insurance is sent out of our office via e-claims.

"Each treatment room is fully computerized. A flat screen monitor and keyboard is all that is seen suspended from an arm on the utility wall. The CPU is hidden behind the utility wall.

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"We have five intraoral cameras that can be shared and hooked up into each room in 30 seconds. When the camera is in use, a patient can view his or her mouth on the TV monitor mounted on the wall. The assistant or hygienist can save the image(s) in the patient electronic chart. This image can be printed for the patient or for insurance purposes. This is a great tool for patient education. Patients who can see the fracture in the tooth are very likely to want to have the tooth restored. By saving the photos in the chart, we can show the patient before-and-after pictures of his or her teeth. The patient's next appointment can be made before he or she leaves the treatment room. We find appointments scheduled by the assistant or the doctor are less likely to be broken, and this also frees up some of the congestion at the front-desk area. A patient will often marvel at the technology he or she sees in each treatment room. Many comment on the Bose stereo speakers that bring great sound from the satellite dish which provides the music of choice without any commercial interruptions.

"Multiple computers allow many tasks to be done at the same time. Posting, scheduling, charting, checking in and out, and employees clocking in and out are just a few of the tasks that happen at any given minute on any given day. Our payroll is done by the office manager by using the computer clocking in and out for her guide.

"Our office utilizes a Kodak digital camera for pictures of patients and events happening throughout the office. We produce a quarterly newsletter in office and mail it out to all of our patients. The digital camera has been a great tool to capture images for this purpose."We use the CAESY information system to provide patient education when a visual effect is necessary. The CAESY system can be run in the treatment rooms or our consultation rooms, if a family member wishes to view the treatment information as well. This has also been helpful in case presentations and during consultations.

"By the end of this year, we are hoping to integrate digital radiography into our office. Our office is already set up to incorporate it into our practice. We are testing several products to make sure we have the right fit for our office and for our needs. With 16 operatories set up for digital radiography, we can't afford to make a mistake. We probably would have done it sooner, but we felt that our employees and the doctors should get used to all of the changes that have occurred in the past year before introducing digital radiography into our daily routine."

If you could change one thing about your dental office, what would it be?
"We need more parking spaces on Thursdays. All four doctors and eight hygienists are seeing patients at the same time. On other days, this is not a problem due to staggered hours. We are considering adding more parking spaces to the north of our building to accommodate this problem."

What provisions were made for future expansion?
"The office was designed with 16 operatories. Each operatory is designed exactly the same. A doctor or hygienist can provide care in any room. This gives us tremendous flexibility for future growth.

"When we consider the possibility of staggering work hours, it would be possible to add two additional dentists to the staff. We also own an additional 1.4 acres of land that would use the existing improvements — entry way, parking lot, water retention, etc. — if a separate party was interested in his or her own free-standing building."

What advice would you share with others who are considering building a dental office?
"Pay for top-of-the-line consultants and trust them when they make recommendations. We are not engineers, architects, or interior designers — we are dentists. These professionals take your good ideas and make them great. They take your dreams and goals and make them come to life. We wanted a product of 'top-shelf' quality delivered on time and within our budget. It really happened. We were able to lock the doors on our old office on a Saturday afternoon and open the doors to the new office on Monday.

"Here are just two examples of how top professionals can save you big money:

"When we just started to toy with the idea of a new office, we asked our local dental supply company to design a floor plan based on a 16-operatory design. Their plan called for a square footage of 9,200. After sitting down with T.H.E. Design during a lengthy interview regarding our wants and needs, T.H.E. designed our build-out at 7,200 square feet. Figuring $185 per square foot, that's a savings of $407,000!

"Our second windfall came during our technology purchases. It was imperative that all of our software worked together. We weren't going to spend all of this money and not have the technology work. We are dentists, not techies, so when we got around to pricing 16 flat-screen monitors for the operatories, our consultants told us how much we should pay for the hardware. It took some work, but we finally got the vendors down to levels where we would save $4,800. This just about paid for the support fee.

"Our advice to someone just starting down this exciting road is to find a team of professionals that you are comfortable with. Don't balk at their fees; their advice will save you money and headaches."

Describe your practice philosophy and how it influenced design and construction decisions.
"Quite simply, our goal is to provide the highest-quality dental care for our patients. From the very start of the design process, we were committed to a high-quality design that matched the level of dental care provided here. We needed an office that said, 'Excellence in dentistry and quality relationships exist here.' In more simpler terms, our patients needed to know that Smiles with Styles was more than our trademark. When we provide comprehensive cosmetic dental care, we present an overall picture of health and beauty that will be delivered in a smooth and comfortable manner utilizing state-of-the-art techniques. Our new facility conveys this message of quality and comfort with fine attention to detail.

"Our floor plan was designed with this smooth and comfortable flow in mind. When a patient arrives at our office, his or her experience from the parking lot to reception to treatment to financial to the appointment secretary and back to the parking lot is smooth and seamless.

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"The challenge with a large office is to avoid the feeling of being in a maze. We designed the treatment area with additional arches and soffits in the hallways to break up the monotony of one treatment room after another. This avoids the feeling of being in a large clinic and adds the dimension of individual care. The high quality of design is exemplified in the extensive use of fine interior wood trim and crown moldings. Even before the patient meets the doctor, this sense of quality has already been experienced by the patient. Just like a well-planned cosmetic case, the final result is harmonious, beautiful, and functional. As you see from the photographs, we have accomplished our goal of highest quality care by using our new facility as the foundation of our success.

"Our second goal is to employ exceptional people. At our old office, we had staff members sitting on the floor to file insurance claims. Our landlord was negligent in maintaining physical property. Our staff was working in spaces that were not designed for the task at hand. Working with the design team, our staff was able to tell them exactly how the needed space should be designed to efficiently complete their work.

"Our new facility was a boost in morale. We received half-a-dozen job applications from people who saw the new building under construction. Because staff had ownership in the design of their space, they have greater confidence in themselves and their teammates. Our new facility matches an exceptional facility with an exceptional team. They feel proud to work at Fairview Dental.

"Our third goal is to maintain a productive and profitable practice. It was important that our office would be a financial success as well as a design/build success. Our preconstruction estimates showed that, by adding just one additional hygienist's production, we would offset any increase in our rent/mortgage payment. What we didn't know was how much more we would increase our productivity. With the additional space, we were able to add a new dentist, which helps decrease our fixed expenses by 25 percent.

"We have seen a 29 percent increase in total hygiene production by adding more hygiene hours in the schedule. We have seen a 22 percent increase in the doctor's production by allowing us greater flexibility with scheduling and greater treatment-plan acceptance. We have seen an incredible 57 percent increase in new patients since our move into our new office with high street visibility and signage.

"Our purpose is to provide the highest-quality dental care for our patients. The design and function of our new office allows us to achieve these goals."

The exterior of Fairview Dental (left) and the front desk (above), which, according to the staff, presents a real "wow!"

Above: The staff lounge. Right: A look down one of the long hallways.

"Entering the large, spacious reception room, one notices the high ceiling with a suspended soffit that provides indirect lighting."

A utility wall hides much of the equipment in each operatory.

Fairview Dental Statement of PhilosophyTo employ people of the highest caliber is of utmost importance to our purpose. They must always be willing to strive to improve technical skills, interpersonal communications, and team interactions. These are people who are excited about what they are doing; are motivated to achieve results and have high standards of quality and integrity. These people understand the importance of teamwork. Teamwork is achieved through willing support, both given and accepted. Do whatever it takes!To exist for our patients — they always come first. We will strive to attract new patients who value good dental care. With our support, they will accept responsibility for their own oral health. Through our guidance, they will understand that only through quality care can they achieve their goals. Our patients don't care how much we know until they know how much we care.To maintain a productive and profitable practice. Only when this is achieved can we continue to serve those whose confidence we have achieved. If we share in the challenges of our practice, then we must also share in the rewards. Sometimes you have to go out on a limb to find the sweetest fruit.To pursue excellence in patient care is mandatory. Continuing education, refinement of skills, and providing only the very best possible is our goal. We view the attainment of excellence as a journey requiring constant growth and openness to change.To provide support, feedback, and leadership to promote growth and long-term commitment from each employee. Our standards will always be set high so that our employees can strive for new levels of expertise and self-esteem. They will be encouraged to reach new heights. We will strive to make our employees happy with their jobs and attempt to help them end each day feeling like a winner.To maintain an atmosphere where honest, open communication can exist, not only among staff members, but also between staff members and patients.

To contact Fairview Dental:
Phone: (630) 897-1156
Web: www.fairviewdental.net