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This Dental Specific Podcast is dedicated to the Dental "Entrepreneur" Michael Dinsio, Founder of Next Level Consultants, delivers #TRUTH when starting up a dental practice. From the very first step to getting the keys of a dental practice, Michael shares his raw & unscripted playbook with you. Not only does this podcast provide you with "What To Do" but more importantly "What Not To Do". With over over 15 years of experience & over 150 past clients, Michael delivers an educational and informative program in a real and genuine way. Start w/ Episode 01 - as we go through a STEP by STEP process.
00:03
That question is so loaded, John. I don't even know where to start with that question. I guess the problem is, and by the way, I love that question. Interesting. This is an interesting topic. What's the solution here? Show up, understand your part, and just crush it. Paper, click, social media, we can talk about all this stuff. But what really matters is patient experience, that wow factor.
00:34
Start off Unscripted, the questions you have with the truths you need to hear. Now your hosts, Michael Dinsio and John Bertagni.
00:49
What is going on you guys? Episode six, this is Startup Unscripted. Super excited about today. Today is construction day, I suppose. We are interviewing one of the best in the industry and we're gonna really break this down, John. And thanks for being, as always, my friend, partner in crime, John Bertagni. Thanks for being here today, buddy. Thanks, man. This is actually when things get a little bit more tangible.
01:17
for folks. mean, you know, hammers, you hear the hammering, you see things starting to come together, but there's steps before that. And, you know, we're lucky enough to have Bruce from Apex out of Chicago. He's actually covers this whole world in terms of construction for design, build and building some beautiful practices. Bruce, how are you my friend?
01:47
Yeah, doing super glad to be on with you guys excited for this conversation. Yeah, this would be by the way, this isn't a conversation. You're just going to get grilled the entire time. Is that right? All right. Well, I'm ready for it. I've had three coffees. I'm I've had a couple Red Bulls. So this should be an interesting episode. I you know, John, we were talking about this episode before Bruce got on and sorry, Bruce, we we tend to have these full blown conversations without
02:15
our interviewers just so that we can be more prepared than you on purpose. But no, I'm joking. No, that's great. That's great. Okay, but you know, we were talking about this concept of, you know, design build versus hard bid. And we're gonna, this program is really gonna break it down as far as like, what the differences and the advantages and all that good stuff. But
02:40
Really what we're trying to fix and the root of the problem, John, right, is that construction makes up like 70 % of these guys and gals, these dentists startups, right? Yeah. Any project, could be a startup, it could be an established doctor relocating, whatever, but 70 % of your budget is gonna go to this guy, Apex, and if there's a place to save, it's here.
03:08
Right. It's not really marketing. It's not really working capital. You know, you do want to spend some money on equipment. We're going to get to that in previous and in coming episodes. But this is the place we've got to save some money, John. mean, you know, this you do. I think this is you're exactly right. What we're trying to do here is allow dentists and empower dentists to have alignment with their partners. I think that's the premise of this entire podcast series. Right. That
03:37
They're educated enough and they're confident enough to have the right questions, but not only the right questions that they pick the right partners that they can say, hey, I love that, but I need to save $1,000, US dollars. How do I do it? And that's where someone like a Bruce is going to be able to say, this is how we can do it. And we're going to get into value engineering. We're going to get into design, build versus and hard bid.
04:07
But today it's about finding the right partner that understands it, that could help maximize your monetary units to get the best space for your vision, which we talked about in a previous episode. So man, Bruce, do you have this? And you've got 20 minutes to get this done. Awesome. Let's go. Let's go. Describe what... So let me... Yeah. Tell us a little bit about Apex first. mean, guys are... John said...
04:36
saying the whole world, you are countrywide, you're doing projects all over the country. you know, obviously, you guys are located in Chicago and just crushing it in Chicago. But tell us a little bit about the company real quick. Yeah, for sure. I'll give you a little background that'll help with sort of the perspective that we come from as a firm, through those conversations that make sense for listeners. So Apex is a family owned firm, working solely in the healthcare market, private healthcare. So we're a design and construction firm and
05:06
We've had the favor of working with over 700 dentists since we began in dental market in the late 1980s. So I think 1988 was the first dental project for us. There's been a threat of healthcare since the inception. We started as an architectural firm actually. So my great grandfather and grandfather were both architects. My dad and his brothers got into the construction world and then here we are today doing it all. We're designers, architects.
05:36
builders. And so through the course of our four generations, we've earned the reputation of being the people who do things right. And that's kind of been our whole our whole approach to the design and construction world. We want to find a way to make this go the right way the first time. So, you know, really what we're known for is our ability to combine that focused health care expertise with a comprehensive
06:05
one-stop solution for design, architecture, and construction. And the purpose of all that is to bring peace of mind to doctors so they can concentrate on treating patients while we look after the project. That's really our whole aim. That's the whole premise behind creating a process that design, architecture, construction, all built into one process, which we call the apex continuum, seeing it all the way through. That's it. That's what we're all about.
06:34
That actually makes a lot of sense. It's the one-stop shop. And I get that. In my past life, I actually started a distributorship that was a one-stop shop. So it all makes sense to me. Here's my next question. So why would someone want to relinquish all their control, everything without a check and balance, to a design-build company? I'm just saying. Great question.
07:04
Yep. Why would I give you everything and say, here's my money, you build it without a check and balance. Let's define it real quick though, guys. Like hard bid is hiring an architect, right? Hiring an architect and going to three, four, five contractors I've seen at all and saying, here's the set of plans. Mr. Contractor, bid this and be the lowest and you win. That's a hard bid, right?
07:31
This is a different- We like to refer to that as being the traditional model because what you're doing is you're following a process where in the doctor's mind what they're doing is retaining an architect and creating a set of drawings that in theory is gonna be an equal playing field for all contractors, all general contractors to bid on and may the best man win, right? That's the theory, that's the concept. And what I'd love to get into is-
07:59
why that's not the case because we've been there, right? We've been the architect, we've been the contractor, and it doesn't work that way. There's not that. Hang on a second. Let me stop that. want you to continue this. Essentially, what this is is a treatment plan. Let's put it in a dentist world, right? Someone's provided a treatment plan, right, which is the architectural drawings. Perfect. They put that treatment plan to five different dentists and whoever is the cheapest
08:29
Right? Because it's typically the best is going to win that full mouth reconstruction. Right? Versus your situation is this person, this dentist, or I mean, this consumer goes to the dentist and says that they want and they provide the treatment plan and they provide the construction or the actual services rendered on the full mouth reconstruction. Correct? Precisely. Exactly right. Now.
08:57
Let me give you a scenario. You should. You should, because I might borrow it. I'll have to pay you for it, The thing is that, let's take that scenario and just run it one step further. So let's say that the patient took one doctor's plan, right? One set of plans, their treatment plan, and actually went and had another dentist, another doctor perform the work.
09:27
That doctor is working off of someone else's plan. It's somebody else's treatment plan and they're trying to deliver that care according to how it was intended to be delivered. Now, do you think there's gonna be any ambiguity anywhere between that treatment plan and what that patient actually gets? It's gross interpretation, gross interpretation. I love where this is, Bruce, because I think what we're all speaking about, the three of us, in between the lines is the architect.
09:57
Is the architect the problem? Bruce, are you saying I'm not? You put me in a you put me in a hot seat here. No, I don't mean to be. But but but truthfully, I think you're exactly right. So so the architect is putting these plans together. And what you're saying is, in theory, I like that you said it in theory, they're trying to create a level playing field. But what you're trying to tell me and I I I agree with you is that it's not level. Why? Like what?
10:26
Why isn't it fair advantage there with a hard bid? Sure. So look, it's no one person's problem or at fault, right? What it is is a breakdown of communication. At the end of the day, what you're trying to do with the design and construction project is translate thoughts onto paper into reality. So you're trying to get, hey, look, I've got this vision. I want to build a dental practice. want...
10:54
you know, this many ops, here's the flow, here's all the adjacencies that are in mind, the design team or the architect collects that input from the client and documents it on paper. Now you're trying to take that and translate it into reality. You're going to build walls, you're going to plumb it underground, you're going to build the dental practice. Now that's just an abundance of information, isn't it? So the biggest shortfall with the traditional model is the
11:21
the lack of effective communication when passing off through those multiple parties. The client translates it to the architect or design group. The design group translates it to multiple general contractors to bid it. And then the general contractor is trying to translate that into reality. They're trying to build it based on that blueprint. And it's just that the communication has to be bulletproof. has to be really, really solid.
11:50
for there not to be finger pointing. So usually where we see the breakdown. Finger pointing actually means money that's in terms of change orders, correct? Yeah, precisely. Someone screwed up and someone's gonna have to pay for that screw up or misinterpretation or miscommunication, correct? Yep, absolutely right. So what ends up happening is, you you get this effect going on where
12:19
architect is pointing a contractor, contractor points at architect and guess who's in the middle, the client. So the client gets to try to interpret who dropped the ball and who is responsible for this problem because I'm the doctor. I mean, I shouldn't be left with this. All I want is you to build what you promised you were building for me. Um, so it just becomes, uh, you know, it becomes a great big, uh, you know,
12:48
issue for the client to work out to make sure that the project can continue to progress in the right way. And we can get into examples and specifics of what happens, but from a high level, it's a communication issue. You know, when a set of plans goes out to contractors for bid, that set of plans has to be 100 % complete, 100 % documented to accuracy, with no
13:15
you know, missing information. Otherwise you're going to have contractors who are bidding. mean, all that they have is a set of drawings to bid off of. And ideally they've been to the site and they know where they're, where they're building this project. Now they need to take all that information and convert that into a bid. They need to be able to tell the client, here's what it's going to cost to hire my firm to bid this project. Now, what if there was some pertinent information that somehow was left out of the drawing?
13:45
What if those drawings were only 85 % complete because there are still some decisions to be made by the client perhaps. There were some things we left to, know, once project is underway, we'll figure that out in the field. That's not gonna be reflected in that contractor's bid, generally speaking. In the main, that's the case. Now there's acceptance to every rule, but what I'm trying to point out here is the normal, you know, the normal impact of the traditional model. And again, we were there.
14:14
And that in that role on both ends of that side, you both sides of that table, the architect and then the contractor. So we thought firsthand into us, we said, this is a problem. This is a broken system. Let's let's fix it. OK, so you said then we're getting into that in the next episodes to come. We are going to we are going to interview an architect, a very good one. Dr. Michael Unthank, just a beast in the in the industry and has a legendary resume.
14:44
He's going to break down hard bid. let's move now. So now that we've kind of discovered some challenges with the hard bid and poke some holes in it, let's now move to, okay, so some flaws with the hard bid, maybe the best man didn't win. I could see some change orders with that problem. And I see it every single day with my clients. And John, I guarantee you, you did too, buddy, when you built your offices. So the question is, why
15:14
design build. I think John and I had a great conversation here. You said you would do design build. Didn't you say that, John? Well, I would with the right firm, right? I wouldn't do it with a design build that does, you know, residential real estate and construction. You know, the reality is you need someone that has expertise in the architectural standpoint. You know, it's one reason why we have Mike coming on the subsequent
15:44
call because he is the expert in the field of architecture, right? He's a dentist. He's a great space manager. So it's not a matter of only talking about the architecture and the construction piece. It's about the space management, knowing the needs, knowing airflow, knowing egress for walkways, so on and so forth. Because just because you have a great architect within your design, build firm,
16:12
doesn't mean that the space is going to be built to the specifications of a dental practice. So I put a disclaimer on that. I would want to make sure that I have the baddest of badass architect and the baddest of badass contractor building my practice. That's how I, know, and from a design bill standpoint, it allows you to have great alignment and great vision for how much I want to spend.
16:40
and you're not actually in a fight. Yeah. And here's the other piece. If you actually have a great architect and a great contractor team that you say, hey, we're going to play great in the sandbox, you could also get the same results. But it's about having a shitty architect that does not put everything on there. And then there's RFIs, requests for information, like crazy with the bid process.
17:09
that makes Bruce say, I'm no longer gonna do this. I'm only gonna do design build from now on. I wanna control the whole process and make the project right. So that's where my mind goes. I went all over the place, but I think everyone needs to understand how many pieces of this there are. It's complicated. Well, Bruce, that's probably why you went to design build. So you went to design build, you already gave the history of.
17:37
you were architects, builders, you've gone through the progression. So to John's point, by having a great architect and an understanding of dental, that makes you guys a great fit. why design build? I mean, big picture quickly, like why design build then? Why does it make sense? Yep. mean, what John said, just a quick disclaimer, you can build your team of a
18:07
a really solid architect with deep background of expertise in the market and combine that too with a contractor with the same depth of experience and knowledge and you can have a good result. That's perfectly possible. The issue is not being able to repeat that in a more broad
18:33
means you can't you can't expect that every doctor is going to land on that combination. And that's what led us to this to this process because we found ourselves in that situation. We had some projects that went wallously. We had a really good architect partner. We were the contractor and went well. You know, there's good communication early on and that's what we discovered. And that's what sort of planted the seed is we said, look, when it
18:58
When it went well, it was because there was early communication between architect and contractor. And it was a two-way communication. There was input coming from contractor and input coming from the architect, both ways that we're getting on the same page early on. And that's when we said, you know what? Let's talk about putting this all together ourselves. So now to get to Mike's question here, why design build? For us, the magic is that focused healthcare expertise
19:28
and being able to combine that focused healthcare expertise with the leveraging the one-stop shop. have the ability to walk from the designer's desk to the architect's desk to the project manager's desk, all within the same office. And what that means now is that we can build a process that ties all of them together from day one, not from three months into the planning of the project.
19:56
or a weekly meeting, right? Like sometimes progress of a project happens on a weekly meeting standpoint. So hopefully the architect is coming to every meeting, right? With the project manager and the dentist and the equipment specialist to walk through that space, you know, that's the optimum. That's where we can hopefully reverse some issues. But, you know,
20:26
Sometimes, and Mike, you and I have been a part of it, sometimes the architects, give this and then that's the end of it. You never see them again. And by the way, those are usually the shittiest plans that you could see. So the interpretation is horrific. And the cheapest. And the cheapest. Correct. So in the end, you're going to pay, you know, exponentially more in change orders based upon this. So when I look at,
20:55
When I look at the process and I totally, I love the design bill process because you're exactly right. You're having weekly meetings amongst staff that are controlling this project. Outside of just the weekly meetings or it might even be daily meetings. Hey, I'm having an issue here. This outlet's too close to this. What do we do? That can change things in terms of communication. Isn't there two things about this though, Bruce?
21:24
To me, there's two things. The first thing is the fact that there's total collaboration and there's going to be a lack of change orders in the end because of that total collaboration. So that's obviously a huge plus. But to me, what that really means is that you guys can control the budget from start to finish in a way that
21:50
In my opinion, you got an architect third party and a contractor third party and they're clashing a little bit. And to me, that's how you get change orders and that's how you get budget issues. know, we laugh. I put my banker hat on, right? So I'm worried about the budget and the doctor's budget and the doctor's worried about the budget. And you're right. You got the pointing of the fingers in both directions. For those of you watching on YouTube, we're
22:18
we're sitting here blaming each other instead of us. But yeah, you get very little change orders and a design builder, you can give them a budget and they're going to nail it because you get the synergies of value engineering. And that's something I want you to talk about is the value engineering process with a design build firm is really what you get the maximum. But hang on a second. I'm not going to let it be that easy because
22:49
do you actually get the maximum of value engineering if someone, meaning the owner of the design build firm, Bruce, controls all the pieces on the, you know, all the pawns on the board? Like how do you play that advocate? You know, we call it the fox in the hen house, right? Like running wild. That's the biggest fear of, yeah. That is the biggest concern of consumers. remove yourself from that? How do you remove yourself from that?
23:17
getting the project right. Yeah, let's talk about it. So first, I want to say what we're aiming for here is accountability, right? Both of you have talked about money, blowouts with change orders, and time. Time and money are the two things that are going to be the loss. They're very, very closely related. So let's talk about how we create accountability, though, both for APEC
23:46
as being a design builder, but then the client, you know, and the assurance that they can have that the design builders acting in their best interest. Bearing in mind, not all design builders are made equal. So for us, it's all about process. To create accountability and ensure that we're not finger pointing, creating issues for the client, time delays, money overruns, all those things. It starts from
24:15
the process on day one. How do we set the project up? What's the foundation we build off? So for us, the process that we've built is it starts with a very detailed assessment of the client's needs. Now, here's the critical part of all that. It's not just an architect going through those discussions with the client about what their needs are. It's our design team and our pre-construction team.
24:43
Now, let me help you understand why that's super, super important. So, director of design and director of pre-construction sit down with the client and they spend, let's just say, two and a half hours going through the front of the practice to the back, getting all the input from the client of what's their vision, what are all their needs from the front door to the back door. Now, for us, that is the foundation that we build off of. We've just got the blueprint.
25:13
verbally shared with us from the client. Now it's our job to decipher that, distill it down into not only a functional plan that works, but also an environment, aka the finishes, the aesthetics that matches their vision. And also the budget, because we talked about budget from day one, we don't go designing without, you know, knowing what the budget is, we can design till you know, we can design to the
25:41
to the limits. But the thing is that we have to set the budget upfront on the project. Now that allows our design team and our pre-construction team to work in tandem. And let's just touch on that for a minute because that's one of the most magical pieces of the design build process is that our pre-construction team is bringing the construction expertise into the design process.
26:09
Rather than designers bringing a plan and expecting the construction experts to make it happen on budget on time magically So there's a push-and-pull relationship internally between pre-construction and design In-house in-house in-house. That's right. And and what's under what's entertaining for our clients is a big it to see this right because we go through
26:37
The fun of it is oftentimes the design. Look, we're making a plan. This 2,800 square foot space, the 8,000 square foot space, whatever it is, we're putting a puzzle together that the client's getting super excited. They've got their production space they want, their support space. Not only all that, it looks beautiful. This is amazing. Now, before we let that get away from us, we're going to have that checks and balances of let's talk budget, let's talk timing.
27:07
Let's talk existing conditions of the space. Are there any columns planted right in the middle where you expected the reception desk to go? Are the mechanical system going to support all the construction related hiccups that typically come up later in the process? We're going to discover them upfront. And we're going to make sure the design is buildable and buildable on budget. Now, that's just a sneak peek into the process and how we
27:34
combined construction and design early on, but I want to touch on how is the client not getting taken advantage of? I wanted you to go back to the risks. Let's touch on value engineering next, because you were getting in. because that really is the magic. But back to John's point, we're not going to let you get off the seat there. How do you create how do you not substitute hollow doors when the plan? Yeah.
28:03
solid doors. And that's what the architect always say is my plan said that the carpet level or the carpet grade was here and they substituted here. And that's my value as the architect. Or another one, which I've seen soundproofing the mechanical room and they actually just put regular drywall and then suddenly things that people can't see or feel to the general population. So
28:33
Yeah, I know your integrity base and you would never do that. But there are people out there that would do this sort of stuff. So that's right. That's right. So back to the so so back to the risk. So there's a reason first and foremost that we've gained the reputation that we have as being the people who do things right. Not only are we, for example, inflating mechanical rooms, we're inflating every single wall and dental office. That's standard. And we'll never build a dental office that doesn't have
29:02
insulated walls everywhere. We'll only install hallowed corridors. We'll never install hallowed corridors. Right down the line for us, it's all about building a quality dental practice that builds a quality reputation. But I'm not just going to use that as the excuse for how clients can mitigate the risk with a design builder. Let's get down to the facts of how we can give the client peace of mind.
29:31
So, you usually the question we get is, okay, Apex, I can hire you, you'll do it all, you'll take away all of my accountability concerns, but how do know I'm getting a good deal? How do I know that this is a competitive build out? Now, one of the challenges that we deal with is that because design build is not the predominant model in the dental industry, it's difficult for clients to actually compare up to other design builders of our equal
30:01
capabilities. So that kind of, you know, is a challenge for us. But what we tell clients is we say, the advantage of a traditional model as presented by architects and GCs is the bidding, the bid leveling, the make sure I'm getting a good deal, as well as the architect ensuring that, you know, if doing their job, that they're ensuring that they're inspecting the project along the way and it's being built according to plan.
30:31
Okay, now here's how we also achieve those things. First of all, the bidding for us happens on the sub-trade level. We're not self-performing contractors. So for us, Explain that a little bit further. Explain that. Sure, yep. Sorry, I'm using industry jargon. what that means- Get down to the layman's here. Yeah, yeah, yeah. So what that means is, yes, we have our own site superintendent managing the project.
31:00
the course of construction. But we are not employing electricians, carpenters, plumbers, all the tradesmen. What we're doing is hiring those tradesmen as subcontractors. And that's what every 90 % of the general contractors are doing, right? Even just a GC. So by APEC bidding out to those sub-trades,
31:28
That's where our bidding comes into play. That's how I can tell a client, I know I'm getting you the most competitive project because I'm bidding it out anyway to my own sub trades and I'm bringing you the best balance of cost effectiveness and quality. Now, let me just say these aren't just any sub trades, right? Of course we've built our pool of trades who are qualified. They've passed the apex qualification. They have to have
31:58
you know, commercial tradesmen, big deal. We're not just dealing with, you know, residential mechanical contractors, plumbers, electricians, you're asking for trouble. It's the sub trades don't have the expertise to support the level of product that we're building. you, Bruce, are you saying, sorry for interrupting, are you saying that the client gets to see all of those bids in a design build like it's a negotiated?
32:27
contract or no? That's not common, but we can do that, right? And a lot of this depends on look, how much trust is there with the client? Because some clients can say, here's what I'm to do just to get back to how they can compare Apex to the traditional model. We encourage them to do that, but they have to do it such that they can get real architecture numbers, talk to an architect, make sure you're getting architecture, design, engineering, the full gamut, right? And then talk to contractors and just
32:57
get ballpark numbers, that's fine. And we'll share with you our ballpark numbers. And I promise what you're going to find out is at the end of the day, the costs are what they are. The industry, if you're dealing with honest architects and GCs and an honest design builder, you're going to find yourself in the same realm. And we do that by a lot of times talking generic industry terms, cost per square foot, which of course we all hate to do because there's so many variables, but nonetheless,
33:27
We encourage clients to interview architects and contractors if they can't find another design builder to talk to. And what that does is give them some assurance that, look, my numbers are competitive. And once we can get past that hurdle, let's talk about how now, client, you're in the driver's seat of your budget. Let's get back to the real benefit of design build, and that is that you're in the driver's seat of the budget. Now, the way that we can help you is provide
33:57
construction numbers as we design. We're to budget this thing concurrently as we design. That's the, the, one of the big differences between design, build and traditional model is I'm not going to go and design the whole practice, go out to bid, find that I'm $150,000 over budget and start over. Now you're going to pay an architect to design, undesign and then redesign, right? It's called value engineering. I'd far rather be able to design according to the budget on the first round. Um,
34:27
That's a big difference between traditional and design build models. And you know what? You just brought it up, that value engineering. Let me ask you this question. You have that budget. You have that vision. Your design, your pre-construction and design, you were talking about the levers or the push-pull. That value engineering, that's happening early in the process with you guys. Precisely.
34:56
Will need to avoid any sort of costly change orders because listeners and viewers, what you have to understand if there's a change in the project, it not only is the effective cost of what that change is at that point in time, but there's additional costs to unengineer or undo things to get back to that point of getting what you want in the end. So it's not only, that door costs this,
35:25
Now what costs this? There's costs in returning things, there's costs in expediting things. So the bottom line is, what I want to ask is this value engineering, how do you approach it? And how much are you giving your clients the ability to say, hey, you're going down a slippery slope. This isn't in your budget. Is that, I mean, that's what a good firm does. That's what a good contractor does.
35:55
That's what a good architect does. Yeah. approach as opposed to I'm building my Picasso and this is important to me. Yeah. Yep. So it happens very often in the first few phases of our process. And the bad guy in that scenario is the pre-construction manager because his job is to keep the project on budget. Our design team, you know, gets
36:21
gets excited with the client's vision, they're going to take it as far as the budget will allow them to take it. Our pre-construction team gets labeled a dream crusher because they're the guys who are constantly saying, hold on a second, budget, hold on a second, budget. And as long as the client understands that their role, they come to appreciate that input, right? Because we're not going to allow the client to go too far without knowing
36:50
what impact their decisions are having. It's super, super critical. I want to link that Bruce, because I think that's the meat and potatoes of this entire episode. Because if you go down the hard bid path, and I've gone down and probably, well, for sure, many more times than I have design build. If you go down hard bid path, I've had contractors pause, stop getting creative,
37:19
stop thinking about creative ways to cut costs. And all they do is they bid what the architect is saying and you lose the creativity, you lose the value engineering, you lose that control in my opinion. And that's, me, that's the worst part of it. the reason the Client Tractors, I'll defend you guys is because you don't know if you're gonna win this project. So you could...
37:47
hundreds of hours into a plan and then ultimately not get picked that would suck. Design build is like to me like the best of both worlds, but it is a little the Fox in the head and so there's got to be some trust there. But so I does that talk a little bit real quick finishing this up how you know a little bit more on that that push and pull like what are some pearls? are some things that these guys
38:17
can do to keep their prices down that you see architects doing, in your opinion, kind of a little aggressively. Maybe it's lighting, maybe it's curved walls, whatever. We talk about all of these. That's a great point. That's something for the listeners, just things to look at, whether they're going with the design build or they're going with hard bid. What are some things for people to look at in terms of their packages that they should scrutinize where there are some
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some fluff where they should, you know, there's some potential opportunities to save some cash. Sure, absolutely. So what I would advise is first and foremost, make sure that you're not sacrificing quality for an aesthetically beautiful practice. Because what you're going to do then is if you build the Taj Mahal of practices with the lighting and the soffits and the flooring and the wall coverings, but you're not dealing with high quality building materials.
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you're pouring money into something that's going to start to fall apart after three years, five years, eight years. You want this thing to be durable. It's a high traffic, it's a healthcare environment. So ask the hard question of your contractor and of your architect about the building materials and the quality first. First and foremost, start there. In other words, know that there's a difference in flooring and wear layers and the type of product that goes down and how long it's going to last and how soon you're to have to it out and replace it.
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Same thing for walls, same thing for doors, same thing for lighting and ceiling, if you name it. Every finish in the practice, inquire about it. Also, ask really carefully about the mechanical systems. What's going in under the floor? How are you plumbing up my vacuum and my airlines and how many power outlets and switches I'm gonna have? It sounds silly, but...
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to know that you're getting a well-built practice first and foremost is important. I talk about the insulated walls and it's funny, but we see it all the time. Contractors bidding projects and walls aren't insulated. I mean, what's the first complaint to patients? can hear everything that's happening in the, you on the room next door. So talk about quality first, then to move to aesthetic. Doctors should be mindful of, you know, what their
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getting as a baseline, right? And build on a baseline. Know where the costs are if you build a practice that's well built, good quality, but baseline aesthetics, and then build up from there. So what I mean by build up from there is now you can start to address the look and feel of the practice. And there's so many different textures and textiles to use, finishes on the walls, lighting is a high impact item that can make a big difference in the aesthetic.
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And it's a cost variable. Ceiling types, acoustical tile versus drywall hard ceiling, soft fits, creating nice detail and interest in the ceiling. Think about floors, walls, ceiling. And in all those three areas, what are you applying to the floors, the walls, the ceiling? And there's so many super creative, super fun options, and that's where you can start to dress up the space. And that's also where the money comes into play. Again,
41:40
Start with a quality baseline and build on top of that. Love it. mean, to me, Bruce, we actually gave of all the interviews thus far, we actually probably gave you the most time to speak about things. But I think it was very, very important because Mike and I think we're the smartest people in the rooms. In this episode, you were definitely the smartest person in the room. And we needed to give you that platform.
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to be able to speak to it, because it's very, very important. And as Mike said, 70 % of these people's budgets is going to construction. So, or the construction process, it's not only construction. So, you know, in my mind, this was very warranted time for our listeners. It was great for me. It's always good to see you. And, you know, I just want you to keep on doing what you've been doing for the industry as a whole.
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I think you've given our listeners and viewership amazing amount of information that they're gonna be able to take to their project or utilize you wherever they are in this beautiful country of ours. So from my side, Bruce, it was a great interview. Yeah, thanks. Really good. Yeah. Being a part of it, I appreciate it. I know how difficult it is to go against the grain and in a lot of ways you are because everybody is so trained.
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hard bid. I think we gave you a great voice today to talk about design build and those options. And I think that I think the industry needs more conversations like this for sure. Thanks guys. No, I really enjoyed the conversation and hopefully it wasn't too condescending, but we're pretty passionate about design build. By the way, that's what this is about. Listen, viewers, listeners, we're on we're on all the channels. Go to the description below.
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Get a hold of Bruce. You have full access to this dude. He's been architect, builder, hard-built, bidder, and now design builder. Gosh, that was a tongue twister. He's got all experience. Go to him directly. Ask him these questions. He's nationwide. We're covering the entire country with our partners in this program. And this is the one guy that will help you understand the best, the pros and cons of design, build, and
44:06
We're really lucky to have you, man. Thanks for being a part of the show. Thanks again, guys. Thanks, Bruce. See you, buddy. See man. All right, see you guys.
44:23
Thanks for listening. Tune in next week for another truth-filled episode of Startup Unscripted.
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