Synergy gives rise to serenity

Shared relaxation niche for patients and team

Story by Terrance S. Swonke, DDS, PC Photography by Greg Hursley

For more on this topic, go to www.dentaleconomics.com and search using the following key words: synergy, serenity, Swonke Family Dentistry, Dr. Terrance Swonke, office design.

Congratulations to the winner of the 2008 Dental Office Design Competition for small practices, Swonke Family Dentistry in The Woodlands, Texas. This annual competition is sponsored by Matsco, Dental Economics®, and ADA Member Advantage^SM.

I started practicing in 1989 in a 1,200-square-foot office located in a rectangular bowling alley strip center. It was the first in the area with French doors, an open greeting counter, and a “living room style” waiting area. During the next 22 years, it served us well as I pursued extensive training with the American Orthodontic Society, the Academy of General Practitioners, and cosmetic course accreditations with the Pankey Institute. With the help of dedicated staff and patients, we developed an orthodontic and restorative practice dedicated to complex restorative cases through extensive recorded diagnostics.

Winding walkway weaves through exterior grounds to entrance of practice

As with many dental practices that grow and mature, the facility that launched our efforts didn't fully accommodate the services we ultimately provided patients. So I worked hard to create an “ideal” facility — one that promoted working with ease and provided a tranquil setting for patients. My endeavor became a relentless pursuit during a seven-year period.

In the same way I developed my practice, I pursued an ideal facility without compromise to my expressed goals. In the same way the success of my practice relied on a skilled and dedicated staff, I knew I would need help from others to make it happen successfully.

I had seen dental projects rushed to completion with mixed results, and realized that process would be counter to my expectations. I did not want the outcome to be disappointing for the time and money invested. So I began the process thoughtfully.

The location

First was a new location that would fulfill my functional and tranquil aspirations. After a four-year search, I found an all-glass modern building with an open suite nestled in a heavily forested and landscaped area. The building owner allowed me to secure the suite without a rush to construction build-out. I could envision my patients traveling from the parking area along the winding walkway past a sleepy pond, flowers, and ferns to reach the entrance. It was perfect.

The design team

At the same time, I was interviewing architectural firms. In formulating a vision for this office, I knew it would not follow typical dental parameters. I wanted to work with a design team that would step clear of the “dental norm,” and initially pursued “nondental” architectural sources. While these sources would potentially deliver on esthetics, after a number of interviews, I realized they could not deliver in terms of the dental aspects.

So I turned to dental design specialists. After interviewing on the phone and in person several specialty firms, I selected PDG/Fazio — a unique team of architect (Dave Fazio, AIA), interior designer (Pat Carter, IIDA) and dental consultant (Jeff Carter, DDS). This team was knowledgeable in the intricacies of dental function and was as excited as I was to step out of the typical dental office genre. This, too, was perfect.

Design philosophy — a synergistic experience

Stepping into the design process was the beginning of a synergistic experience for me. My goals for the ideal office grew and expanded through a continual compilation of insights from my staff and design team.

My design directives began a process of dialogue that moved to design schematics, feedback, and further clarification. With each design exchange, the concept for the office was advanced and refined, yet never veered from my initial objectives.

Within a short time, I could see that the vision I had held for so long was expanding, improving, and becoming more than I could have ever accomplished alone. It had become “our” vision.

The design concepts that were integrated into the office were sourced by my drive to create an environment in which my staff and I could work easily and foster a relaxed patient experience.

Beginning with the first patient, I did not want to replicate the waiting room of crowded chairs and mounds of magazines, and that feeling of being in a holding area.

Nomad™ portable X-ray system by Aribex

So, after much discussion, we developed three alternate waiting areas (two of these are shown on page 10). Each is available for patient/staff private use while serving multifunctional needs:

• The massage chair: a room for one or a few patients to relax with a full view of the pond and fountains.
• The wireless landing: a small library desk area for laptop use with a view into the dense woods.
• The multipurpose lounge development area: a built-in seating area with a table desk, a 50-inch flat screen TV, and an upscale kitchen area with beverage service and snacks available.

Surrounded by partial walls and curved blue green glass panels, this area serves many purposes, including staff huddles, lunch, and training; patient education, entertainment and consultations; and doctor-to-doctor consultations.

Patients are greeted and encouraged to make themselves comfortable in any of these areas prior to treatment. The response has been remarkable and ranges from first-time patients thrilled with the freedom of their waiting options, to a patient's spouse relaxing in a massage chair, to the early-morning mom enjoying a first cappuccino from our Nespresso machine, to the kids in headphones transfixed by a big screen movie while their Dad finishes treatment.

Unencumbered flow

Another design priority was to facilitate unencumbered access to all spaces for the staff and me. Perhaps the most challenging criteria is that I wanted an easy flow of activity and yet be able to segregate activities for optimum efficiency and effectiveness.

Centralized lab area at Swonke Family Dentistry

For me, this meant eliminating “room boxes with doors” seen in most dental layouts. I referenced the attributes of a yacht's design in which every space is accessible and serves multiple activities. Every inch of a yacht is used, and the final finish delivers quality and comfort.

In our plan, spaces are partitioned as minimally as possible, with doors occurring only at private spaces such as toilets and doctor-business alcoves. Generous corridors that circulate around a clinical core area promote unfettered access by staff and patients alike from treatment and waiting areas.

Each area is defined by its functional storage and use. Every inch is used and designed with purpose. The result is clinical and administrative spaces that are segregated functionally, yet visually connected through partial height walls, columns, and glass detailing.

A centralized lab

One of the more unique design objectives is the positioning and exposure of the lab area. Unlike most dental office labs, which are sequestered and closed to patients, I wanted this space to be a priority area for participation with staff and patients. To that end, this is the first clinical space one sees when entering the practice's treatment area.

A run of countertop and cabinetry at the core wall houses the sink and lab equipment, which is exposed when in use and hidden after use within “garages.” A center island with integrated computer and large screen monitor is the center point where my assistant and I can work on diagnosis and treatment protocols.

Because the area is designed with an open concept of glass and columns, patients can observe or even participate in treatment planning for those who are interested in their specific treatment rationale and projected outcome.

Our lab serves as the central location for review of all case diagnostics — digital and physical data for multidisciplinary cases — and is an integral part of our effective treatment planning process.

And the serenity

Once the functional directives were addressed, my design team developed the interior esthetics consistent with my objectives — openness, understated elegance, and a sense of serenity.

By their recommendation, this translated to a mix of natural materials, including travertine stone flooring, green glass, maple hardwoods, stacked stone walls, and select areas of color. This also includes the upper core area ceiling of aqua blue that gives a sense of being outdoors. Full-height walls separate treatment areas, but partial-height walls and glass in other areas reinforce the feeling of openness.

Wide corridors enhance practice's core area (top) while scenic outdoors is seen from operatory window

I confess that I was not fully prepared for the final result. It truly exceeded my expectations. For all the conversations and drawings reviewed and approved, I was in awe and thankful for the synergistic collaboration that allowed my design team freedom to deliver on our vision.

For years, I have thumbed through journals and admired the featured dentists who built new facilities that changed the experience of their dentistry. They were the inspiration to my dream for an office that reflected my practice philosophy.

We are enjoying the fruits of our vision every practice day. While I anticipated my persistence during the process, I did not of others — the landlord, the PDG/Fazio design team, subcontractors, my wife, family, and peers. All of these people encouraged me and helped make this possible.

When I started this process, I declared it would be thoughtful. I promised to relish each step in its own time, consider each idea offered, and be “anxious for nothing.” I believe it was a good mantra that allowed the design to unfold and become a collaborative reality — synergy leading to serenity.

Editor's Note: ADA Member AdvantageSM is a service mark of the American Dental Association. ADA Member Advantage is a program brought to you by ADA Business Enterprises, a wholly owned subsidiary of the American Dental Association.