Daily Archives: June 5, 2018

Opening Up A Medical Practice In Ontario? Medical clinic, Dental, Vet- ETC

Let’s go through a normal scenario of opening up a Medical practice- Vet, Dental or Physician’s etc.

  1. You Make The Decision. You are finally going to do it! You are going to open up your own practice.
  2. You inquire to a consultant about available space to lease. You may talk to another consultant about the best place to open your practice. You look at demographics of certain areas to determine the best place for your practice. Finally, a space is found.
  3. An Architect produces a drawing for your practice layout. They comb through all the details of every room. They specify all the finishing details. Paint colors etc. You pay or hire a consultant to produce these drawings, as well as to apply for building permit in the area you are planning to open to.
  4. You pay another set of engineers- mechanical, electrical, structural, etc. They specify how the plumbing is to be run, and how the heating is to be installed.
  5. The drawings for your new place are sent out to General Contractors to bid on your job. They follow the drawings and submit a price for building.
  6. You agree to a General Contractor’s bid. There is a schedule, and there is a price. Both of which you believe will not change.

Although these steps seem straight forward, the costs incurred by the client are significant. Money is being spent in all different directions. Consultants, engineers, architects and contractors. You will pay for city permits, inspections, etc. The process is long and complicated.

Build Technology Contracting has been fortunate to have been the builders of one of the biggest dental facilities in Canada. The project was complex. There was over 20,000 square feet of area to be constructed. The building was old and needed upgrading. We had to install from scratch brand new HVAC, Plumbing, and Electrical systems. Rooftop units needed to be replaced. The list of services and upgrades is never ending. But one thing we did, was that we did almost all this work in house. This is what makes a huge difference not only in overall cost to open but also in quality of the work.

Here are some tips when beginning the journey of opening up your own practice.

Consultants are not necessarily on your side

We have seen this before many times. The architect and engineers, who works for you, are not always on your side. There is unfortunately a pretty significant conflict of interest working against you. This is not to say that all consultants are like this, but it is definitely something to keep in mind. An example of this was on a project we did where an engineer specified about 20 high bay lights to be installed in an open concept theater area. They specified a specific brand of light that had a cost of about $800 per light. After researching other options we helped the client find an alternative for about 25% of the cost. Not only was this light cheaper, it also produced the same if not better quality. Although we can not confirm this with certainty, it seems as though engineering/ architectural firms might benefit from the products which they spec for their clients to buy.

Another example was on a project we did where the engineers had spec’d a specific fire alarm to be installed. This was a very big building and the expected cost of installation was upwards of 100 thousand dollars. As the Contractors on the job, we were confused as to why a fire alarm system had been called for since the building already had a sprinkler system. We pleaded with the engineers for cheaper options. We discussed alternative brands, smaller systems and anything we could think of. Eventually, we studied the code in detail and realized that the building did not actually require this fire alarm system. We brought this up to the engineers, who eventually acknowledged that we were correct. We had saved the client from a huge spend that was not necessary.

Contractors are going to burn you on change fees

The reality is when building a medical facility, that there are going to be changes. Not everything on paper is going to make sense in reality. This might take some time to realize and it might even be evident after construction has already started. When you want to make a change, your contractor is going to charge you. A lot of construction companies now are underbidding jobs because they know they can make it up on the change fees. You are unfortunately almost at their mercy when it comes to making a change from the original drawings. Keep this in mind when signing with a contractor. From experience, most changes are not a big deal. They can be done pretty quickly with not a lot of complication. Speak to your contractor before starting about changes and their associated fees.

Contractors make money by sub-contracting. They make big margins on other people doing the work.

Generally, your Contractor is awarded a job. They then go to other companies who have employees that perform the work. The General Contractors cost is usually about 30% less than the cost the client eventually pays for the work. For example: A contractor approaches a Electrical Sub-Contractor to perform work on a 2,000 square foot dental facility. The Client is Billed $40,000 for the work. The Contractor pays the Electrical Contractor $28,000. The Electrical Contractors cost for materials and paying employees is about $14,000. This in a nut-shell is how a normal construction operation is run. The cost for a job flows downstream with multiple companies taking a piece even if they do not perform the work.

 

Why work with Build Technology Contracting?

First of all, we do the work. We are all on the job site, we are all involved in the actual construction. The same people you will meet when we discuss your job, will be the people who perform labor on your project.  We are not going to hire another company to perform the work and just take a profit of the top.

When you work with us, you have the option of using Build Technology architects, engineers and consultants. We work with them on projects and there is a trusting relationship that we all take very seriously. We are not going to take advantage of the client. If you are our client, we are going to keep that relationship open and honest. We will give you our opinions and always present the best options possible for your specific situation. We respect how hard you work for your money and we vow to make sure you do not waste it.

No matter what phase you are at in building your dream medical practice, we can help. We would love to meet with potential clients to discuss future projects and how we can help make your dream into a reality.