How much does stuff cost?

Jeff Carter, DDS

My most memorable experience from the first day of dental school, 28 years ago, occurred at the medical center bookstore. I gathered the required freshman dental student textbooks and placed the enormous stack on the checkout counter. As I waited for the cashier, I wistfully recalled my favorite textbook from my undergraduate biological science degree. It was a three-inch-thick behemoth belonging to a graduate level biochemistry course. The cover was navy blue and emblazoned with orange-colored artistic representations of molecular structures. I never really understood exactly what the orange structures represented, but I loved them.

I thought this mammoth, encyclopedia-sized biochemistry book looked so impressive, I would purposely leave it near high viewing areas around the apartment where my roommates or any visitors would have to see and feel its presence. Of course, this biochemistry course and book also consumed every last available neuron in my brain to squeak out the lowest score you could achieve and still receive a "B" grade. The difficulty factor only added to the book's mystique. I paid $22.95 for the biochemistry text.

The dental school bookstore cashier rang up my first "dental" book purchase. For the reason I was about to discover, none of the books had price tags on them. It was a small, muted-gray, bland-looking book entitled "Dental Morphology." The cash register cha-chinged and the "surprising" price of $79.95 was displayed. This was my first introduction to the economies of scale and how they impact health-care economics. The sympathetic cashier explained the context of the pricing and welcomed me to dental school. I proceeded to spend 400 percent more than I had allotted in my first-quarter dental school budget for textbooks.

To my surprise, I had failed to research and plan adequately for that first day. Fast-forward nearly three decades to the 21st century and consider the daily research and planning required of you to effectively operate the greatest dental care facilities in the world. And make no mistake about it — going all the way back to the $79.95 textbook, striving for excellence and growth always requires "surprising" investments of time, energy, and money. Conversely, achieving mediocrity and stagnation always requires "comfortable" investments of time, energy, and money.

My experience has been that the practitioners most aware of the specific investments required to design, construct, equip, and furnish great dental facilities are the ones who have just completed that process. For the rest of you, here is a quiz to test your level of surprise as you strive for excellence and growth in your practice facility.

1. Retail cost for "top-of-the-line" dental patient chairs range from:

1. $2,000 to $4,000
2. $4,000 to $6,000
3. $7,000 to $9,000
4. $10,000 to $12,000

2. Retail cost for most periapical X-ray units is in the range of:

1. $500 to $1,500
2. $2,000 to $3,000
3. $4,000 to $5,000
4. Costs vary dramatically between manufacturers

3. Retail cost for the Air Techniques AT-2000XR, in my opinion the best X-ray film auto- processor (for small- and large-format films), is approximately:

1. $7,000
2. $8,500
3. $10,000
4. Product was discontinued due to competition from digital technology

4. Retail cost for the Ramvac Bulldog QT 2 (supporting two doctors in up to six operatories), in my opinion the best "semi-dry" vacuum pump available, is approximately:

1. $4,000
2. $6,000
3. $8,000
4. $10,000

5. Retail cost for the Air Techniques, twin head, oil-less air compressor (three to four users), in my opinion the best on the market, is approximately:

1. $3,000
2. $6,000
3. $9,000
4. Oil-less compressors are not available in the dental market

6. Retail cost for phosphor plate scanning systems such as Scan-X or DenOptix is approximately:

1. $10,000
2. $20,000
3. $30,000
4. $40,000

7. Retail cost for a dual-function cart or wall-mount delivery unit by A-dec, manufacturer of the best delivery units available in the dental market in my opinion, is in the range of:

1. $3,500 to $5,500
2. $6,500 to $8,500
3. $9,500 to $11,500
4. $12,500 to $14,500

8. Dentists will often receive dental equipment purchase-price discounts off of retail in the range of:

1. 2 to 4 percent
2. 10 to 12 percent
3. 22 to 24 percent
4. The unique distribution process of dental equipment does not allow discounting from MSRP

9. Dental facility generated costs for utilities, taxes, insurance, and maintenance typically project totals of:

1. $2 per square foot per year
2. $7 per square foot per year
3. $12 per square foot per year
4. Impossible to predict

10. Interior, finish-out, construction costs for Matsco's Design Competition award-winning dental facilities as highlighted in Dental Economics is typically in the range of:

(Note: Interior finish-out construction costs include rough construction; plumbing and plumbing fixtures; electrical power and lighting; ceiling, wall and floor finish materials; interior built-in cabinetry and trim; and functioning HVAC system ... in other words, a completed space ready to receive equipment and furnishings.)

1. $20 to $50 per square foot
2. $60 to $90 per square foot
3. $100 to $140 per square foot
4. $150 to $200 per square foot

11. An architecturally designed, free-standing dental facility can generate architectural, interior design, engineering, and consulting fees in the range of:

1. 10 to 14 percent of the total construction cost, including interior finish out, shell, and site work
2. 8 to 10 percent of the total project cost
3. fees can vary greatly based on the level of design and level of service provided
4. all of the above

1. C, 2. C, 3. A, 4. C, 5. B, 6. B, 7. B, 8. C, 9. B, 10. C, 11. D