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March 2005, Dental Economics

By Garrett Ludwig (garrett@architext.biz)

That’s a time-tested formula for success that is achievable by all, endorsed by many, but applied by few. Charles Trauring, DMD, is one of those few. His adherence to the tenets of this prescription for success has earned him exemplary status as a businessman and virtual mastermind of the above-referenced concept in the dental arts.

I first met Dr. Trauring during an open house for one of his friends and colleagues, whose office we had designed. At that time, Dr. Trauring shared his vision of a future project, and endorsed his dream with an articulate recognition for the distinctive role that the facility itself would play as the framework for his progressive concept in dental health care.

When we next met, it was apparent that Dr. Trauring had transformed his dream into a concrete belief through diligent research and the assimilation of the various elements needed to bring his concept to fruition. His vision and belief were punctuated by his selection of a new site for his Brookline office. The location was ideal – the contemporary building boasted abundant parking at a convenient site on a main city artery in an affluent community. Unfortunately, upon completion of our feasibility study, it was determined that it would have been cost-prohibitive to bring the structure up to code, as well as circumvent structural and technical encumbrances in order to create an efficient office environment. Without breaking stride, Dr. Trauring chose to walk away from that project, despite having invested a great deal of time and money in the process. That is when it became apparent that I was dealing with an individual who could separate emotion from ambition. Although I supported the fact that it was an extremely wise business-minded choice, the true significance of his deft decision-making eluded me until our next meeting.

Weeks later, Dr. Trauring asked us to perform a similar study on the second level of the Prudential Tower, which had been vacated by a health and fitness club. It took only moments to determine that the footprint of the space would prohibit its viability as a dental office, based on the delineation of space proposed by the building

management. In short, more than 40 percent of the center core of the 19,400-square-foot space was consumed by 28 elevator hoistways, building utilities, elevator lobbies, stairwells, and lavatories. The latter included showers and saunas – remnants of the former tenant. That left a loop around the center of the building that, at its greatest width, was 28 feet. The remaining space was, in turn, encroached upon by a mandated public egress passageway that surrounded the center core of the building. Understandably, the configuration of the passageway was planned with the logic that it would allow for multiple tenant suites to be positioned around the perimeter and still maintain life-safety code-compliance. The useable space that remained was only 22.5 feet wide – terribly insufficient for a high-profile, functional and efficient dental suite.

Also, from a standpoint of cost, it would have been necessary to lease almost the entire floor in order to accommodate the needs of the practice. This square-footage need-factor was determined by a thorough analysis of the intended function of the overall project, and included room sizes, access corridors, wall thicknesses, storage and utility accommodations. From an even more daunting perspective, function would be forced to follow form, resulting in a flow pattern akin to that of a series of boxcars. Based on the logical assumption that a patient would enter the suite through the waiting area and proceed past the reception and business areas, that flow pattern would displace the treatment rooms to the distal end of the suite. As a result, the simple act of greeting and escorting a patient to the treatment rooms would impose an exponential, nonrevenue-producing loss of time for each assistant and hygienist.

So, in the absence of a formal presentation, I suggested that Dr. Trauring look for another facility for his practice. Without hesitation, he said, “Find a way to make it work!” In my eyes, this trenchant statement elevated him from business-minded dentist to decisive entrepreneur, and became the inspiration for a no-holds-barred, solution-based feasibility study. Not only was he willing to devote the time and the funds to research every potential for a viable design, but he was prepared to make the same commitment to overcome any obstacles to bring his vision to a tangible state.

Our objective was to eliminate as much of the public egress passageway as possible, thereby increasing the useable space. After a thorough review of the life-safety codes and the consideration of several design iterations, we determined that we could eliminate 95 feet of the egress passageway and acquire the much-needed width to the space. The net gain was just shy of 500 square feet of additional, useable space.

In order to make this accommodation, it was necessary to effectuate the endorsement of the building management, since the change necessitated the creation of a new passageway through what had been the fitness center lockerrooms.

The 6,500-square-foot facility now boasts five hygiene rooms, 10 operative rooms, and one dedicated to endodontics. All support areas, including private offices, lab, sterilization area, and staff lounge were sized to accommodate full occupancy. In anticipation of continued growth, a plan was prepared for the remaining 5,000 square feet of space, currently occupied by a day-care facility.

There are two factors that I hope to have imparted in this article. First, more often than not, an accommodation can be made to achieve an objective when planning an office – be it technical, structural, or mechanical. Although some changes may appear costly, the ultimate yield of increased function and efficiency should be considered. Second, if you are diligent about qualifying that the end justifies the means, you are certain to succeed. Keep in mind that most mall stores pay a premium for their space, which they lease. They often pay a percentage of their gross receipts back to the mall as well. Most of these high-profile retailers continue to post increased profits annually. So, in theory, it’s not how much you spend, but how successful you wish to be – financially or professionally – that should serve as a barometer for a good investment. Dr. Trauring has a clear understanding of both theories and is now living his dream.

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