The Equipment Arrived Three Weeks After You Opened. Now What?

The building was done. The inspections passed. The certificate of occupancy was issued. The space looked exactly like what had been designed — freshly finished, fully built out, ready. The staff had been hired, oriented, and scheduled. Patients were booked. The loan was funded and running. And the equipment hadn't shipped yet.

That is not a hypothetical. It happens with enough regularity that it has a pattern, and the pattern always starts the same way: equipment selection was treated as something that happens after construction gets going, not as something that drives construction from the beginning.

What Lead Times Actually Look Like

The clinical equipment that defines what a facility can do for patients is not available off a shelf. It is manufactured to order, configured to spec, and shipped on its own timeline — a timeline that has nothing to do with your construction schedule unless you deliberately build the connection.

Dental chairs and delivery units run 12 to 16 weeks from confirmed order to delivery. A CBCT cone beam imaging unit — now standard in a modern dental practice — runs 10 to 14 weeks. Panoramic X-ray units are in the same range, 8 to 12 weeks. Casework and custom cabinetry, which in a clinical setting is typically built to specific configurations rather than stocked in a warehouse, runs 8 to 12 weeks. Autoclave and sterilization equipment runs 6 to 10 weeks. These are not worst-case estimates. These are the lead times the manufacturers publish, and they assume your order is placed without complications and the production slot is available.

In veterinary facilities, surgical tables run 6 to 8 weeks. In medical facilities, procedure tables vary by manufacturer but commonly run 8 to 16 weeks. Specialty imaging equipment — MRI, CT, fluoroscopy — has lead times that start at 16 weeks and can run considerably longer, with installation requirements that have to be engineered into the building from the beginning.

The Arithmetic of Misalignment

A typical clinical buildout takes 9 to 12 months from breaking ground to certificate of occupancy. If equipment ordering starts when construction starts — which is already late — a 14-week lead time gets you equipment delivered in month 4 or 5, sitting in a warehouse while you have 4 to 7 months of construction still ahead. That's fine. Equipment can wait in a warehouse.

The problem is when equipment ordering starts in month 6 or 7, because the owner was focused on construction decisions and the equipment conversation kept getting pushed. A 14-week lead time from month 7 puts delivery at week 56 or 57. Construction finishes at week 52. The gap between "building is done" and "equipment is here" is 4 to 5 weeks. During those 4 to 5 weeks, the loan is running, staff are on payroll, and the facility generates zero revenue.

The actual cost of that gap depends on the practice, but it's not small. Staff payroll for a clinical team runs tens of thousands of dollars per month. Loan service on a $1.5 million construction loan at current rates is several thousand dollars per month in interest alone. A 4-week equipment delay in a mid-sized dental practice could easily represent $40,000 to $60,000 in carrying costs with no offsetting revenue. And that assumes the delay is only 4 weeks. Customs delays, manufacturing backlogs, and shipping complications can extend it.

The Installation Problem Compounds the Delivery Problem

Equipment arriving at the facility does not mean equipment is operational. Clinical equipment requires professional installation, and in many cases the installation sequence matters. Dental chair plumbing connects to dedicated supply lines that have to be roughed in during construction to the manufacturer's spec. CBCT units require structural reinforcement, specific electrical circuits, and in some cases lead-lined walls — all of which have to be in the building before the unit arrives. If the rough-in doesn't match the equipment spec, the installer identifies the discrepancy on installation day and the project goes back to the contractor for corrections.

The only way to avoid this is to have the equipment spec before the MEP rough-in is done. Which means equipment selection before design is finalized. Which means the equipment conversation starts at the beginning of the project, not in the middle.

How a Design-Build Team Handles This Correctly

Equipment selection and ordering is a construction milestone, not a purchasing task that runs parallel to construction on its own schedule. The design-build teams that manage this well treat equipment as a design input. Before the floor plan is locked in, they're asking what chairs, what imaging systems, what sterilization configuration, what casework specifications. The room dimensions, the utility rough-in locations, the structural provisions — all of it is coordinated against the equipment spec before the drawings are finalized.

Ordering is then tied to a milestone. When design is approved and the permit is submitted, equipment orders go in. By the time the building is dried in and MEP rough-in begins, delivery windows are confirmed and sequenced into the construction schedule. Equipment arrives when the building is ready for it, the installation crew is scheduled, and the first patient walks in the day the building opens — not three weeks later.

Dr. Gleason's practice in Minnesota went from closing on a Thursday to opening on a Monday. That doesn't happen by accident, and it doesn't happen when equipment is an afterthought. It happens when every milestone in the project — including equipment selection, ordering, delivery, and installation — is planned from day one.

If your project doesn't have an equipment schedule attached to your construction schedule, that is the problem to solve before anything else. Primus builds that coordination into every project from the start. Learn more at primus-companies.com.