Interview with a Contractor

I spend a large part of my time working on office projects that are either renovations or total relocations. I started talking with some of the experts that I work with to get their perspective on how to accomplish a project smoothly. In the next few weeks I’ll bring those interviews to you.

Today I spoke with with Craig Sweitzer of Craig Sweitzer & Co., LLC. Craig’s company is located in Western Massachusetts and they have been building dental offices for 25 years. In this interview, Craig talks about some of the considerations and planning that go into the modern dental office.

What should a doctor expect from their contractor?
The planning and construction process can be a daunting task. My clients deserve the highest level of professionalism when working through a construction project. Most doctors are quite busy with their practice and cannot waste time, effort, and money on a poorly conceived or executed construction project. The contractor’s background and experience are quite important. Dental offices have complex mechanical requirements and dentists tend to be demanding customers. Their profession requires perfection and they tend to expect the same of their contractors. This is only natural.

When a doctor is looking at a space for a dental office, what are a few things they should be on the lookout for?
Considerations for a new location include zoning, parking, traffic flow and count, building configuration, and local infrastructure such as sewer and water. The availability of city water and sewer make installations easier. Some buildings require fire protection sprinklers and city water becomes necessary. If a building is being considered where city water and sewer is unavailable, construction options are limited.

What are the differences between a concrete slab vs. a space with basement or ceiling access?
A “slab on grade” means a concrete floor with no access to the underside. Since dental offices require so much under-floor plumbing for drains and suction, cutting and removing paths of concrete is required to install this plumbing. This will involve more work, noise, and mess than a space with a cellar access. A space with a basement or located on the second floor space allows easier plumbing access, but that being said, most of the offices that we do involve cutting a concrete floor.

What about the bathrooms? How many? How big?
The Americans with Disabilities Act (ADA) requires most offices to be handicapped accessible, which means handicapped bathrooms, access ramps, and adequate doorways, among other requirements. If the building has common bathrooms that meet the ADA specifications, the project is not as complex and space for these bathrooms is unnecessary within the planned doctor’s office. If not available in common space, separate handicapped men’s and women’s bathroom are required. These usually consume about 42 square feet each.

A lot of doctors ask me about negotiating with their landlord. In your experience, what is typical and customary for a landlord to provide?
Many landlords will provide money to the tenant as a build-out allowance upon signing a lease. Others will offer specific work such as a “vanilla box”. This is a newly painted space with the electrical panel, HVAC (heat, ventilation and air conditioning) distribution, a suspended ceiling with lights, and two handicapped bathrooms. At times, money from the landlord toward the build-out is better than the work being done by others which may locate bathrooms, doors, or windows in a location that doesn’t fit with the flow of the doctor’s planned office and operatory layout. Some properties are only offered as is. If the price is right, it may be a good option.

Typically I recommend that the size of the usable space should be 400 sq.ft. x # of desired operatories to get everything you need, what has been your experience?
Obviously, too much space adds costs beyond what is efficient and too small can be a mistake because it minimizes space for expansion, storage, private office or bathroom, or an employee lounge. Most offices we build have future operatory rooms planned and the rough plumbing and electrical installed for future equipment and use. It’s been our experience that these expansions will typically be finished one to five years after the original office opens. Most offices we do range between 1,200 and 2,400 square feet.

When a doctor decides to open a new office or to expand an existing space, what’s next?
There are generally two routes that a doctor takes: he or she either contacts the equipment specialist (ES), or contacts me and I bring in the ES. Patterson and I consult with the doctor and Patterson draws a preliminary floor plan. Most include a waiting room, a receptionist and payment area, lab and sterile area, 4-10 operatories or hygiene rooms, an employee lounge, bathrooms, storage areas, private office and consult area. Some doctors prefer an employee entrance separate from the patient entry.

After the basic floor plan is generated, we are happy to give a “ball park” estimate for the build-out. Subsequently, the equipment and the office layout and interior finishes are finalized and a construction contract with final pricing generated. I supply a licensed architect, if required, and some doctors request that a designer be brought in to help with finishes, artwork, and furniture. Patterson and my company present the doctor with a complete package. Our flexibility allows us to meet the individual needs of the doctor.

The final bid and contract price usually includes all work to be done within the space including building permit and architectural fees, all mechanical systems such as plumbing, HVAC, and electrical, and room construction including walls, doors, ceiling, trim, wall and floor finishes, and accessories. The facility is ready for the installation of the dental equipment.

Why do you see projects go over budget or over time?
Due to complexities and unknowns that may exist at the start of the project, costs can be listed as allowances for some items so that final choices can be made as the job progresses. Planning and final design takes many resources and often a client wants to complete the preliminary construction work before these final details are completed. That is when a contract can be written on a “cost-plus” basis. Changes to the scope of work or unforeseen conditions will sometimes make a job more costly or take longer than anticipated. It’s not unusual for a client to decide to upgrade some finishes or add features as the job progresses.

What are some of the typical options that are available?
Our basic office includes standard suspended ceilings, vinyl floor tiles in patient areas and carpet in other areas, painted walls with some trim using tasteful colors and accent walls, soffits and a custom reception desk with laminate top. Up market designs can include custom woodwork, solid surface tops, drywall ceilings with crown mounding, moulded doors, ceramic tile, accent glass and lighting, raised paneling and trim, soffit assemblies, wall covering, and waterfalls, atriums, planters, or fireplaces. Really your options are only limited by your imagination and budget.
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Craig Sweitzer has been building dental offices for 25 years. Craig has a B.S. in Business Management, and state licenses as a construction supervisor and real estate sales. He is the chairman of a local planning board, and has served as building inspector and as a commissioner to the regional planning commission.