When planning a new healthcare facility – whether it’s a dental practice design and build project, medical fitout, health hub, day surgery centre, veterinary clinic, or any other healthcare space – you’re faced with a critical decision.
Should you engage a design team first and then go to tender, or should you opt for a Design & Construction (D&C) partner to manage everything, from start to project completion?
While both approaches have their merits, D&C matches and outperforms D&T in most areas. Here’s why we think it’s the smarter choice – backed by what we’ve seen in our 34 years’ experience.
Advantages of a Design & Construction (D&C) partner
Single Point of Contact/Responsibility
In a traditional design-then-tender approach, the process is fragmented. You work with an architect or designer first, then send the plans out to tender, hoping the builders interpret them correctly. But miscommunication is a common flaw when multiple companies, people, and opinions come into the process. Discrepancies between design and execution can often arise from this and lead to costly delays.
With D&C, everything is handled by a single team from concept to completion. The company is responsible for both design and construction, reducing miscommunication between the design team and contractors. This means you have a single contract and single point of contact for each phase, making the process more streamlined and efficient. You won’t need to coordinate between separate teams or resolve disputes between different parties – the entire project is handled under one umbrella, ensuring accountability and consistency of budget, timelines, and overall quality.
Cost Certainty Earlier
One of the biggest concerns in healthcare construction is budget management. D&C builders provide cost estimates earlier in the process, with both teams working in sync to significantly reduce the risk of budget overruns. In a design-then-tender approach, you might only discover cost overruns after the design phase is complete, often requiring redesigns and causing project delays.
By involving the builder from the start, potential cost risks are identified early, and design decisions are made with cost efficiency in mind. This transparency allows you to make informed financial decisions without the unpleasant surprises that can arise from an isolated design process.
Faster Project Delivery
Time is money, especially in healthcare. Every month, every week, every day your new practice isn’t open means lost revenue and missed opportunities to serve your patients and gain new ones. The design-then-tender approach is notoriously slower – in part due to the tendering process that can take weeks or even months before construction begins.
D&C streamlines the process by overlapping design and construction phases. While the design is being refined, early construction work such as site preparation can commence, significantly reducing your project timeline. This efficiency ensures that you can open your doors and start treating patients much sooner than with a traditional approach.
Value Engineering & Buildability
D&C builders bring real-world construction knowledge to the design process, ensuring that your practice is optimised for cost efficiency and constructability. In contrast, in a design-then-tender process, the architect may not always consider practical construction efficiencies, leading to costly design revisions later on.
A D&C builder evaluates every aspect of your project from a practical and functional standpoint, making sure materials, labour, and design choices align with real-world building conditions. This minimises unnecessary costs and ensures that your healthcare facility is built with both aesthetics and functionality in mind.
Reduced Risk for You (the Client)
In a D&C contract, the builder assumes more risk for cost overruns and design changes. This significantly reduces your exposure to unexpected financial burdens.
In contrast, with a traditional design-then-tender approach, any design errors or omissions may lead to costly variations once construction starts, and often falls back to the client. These unexpected changes can cause delays, require additional approvals, and escalate project costs — issues that are largely mitigated in a D&C setup.
Lower Time Investment for You
Managing a design-then-tender process requires significant involvement – coordinating designers, reviewing multiple tender submissions, comparing quotes, and resolving discrepancies between plans and execution.
From dental clinic design, through to construction and fitout, D&C removes this burden. With one contract and one team, you have a single point of contact handling everything. This means you can stay focused on your practice while the experts manage your project, reducing the stress and workload on your end.
As a healthcare professional, your time is valuable. When you are taken away from your work to focus on a healthcare practice project, you expose yourself to a direct loss of income, while your team misses out on your vital leadership in-practice. Your focus being drawn away from patient care can impact the performance of your business. By choosing D&C, you stay present where you’re needed most, trusting the industry professionals to handle your project efficiently.
Additionally, the complexity of overseeing multiple contracts, negotiating between different service providers, and ensuring compliance with healthcare-specific regulations can be overwhelming. A D&C team takes on this responsibility, streamlining the entire process so you don’t have to. Instead of spending hours in meetings, reviewing documents, and troubleshooting issues, you can dedicate that time to what matters most – your patients and your business. The efficiency of D&C not only saves time but also minimises disruptions to your daily operations, ensuring a smoother transition to your new or upgraded facility.
“They were able to take care of the finer details, and then they would come to me with the big decision points. But it took a lot of the work out of my hands and allowed me to focus on the things that I could do.” Dr Kurien Mamootil – Geelong Endodontic Specialists.
Industry-Specific Designers | Healthcare Architects
Healthcare construction isn’t like building a standard office or retail space. There are strict regulations, technical requirements, and industry-specific challenges that must be considered. D&C builders with deep experience in healthcare understand the ins and outs of these unique demands – from effective patient and staff flow, to meeting specific compliance requirements and industry standards for healthcare. Having the ability to address this at the design stage reduces the risk of costly oversights down the line.
A Unified Team
A successful healthcare project doesn’t come about from great design or quality construction in isolation – it’s the result of a team that works seamlessly together. With D&C, you’re not just hiring a designer or a builder; you’re gaining access to a collective of top-tier project experts, strategists, leading architects, skilled tradespeople, and trusted partners – all working in unison to deliver results that redefine expectations, possibilities, and outcomes.
Trust is built over time, and a well-established D&C team has years of experience working together, regardless of the complexity of a project. Whether it’s a state-of-the-art dental clinic design, a modern medical fitout, a patient-centric health hub, or a high-functioning day surgery, they know each other’s strengths, communicate efficiently, and push each other to constantly improve. This collaborative environment leads to innovation, ensures continuous feedback, and consequently elevates the future of healthcare design and construction.
When to Consider Design-Then-Tender
There are some instances where a design-then-tender approach might be considered by healthcare practice owners. However, even the potential ‘advantages’ come with notable drawbacks:
You want full control over the design before engaging a builder.
In theory, this allows you to design your dream practice before engaging a builder. But in reality, this often leads to impractical or unrealistic designs that require costly revisions once a separate builder is engaged and gives you the bad news that the build is not achievable within your initial budget plan. A D&C builder ensures that your design is not only beautiful but also feasible and cost-effective from the start.
Your project is highly bespoke or requires specialised architectural design.
If your project has unique architectural demands, you might think a traditional design-first approach is necessary. However, D&C teams often have experience that spans across multiple industries and that successfully accommodate specialised requirements while ensuring buildability and efficiency.
You have the time and resources to manage the tendering process.
If you’re comfortable overseeing the entire process — including reviewing bids, managing contracts, working through extensive town planning complexities, and troubleshooting issues that arise – then design-then-tender might work, and you may save 5-8% compared to an end-to-end D&C partner. For most practice owners, however, this is an unnecessary headache, and the small savings are far outweighed by D&C being able to remove these difficulties so you can focus on your business, not project management.
Bottom Line: A Smarter Way to Build Your Healthcare Practice
Design-then-tender may seem like the traditional route, but for healthcare projects, the risks and inefficiencies make it less than ideal. Design & Construction offers a smarter, faster solution, ensuring your healthcare practice is built right the first time — without the stress, delays, and budget blowouts.
If you’re planning a new healthcare practice and want a seamless, efficient, and expert-led process, choosing a Design & Construction builder is the best decision you can make.
Frequently Asked Questions (FAQ)
How does D&C ensure cost certainty?
By involving the builder from the start, costs are assessed and controlled throughout the design process, reducing the risk of budget overruns.
Will I still have control over the design with D&C?
Absolutely. D&C ensures your vision is maintained while benefiting from expert recommendations to enhance efficiency, functionality, and compliance.
How much time can I save by choosing D&C over a traditional approach?
Depending on the project, D&C can reduce your timeline by months, ensuring faster project completion and earlier revenue generation.
Does OPTIMA have experience in delivering successful design and construction projects in healthcare?
Yes, OPTIMA has a proven track record of successfully delivering healthcare design and construction projects. Our methodology has been refined over 34 years’ industry experience, focusing on internal collaboration and client communication for a seamless project delivery, from start to finish. From medical clinic fitouts to dental clinic design and construction, healthcare is what we know, and where we thrive.
Explore our past projects here: www.optimahg.com.au/projects
