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In this episode we discuss our most asked question: Why do we believe Single Entry is the way to practice in the future? What are the advantages? How do I implement it into my practice? Tune in to our first part of the Operatory of the Future discussion with Kappler and SurfCT.

Transcription below:

Paul

Single-entry operatories are not very popular here in the US at all. And in fact, when we’ve done jobs in Dubai, the offices there are very elegant and very beautiful and they all have single-entry. But here in the US it’s not so prominent.

Holger

The single-entry was coming back to the US about 30 years ago and one or two major companies in this country have seen that there is a problem. The problem was that assistants have to get out really fast out of the operatory to grab something they forgot about and the new workflow and ergonomic solution was to have an that was blocking the exit of the room. 

As a result, they invented a room with two doors- one for doctor and one for the assistant. Which for me is creating a problem in trying to solve a problem. Before they invented that it was a single entry. There was a period of about 30 years where the dual entry was really popular and there have been strong arguments in support of it. We don’t see these as arguments but as a good opportunity to make sure you have your workflow and ergonomics set up the right way. Single entry does work. It works worldwide. I think there are one or two other countries in the world that have partly dual entry. For example, Australia.. But most likely, the US is the strongest market that has them. The rest of the world is using single entry.

Paul

Well I want to jump into that. I know when I was in these offices and I looked at that single entry, it provides a nice place to have a conversation. It’s a little quieter. There’s probably some other advantages to it. Julia, what do you got for us?

Julia

I just got two pictures. Here in the US, everyone is used to having that dual entry, so a lot of times when we try to talk about single entry there are a lot of concerns. They are not sure why it will work, and they don’t see the advantages. I’m just gonna share a picture of an office we did remodel where we actually changed that.

This is an office in Cupertino, California. On the left hand side you can see what the office looked like before we remodeled it. We changed the entire workflow and we changed all of the operatories from dual entry to single entry.

Paul

On the left hand is the same office as on the right hand?

Julia

Correct! Now, my question for you Paul is that when you look at those two pictures, what feeling do you get by looking at them?

Paul

The one on the left is certainly an office I would not want to go to. The energy there seems low. But let’s talk about the carpet. The carpet is creepy. It was creepy to me before this mess we are in. Now, if you have carpet in your office… wow. 

[ laughter ]

The one on the right, I love the computer- obviously we do a lot of technology- but  overall it’s clean, its elegant, there is energy there. It’s got glass. It’s sleek. I would love to be a part of what’s going on on the right, but I would not go to the office on the left. It’s hard for me to believe this is the same office.

Holger

I would go to the office on the left. You know why? Because there is a perfect opportunity to explain to them what they can do to do it better, because it’s not possible to get worse! It’s a good client to help to make sure you get it set up in a way that you really can survive in dental.

Paul

That makes sense! This is your specialty. You guys can take what is on the left and turn it into what is on the right.

Holger

You just looked at it from a patient perspective. That’s great. That’s what we have to do.

Julia

What’s also important besides that one is more modern, is also the feel that you get when you imagine walking into that operatory. 

On the left side, you have a dual entry. You even have a hallway by the window that connects you to all the other operatories. Imagine that it is a busy office and you sit in that chair and you can hear everything that is going on. On the right side, you can enjoy it all by yourself. Giving your patient that privacy gives you a feel of having more confidence going to the dentist, because it’s more calm and not as busy.

Holger

Sometimes dentists say, “I do not feel so great in an operatory with only one entrance”. This is something we have to talk about. Doctors have these questions. They say,  “I have a nice set-up, I have two-doors, I can easily get in and out. So why should I change it to one door?” 

This is not the case, and we can see it perfectly on the right picture here. There is enough space in the back to get in and out for the assistant. That’s the great thing. That table on the cabinet can be pushed away and you can get out even if the patient is laid down. 

Paul

The cabinet plays a large role in this. I’ve heard you refer to it as the “egg”. Is that called the “egg”?

Julia

It’s an egg shape, so…

Holger

An egg is one of the smartest pieces in the world, because of the structure. It’s so stable. The egg is a smart solution.

Paul

It looks very elegant. The way that egg moves in and out of the way is really great. The single-entry operatory for me, as an outsider looking in, it just looks to be more sterile. It looks to be more private. It looks to create a better experience. In the dual-entry operatory, you’re not going to be able to control noise. Even more scary, you’ve got another opportunity for someone to come into the front over there, which is three entries. There’s something elegant about this single entry operatory. I see it all over the world when we work overseas, so i think there is something really special here.

Now, I wonder if doctors have the information they need to make that choice or are they just put into a two-entry operatory scenario. Has this discussion happened with the majority of doctors in the world?

Julia

It’s really here that everyone is so used to working with two doors that they are afraid that it’s not going to work if they do it differently. Most of the time the first answer we get is “How can my assistant get out?”. Like Holger was saying at the beginning, we ask them, “Why does your assistant have to get out of the room?” because she shouldn’t! 

That ties back to our sterilization and storage conversation we had last week. It’s really about how you organize your centralized storage to be able to prepare, so that your assistant doesn’t have to leave the room.

Holger

Not only in IT is everything connected, but in the workflow, layout, design, and setup, everything is connected because you cannot have a single entry operatory if you do not think through the whole office. It’s so important to get the right team in place and not just go to whatever architect or whatever designer and get a layout or design. This is not how it works because there are so many bits and pieces you have to put together. 

It’s like going to an office and they tell you “I already bought the server, cables, and monitors. Can you set it up for me?” This will not work, right?

Paul

No, it will not work. It’s really about systems and having the right systems in place and having those systems serve the doctor, the team, and the patient- coming together to create that experience. 

So often I talk about Starbucks, and the differences between a regular cup and Starbucks. It comes down to systems and design.

My mother is 78 and she doesn’t know how to send an email, but she knows how to walk into a Starbuck and order her favorite drink anywhere. The design is set-up in such a way that it is easy to do and it makes sense. 

When you’re connecting with a patient in an operatory, I think a single entry makes a lot of sense. I was surprised not to see so much single entry in the states. I think it comes down to education and showing the options.

Julia, last week you talked about just-in-time sterilization which i thought was so important. That sterilization center you’re providing really also works together as a system with this single-entry operatory. 

Julia

Yeah, because like you see on the left side, we have three cabinets, we have a lot of upper cabinets where we used to store all of our equipment as opposed to having that centralized so that we really only bring cassettes, tubs, trays into that one operatory that we need for a day. This allows us to control our inventory better and avoid our assistant having to leave the room. We now have the minimal cabinetry in our operatory that gives us more space like you see here.

Paul

It’s interesting you say that. 

So many times, doctors will ask us for advice. I always say, less is more. They have a hard time understanding how to create less in their operatories. They don’t know! They are like “No, no we need the storage, we need the cabinets.” From the outside, I’m like “Why do you need that?” It goes back to the system. If you don’t have the right sterilization system.

You guys are not only supporting single-entry clinical operatories but you’re also talking about making a more elegant, open, cleaner platform. We’re not just talking about ruining the carpet. In today’s world you cannot have carpet in your dental practice. You’re talking about an overall clean design that will have someone like me- from the patient perspective- say, “Hey, this is the type of place I want to go to”.

Holger

Hey, safer and cleaner, right?

Paul

Clean and protect. Clean and protect.

Well listen, I really appreciate you all sharing this information today. Let’s see how the crowd reacts and maybe we’ll come back to single-entry operatory, but this has been really really eye opening for me. Thank you.


Stay tuned and don’t miss our next Video about dental office design.

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