The design for the site of an orthodontic office has to encompass a wide variety of heterogeneous concepts that have little or no logical connection with each other including functional and ergonomic requirements, the available existing space, the existing building itself, the flow of traffic, the conduct of the practice, costs, colors, materials, textures, and lighting.

Carrying out this transformation cannot be done without an in depth study of the specifications and characteristics of every phase of the operation, a careful analysis of the needs and mode of operation of the office team. But this plan for a facility remodeling should not respond solely to functional needs; every office location should be designed to house a particular activity. The waiting room and reception desk should encourage communication and empathy. The consulting room should soothe fears and stimulate dialogue. The treatment rooms or area should reflect professionalism. The sterilization area must gleam with an almost virginal cleanliness and demonstrate the rigor of its antiseptic qualities. Throughout, management of space, forms, dimensions, and the choice of materials and colors must flow from a well thought out plan where they all participate in the creation of an atmosphere that sends a message to patients. “Architectural works speak to men’s hearts, awakening emotions. The task of architecture is to stimulate righteous emotions.” [2]

It is commonly accepted that a good practicioner-patient relationship favours good patient co-operation with treatments. However, medical literature and our own research have led us to a more pertinent approach. The body and the mind cannot be dissociated in humans and numerous observations show that therapeutic results are favoured by the human relationship. (Given similar techniques, biological answers differ). Now concerning the environment, the question is:

“How can the clinical framework integrate this research?”

Stating the problem and its ramifications

The rapid changes that have affected the practice of orthodontics in recent years make it necessary for us to re-examine the traditional ways we have managed our offices. Our basic training, essentially technical in nature, never prepared us to direct the operation of an enterprise that has important business as well as orthodontic treatment components. In today’s world we should properly consider our practices as veritable full scale health care delivery organizations. The accelerating rate of change in modern medicine and in the way both patients and referring dentists perceive it and the exponentially rising flood of information about business administration, finance, and law, have all contributed to the block of time that orthodontic offices must devote to management concerns. These details must be dealt with appropriately to allow orthodontists to practice their profession under optimal conditions. And among those essential non-clinical tasks, there is little doubt that proper direction of human resources is the most difficult. And that is entirely understandable because in serving as team leaders orthodontists must interact with a host of individual personality issues. This new challenge is monumental. To confront it successfully orthodontists must become more than skilled technicians, they must perform as successful managers. In this article we propose to present practical rules for efficient office management.

Change is inevitable: it occurs in every domain and we should realize that it doesn’t work as a one-time leap forward but is, instead, an on-going process. And as an underlying principle we should also understand that planned and well executed development is always preferable to abrupt changes that are imposed by external forces. By exercising ceaseless vigilance we can prepare in advance for the improvements that we must make to keep our offices up to date.

In all organizations, resistance to change is built into the behavior of every staff member. Management should take this factor into account and establish ways of dealing with it in each pro ject that is undertaken. Every activity requires the voluntary and active participation of all members of the office team. As the group leader, the practitioner must define the needs, outline the fra mework of the action, dissolve resistance, and provide the breathing room that is indispensable in stimulating voluntary and motivated cooperation of participants.