Ash welcomes Dustin Long of Big Sky Construction to talk about building dental offices from the ground up. Dustin brings decades of experience and shares what sets dental office construction apart from other building projects. He emphasizes the importance of a collaborative process that starts months before the first wall goes up, involving real estate brokers, CPAs, designers, and other professionals to ensure each practice fits both the client’s immediate and future goals.

They cover the full journey, from picking the right location and working through lease negotiations to tailoring the practice to match the dentist’s vision and workflow. Dustin and Ash also discuss common pitfalls—like hiring non-specialized contractors—and how mistakes in pre-planning can lead to costly corrections and lost income. They stress the benefit of relying on specialized teams and trusted advisors throughout the process and share a story of a client who narrowly avoided disaster by sticking with dental-specific experts.

To find out more about Dustin, you can connect with him at: www.BigSkyConstruction.com, email him at dlong {at} bigskyconstruction.com or call him at 206-259-0936.

Key Topics Discussed:

• Importance of creating a seamless and enjoyable construction experience
• The critical pre-construction planning phase (6–9 months before building starts)
• Working with real estate brokers, CPAs, designers, and equipment reps
• Assessing existing spaces for suitability and hidden costs
• Customizing design based on the dentist’s present and future goals
• Differences between dental office construction and generic builds
• Risks of using non-specialist or inexpensive contractors
• Importance of precise measurements and planning
• Financial planning, including working capital and lender selection
• How a team of specialized advisors can help avoid costly mistakes
• Stories of clients who benefited from using dental-specific experts
• The value of study clubs and peer learning in the dental community

Welcome to Beyond Bite Wings, the business side of dentistry, brought to you by Edwards and Associates PC. Join us as we discuss how to build your dental practice, optimize your income, and plan for your future. This podcast is distributed with the understanding that Edwards and Associates PC is not rendering legal, accounting or professional advice. Listeners should consult with their business advisors before acting on any of the information that is shared at Edwards and Associates PC. Our business business is the business of dentistry. For help or more information, visit our [email protected].

Hello and welcome to another episode of Beyond Bitewings. My name is Ash, and in today's episode we have a very special guest. His name is Dustin Long and he is with Big Sky Construction, specializing in the medical field, dental field. He has many years, multiple decades of experience in construction in other parts of the United States, but his company is currently trying to penetrate the market in the dfw. We had the opportunity to meet him at the SWDC convention and he had a lot of interesting things to say and we decided to have him on this episode so he could share more with our listeners. So without further ado, Dustin, how are you?

Ash, thank you for the introduction. I'm excited to be here. This has been a great show. And yes, my name is Dustin Long with Big Sky. We've been building construction for many decades here in dfw. I also have a company in the Pacific northwest. The last 10 years, we've built over 300 dental offices.

Wow, that's amazing.

In 10 years. Yeah, so we've got a lot of dental experience. We've. We've seen the goods, we've seen the bads, we've seen struggles, we've gotten through challenges. And that's what it's all about. It's about connecting with our clients. It's about building relationship, creating teams that can get us from point A to point B as seamless, as smooth and as enjoyable as possible. That's one thing that we really strive to do, is provide our clients with an experience.

A lot of contractors are out there. They'll tell you, listen, there's. There's three things that a client can have, but you can only pick two. They'll tell you, you can have cost, you can have schedule, or you can get quality. So pick two of the three. Big sky, we actually give you not only all three, we're going to give you a fourth. We're going to give you that experience. We want our clients because they're not going to do this too many times in their.

In their Career. Most our clients are only going to do this one, two, maybe three times.

Right.

So why not make sure that this experience for them is enjoyable? Is fun. Construction is a lot of fun. Seeing the different milestones, seeing it from where it's a bare, raw space to framing and wiring and all this piping, and then you start putting these beautiful finishes to it. It's a storytelling that we do in 12 weeks. It happens so quick. From the time we start to the time they're starting to see patients are moving in, it's 12 to 14 weeks. So in a blink of an eye, it happens. I'm very passionate about what we do because, first of all, I love it.

I'm a people pleaser, and it's just a lot of fun. Yeah. And when you're. When you're so passionate and have fun doing what you do, you end up being one of the best doing it.

Oh, yeah, absolutely. And I can feel this energy coming off of you. Honestly, I don't think I've felt that way towards construction, but you're making me a believer. I'm like, oh, yeah, there's storytelling in construction too.

Yes, 100%.

You know, as you saying this, I'm also thinking, like, you're right. You know, there are a lot of our clients that are doing this for the first time, and it's a scary process for them, right?

Oh, for sure.

And then, of course, the costs associated with it. And then let's not forget about the giant student loan that they have.

Yes.

And then, you know, they're constantly questioning themselves, hey, was this a smart move? Should. Should I open up this practice? Or should have. Should I have just stayed as an associate? But then, you know, working with people like you, I think it helps calm their nerves.

Oh, 100%. You know, I can't tell you how many clients have. Have said that very same thing.

Really?

God, you know what? I'm so scared. I don't know if I should be doing this. Ash, I gotta tell you, with over 300 clients, every single one of them has been a success. As a matter of fact, we have clients now that are coming back to us and saying, hey, I want that second location, or, hey, I have outgrown the one you originally built for us. I need a bigger practice. I have not yet met a client that did not succeed. But you know what? What dentists have that I love about dentists? They've got that entrepreneurial spirit. What they need and what we show them is you're great at what you do.

Make sure to bring in the specialist, surround yourself with the people that are the best at what they do to get you to the point where you can do what you do best. And that's dentistry. So that's where we really excel, is we bring that team of trusted advisors to the client so that we can get them into that beautiful or awesome or clean or whatever the client's goals are so that they can do what they do best. And that's dentistry way. And not just construction. So the storytelling, while the part of construction, seeing the different phases and the milestones, that's the story I love most. There's also a huge backstory, a buildup before you get to that point. That's right.

You've got to build this practice on paper first. There's so much that goes into it. As a matter of fact, most of our clients are working with us six to nine months before we start construction.

Okay, you mentioned that.

We're looking at the spaces. We're working with the CPAs, we're working with the attorneys, we're working with designers. Designers, all these other entities involved in the early process to make sure that when we get to the build, the money's dialed in, the client is confident and secure with that decision at that point. So that it's just, again, that smooth, enjoyable experience.

I'm glad you actually mentioned that because oftentimes, you know, listeners or even clients, they hear like, oh, 14 to 16 weeks. And then they think they plan around that timeline. But that's really for the build up.

Yes, it is.

Right. But then it takes some time and as you just mentioned, and maybe, you know, elaborate a little bit on that. So what do you mean by six to nine months? What. What needs to happen in that time?

Great question. So, you know, this is where we help to try calm those nerves in the client. Because there's so many balls being juggled at once. That initial six to nine months, we're working with a real estate broker, we're finding the right space. We're making sure that we're catching any red flags with regards to those spaces. Because we can build a dental office anywhere. I can build the dental office on the roof of a high rise. It's understanding the space that we're putting that dental office in.

So then we're working with the trusted advisors to say, hey, there's a couple things with this space that we need to be aware of. There's a couple things that could be adding cost to your budget that we should go and leverage the landlord and ask for More money, ask for more free rent. So we're doing that on the very early stages. Once we've gotten through that process and we understand what we're walking into or what we're going to be building into, we then start the process of designing this space. Hey doc, what do you want? How many operatories.

That's right.

Do you. And not only today, but in the future, you know, some clients will come to us and be like, listen, I just want to keep this thing, keep it easy. I want five, six ops. It's just going to be me and a couple hygiene and I want to live a great simple life. Awesome, that's perfect. Some docs like, well, no, I want to start, we've got a startup right now. As a matter of fact, we just met yesterday, who's saying, listen, I want 10 ops, I'm a startup. That's a big practice.

That's very ambitious. That's very ambitious for a startup. But his goals are having associates, having multiple hygiene. He wants to do restorative and other heavier cases in house. So understanding all those goals, not just today's goals, but his future goals so that we can start incorporating that into a floor plan.

That's true.

So when we take all of that information and we start designing the flow or the test fit, the initial picture of what that practice looks like, showing the layout.

Right.

How many people do you want to check in, check out?

That's true.

You know, you're going to have one designated, two, three, showing all the operatories, talking about the infrastructure. You know, do you want nitrous? We got to carve out a closet for the medical gases. So we start nailing down all the nuts and bolts of what this practice is going to entail and then we create a floor plan. A couple tweaks later, we've now got the practice, a visual look at what this practice looks like from there. Then we start the fun part that the clients really love and that's designing colors. What's it like? It's amazing. So again, over 300 practices in 10 years, none of which look the same. What's cool is I love walking into a finish space because I've been working with this client for so long.

And then we're high fiving each other and you can see the client's characteristic, their personality now shown in their practice. We've built projects, I've had clients come to me like I want a man cave looking practice. I had a client come to me and she said, she goes, I want my practice to look like my closet.

And I'm like, interesting.

Okay. So I had to go visit her house. Look at her closet. Her practice has pink wall covering.

Okay.

Curved radius, beautiful vanities, chandeliers.

Wow. An homage to her closet. That's the first one for me. Yes.

So it's really fun to get to that process because now we're through the. Okay, this is kind of scary. This is. I don't know what I'm doing. We're now to the point of like, oh, man. Okay. Now we're really starting to get to know the client and what their personality is and how that practice is going to set apart to identify who that dentist is. That's really where you start seeing this beautiful energy shining from the dentist because they.

They start seeing it coming into reality. Now we've gotten through that process. Then we get to the actual. Okay, here's the cost. Let's start talking about all the costs because we've got this dream now drawn up. Now we need to make sure that we are hitting your budget.

That's true.

So then we go through this process with the client to make sure that we're hitting their budget. That's one of the most critical parts before we start construction is making sure we're all on the same page. And there's this one thing that's great about Big sky is no matter what your budget, we're going to hit it.

Oh, wow.

It's not just a. This is a give or take. Sorry, Leave it or leave it or take it. This is a. This is a massaging process of building your dream practice at the budget that you can spend. We're also looping in the equipment representatives, we're looping in the technology specialists. We're looping in all the individuals that it now requires to build this practice. And then once we've identified and nailed all of that, then we start the fun part, which is my expertise.

And that's the building. The building process. And it's just. It's a beautiful thing. Walking clients. We have several milestones through the course of the project to make sure dentist office. So many people think, you know, building is building, construction is construction. Oh, I can build a dental office.

Have you ever built one? No, you can't build a dental office. Dental offices are so exact ash. If you take an operatory and your chair is even an inch from where it's supposed to be, the doctor is now pinched. Ergonomics are out the window. The patient is having a hard time getting in. The assistant can't get Out.

That's right.

There are so many critical measurements that if they're not nailed from day one, the clinic is screwed.

That's true. Maybe a very costly renovation later.

Exactly, exactly. And it's unfortunate. And I've seen cases where clients, you know, they thought, well, you know, my uncle's brother has a contracting business now Big Sky's getting the call back because they thought we were too expensive at that point. And they're like, man, we really messed up. We've got to saw, cut concrete, we've got to do new core drills, we've got to do new finishes. So nailing it on the first go is so important for these dentists because while it is a costly investment to open a practice, it's so much more costly to redo.

That's right.

A practice.

That's right. And I'm glad you actually brought this up, because that's the thing, I think with most people that are starting out, they always just look at the numbers. It's like, how do I keep it to a minimum? Right? Not trying to be a cheapskate, but, you know, I have a certain limited amount of funds, you know, that I got approved for from my lender, and I want to make sure I hit those numbers. So if I can get a cheaper quotation somewhere else, that would give me, I don't know, more into my working capital. But as you just mentioned, I'm glad you mentioned this because I've seen it happen with my clients where they went with, you know, nothing against that construction company, but they don't specialize.

Right.

And they don't practice, and they were cheaper. But then once it was built, here's the weird thing, like, even in the measurements, I think something to do with the drywall, they didn't account for that on both sides. And it really messed up the cabinetry and the equipment and.

Ouch.

And they originally was supposed to have six ops, and they later had to remodel it to four ops. And that really changed everything because as you said, the pre planning stage, six to nine months, he was planning on, he had already sent out an agreement to his associate. He decided on what days they were going to come in, but now the number of opportunities have been reduced. So he had to change, like, redo the whole thing, his hygiene days and does. Like, should he even bring into his other associates? It was just a huge mess to fix.

Ash, think about that. I want six. I got four. That's upwards of $100,000 per chair lost every year. And here's Another loss in opportunity that clients don't think about sometimes. We mentioned the schedule. I can build a dental office in 12 to 14 weeks. We are in and out.

I've had clients come to me and say, Dustin, it took me six to nine months, months to build my dental office because my contractor didn't know what they were doing. Six to nine months. We know you dentists know what you make every month.

That's true.

How much did you just lose because of that added time? It's a bummer. But you know what, we're here to help you avoid those challenges. That's true. Because there are going to be challenges in construction.

That's true.

That's, that's why we are here doing what we do. That's why we specialize in what we do.

That's true.

We provide the solutions to challenges. But there are certain challenges out there that a dentist should never experience.

Right.

But you have to surround yourself with the specialist and the experts at what they do.

Absolutely agree. I mean, one example I always give out to people is that if you're driving a fancy German car, you're not going to take it to any Joe Schmo mechanic.

Exactly.

You know, it's a specialized vehicle that requires specialized trained mechanics to work on it. So, you know, the field of dentistry, it's similar to that. So yes, initially the cost might be a little bit higher, but as Dustin just mentioned, in the long run it's worth it. And then, you know, if it truly is, finances like this is where people like us also come into play, where we can help you figure out how to qualify for higher working capital in the lending environment. Maybe when you approach the lender yourself, they qualified you for a certain amount because they just went off of your tax returns. But then like for instance, let's talk about Edwards and Associates. We partner up with multiple big banks, small banks, where they understand the true income of a dentist, where they know that depreciation is not a real expense and that should be added back and your income then goes up and that qualifies you for a higher amount. They also know that if, even if you have, I don't know, half a million dollars in student debt, that that should not affect your ability to borrow funds.

And then even with the working capital, like, you know, people have these standard numbers saying, oh, you know, it typically takes six to eight months for break even, so you need to have enough in payroll, you know, from the get go, because you can't be expecting to get, you know, 20 walk ins per day. As soon as you open the doors. So you need to have that contingency fund set aside to pay for your ongoing overhead expenses. But again with that, there are other ways where we can have you qualify for a higher amount. Find ways through your accounting, financials, as well as lenders that are willing to work with you and truly understand what you're capable of. Lenders that will invest in you and not just, you know, the collaterals that you have to offer. So things like that. And again, just piggybacking off of what Dustin just said, like having that team of experts will allow you to realize that you may actually have more options, even in an environment where you may feel like, whoa, this is more expensive than what I thought or what my cousin told me, Right?

Absolutely, yes.

But like I said, just. Just being as they say, knowledge is power. Right? So go out there. And it is true. Like, you're not going to know everything, right? So that's when you find these trusted advisors and seek for their assistance 100%.

Yeah, absolutely. Yeah.

Now, let's see. This is something I sometimes ask some of my guests on the show. Is there a story of failure that you can think of with maybe a client and you don't have to mention names or something, and. Or maybe it was like a disaster, but then somehow they came out of it.

You know, I've got several stories like that where Big sky came in.

Okay.

And was the solution.

Okay? Yeah, let's hear one.

You know, we just actually finished a project for a client where he used our council. We toured probably five or six different locations with him.

Okay.

Helped him through the lease negotiations, designed his practice, helped him get the equipment dialed in, got the technology package all figured out, and, you know, it's quite common for a client to be. Okay. We get to that point, and now they're like, I need to make sure that I'm getting a good price, A good and fair price. Absolutely, 100%. So we go out to bid, and he found a contractor that was quite a bit cheaper than us. Now, unfortunately, the contractor he found had a particular reputation. And he gets to the point of almost contracting with this other contractor and come to find out they had missed a lot of his project. They didn't understand what medical gases were.

They thought they were going to be buying copper from Home Depot. They had no idea that this particular doctor wanted sinks in all the operatories. He was also going for a very particular look where a lot of his operatories were surrounded by glass. Well, apparently this contractor thought that the owner was going to do the glass himself.

Oh, goodness.

This contractor also thought that the medical gases were provided by the equipment reps who sell chairs and cabinets. So he calls me back later and is like, dustin, I am so sorry. I had no idea. But I'm very glad that he had a CPA helped him through the vetting process.

Oh, goodness, yes. And some dental specific cpa, I'm assuming.

No, no, no, no. It was a dental specific who helped him realize this contractor. The reason they were so cheap is because they missed about 30% of the project.

Okay.

So the CPA. Thank you. In this case helped this client understand and avoid the disaster that he was about to encounter.

Oh, thank goodness.

And he looped back, came back to Big sky and said, you were right. I would love for you to build my project. We've built the project. Successful project. High fives on the way out. And he's actually one of our biggest references at this point.

Oh, good.

In the region that he's in.

Oh, that's fantastic.

That's fantastic.

Oh, my goodness. I'm so happy to hear that. It happened before.

Yes, yes. Construction was done. Now there are, there are stories where, you know, I'll, I do continuing education courses, and I've got a few PowerPoints where, you know, you, if you see this, you need to run, you need to, you need to avoid this. And I've had a couple clients, you know, they'll, they'll raise their hands. They're like, man, Dustin, I wish I would have known about this prior to the build out, because I'm in that exact same situation. And what can I do at this point? And of course, at that, you know, we're in front of a huge group. I'm like, let's speak after this. Let's see what we can do.

Because there are solutions. There's always solutions. But the point being, it would be awesome if we could just avoid them from day one.

That's right.

Dentists are extremely smart people.

They are, no doubt.

And they're incredible at what they do. But sometimes, and even, even in my case, you know, I'm an expert at construction, but I'm not an expert at all things dental.

Putting in a crown.

Exactly. I couldn't put in a crowd. I have to rely on the experts advice, the expert advisors. And so I just highly recommend and encourage. And this is one of the biggest points that I put across whenever I'm speaking or whenever I'm doing a continuing education course or whatever. It's. Listen to your trusted advisors, because there are people out there that are seeking your best interest. They're like, Big sky, we want you to succeed.

We are 100 word of mouth. We rely on our clients to tell their colleagues or their associates who are breaking out, wanting to start their own or their study clubs. And if you're thinking about doing something in the, in construction or to your office, you've got to call Big Sky. So listen to your trusted advisors. That is one of the biggest points to get across here today.

Yeah. And you actually brought up a good point there. Study clubs, they're very, very important, could be a very strong resource to gather all that information. Especially if you feel like you're in the early stages of wanting to start or open a practice. It really helps having other professionals sometimes in certain study clubs, you may have someone there that was exactly where you're at now two years ago. Absolutely. Share their stories and tell you what to keep an eye out for and what to be aware of.

And we'll, we've spoken at numerous study clubs. They'll, they'll dedicate a night specifically to talk about, hey, let's, let's, let's refresh your practice. Or they're looking to buy a practice, what to look out for. Or they want to start a practice or they want to buy a building. We've, we've spoke at many study clubs in regards to those specific points to make sure that they get off on the right path for success.

That's fantastic. And I can tell already that you are very passionate about what you do and you love educating.

Yes, 100%.

So you know, if, if we have listeners that are more curious or would like to know more, would you like to share your contact information?

Absolutely. You can, you can call me, you can text me, you can email me. My phone number is 206-259-0936. That is my personal cell. My email is D long L O N G @big sky construction.com. i, I, you know, it's, it's funny being in this industry. There are many nights that I'm working till midnight 1am and I'm doing virtuals with our clients because you're seeing patients during the day. But they want, they, they want to be in the know and we want our clients to be engaged.

So we're virtually working on their project late at night. So you can call me, text me, email me. Almost 24 7, I got to sleep sometimes, but I am a bit of a workaholic and I do set family time aside as well.

I was going to say, like, be careful of what you.

I've got two teenagers and a great family, very supportive wife. But, yes, I am here to help you. I'm here to educate you. And obviously, I'm here with all the resources you would need in order to open your own practice.

Right. Right. Thank you. Thank you so much for being on our episode today.

Absolutely.

All the valuable information.

This was very fun. Thank you, Ash.

Yeah, same here. Thank you.

Thanks for listening today. Be sure to subscribe to beyond by Wings on your favorite podcast platform. For more information, you can follow us on Facebook, Twitter, and LinkedIn or reach out to us on our website. You can also shoot us an [email protected].