Multispecialty Practices

By Jeff Carter, DDS, and Pat Carter, IIDA

Multispecialty practices are a recent trend that can greatly impact the design and construction of dental facilities. These facilities are ambitious ventures led by visionaries and may involve ground-up construction, extensive planning efforts, robust design exploration, and unique business partnership arrangements.

The most typical multispecialty dental practice, as we define it, is a single practice entity that provides general dentistry services in collaboration with the provision of one or more dental specialty.

What are potential benefits of a multispecialty practice?

• The “one-stop-shop” concept is very prevalent in many successful business models. Most patients would prefer to have multidisciplinary cases completed in one facility vs. traveling to multiple locations. This is especially true if the travel involves long distances or difficult inner city travel routes and parking challenges.
• The multispecialty practice model can provide unique marketing opportunities to distinguish your practice. This marketing edge can be very strategic while competing with franchise dental facilities in your area.
• Additional production from expanded services can justify your investment in upgraded equipment and technology. For example, investing in a cone beam CT unit is very attractive to a practice that places and restores implants and provides more extensive exodontia services.
• General practitioners can benefit greatly from working in partnership with and in proximity to specialists. Specialists can also benefit from this enhanced relationship as opposed to communicating by phone, email, or an occasional lunch-and-learn with their general practitioner referral base. The professional synergy can be inspiring to many.

What are the typical facility upgrades of a multispecialty practice?

• Inclusion of a sedated patient exit not visible from the main entry of the facility.
• Redesign of at least some of the treatment rooms to add a door for privacy, increase cabinetry and surfaces to integrate sedation monitoring equipment, and add overall square footage to ensure efficient wheelchair and multiple provider access. In addition, larger rooms can facilitate transport and positioning of mobile devices such as CAD/CAM acquisition/scanning units and mobile surgical microscopes.

Surprisingly, the modifications to transform a typical general practice operatory to a “flex” operatory capable of accommodating six-handed procedures with IV sedation are often very minimal. Operatories located at the end of corridors are ideal candidates for conversion to a flex operatory.

• Addition of a central X-ray area integrating the benefits of large format digital X-rays. Ideally, a cone beam CT unit is a first choice. Advanced panoramic-cephalometric units with tomographic capability are also good transitional units in a multispecialty central X-ray niche.

An expanded central X-ray area is also an ideal place to put a photo niche where you can capture portrait-style images of patients. An inexpensive photo backlight with synchronized flash greatly enhances the quality of extraoral photos. This addition can be very beneficial to multispecialty practices that include orthodontics and advanced cosmetic services.

• Upgraded dental mechanical units, including dry vacuum pump(s). These newer vacuum pumps (vs. wet vacuum pumps connected to waterlines) can eliminate the need for “blood bottles” in more advanced surgical procedures.
• Upgraded HVAC systems to ensure proper heating and cooling. An enclosed operatory with five or six occupants requires significantly more tonnage of HVAC to offset the increased dynamic heat generated.
• Addition of a dedicated patient restroom in the clinical area.
• Integration of a backup power system (i.e., generator) to provide power to strategic areas of the facility during outages. This is especially warranted if your practice emphasizes sedation cases.

How far can you take the multispecialty concept?

It takes a visionary to discern a unique multipractice opportunity and ensure success. We are not suggesting you attempt to form partnerships with six specialists as your first step! A better place to start is to ponder the following questions and gauge how viable a multipractice concept may be for you:

1. Which specialty is most aligned with and which specialty is least aligned with your skill set as a general practitioner? These two specialties have the most potential for growth in your practice.
2. Is there is a demand in your area for one or both of these specialty services?
3. Do you have relationships with, or know of, providers of these specialty services who might be open to a unique practice relationship with you?

Jeff Carter, DDS, and Pat Carter, IIDA, are owners of PDG - Practice Design Group. Located in Buda, Texas, PDG offers a full range of design and consulting services to dentists nationwide. For information, call (800) 511-7110 or visit www.practicedesigngroup.com.