Whether or not you are a new physician opening your first medical practice, or an established physician looking for a new office location, practice start up can be a daunting task. From choosing a contractor to furnishing your new suite, the project is certainly going to be costly and time consuming.
Doing some simple homework can save both time and money and make the project a more enjoyable, less stressful situation and assure that you will still be happy with your choices for many years after your space is complete.
Before choosing your practice location, you should study your practice demographics. For an established physician this mean running a software report outlining your patient's home towns and choose a location central to the towns and counties that support your largest number of visits. You will want to be close to public transportation and to the referral doctors that send patients your way. For new physicians, your choice of location should be close to the hospital where your completed your training and may be able to rely on contacts made during this time. Once you have a good understanding of your demographics, you can begin to scout for a location.
There are some distinct advantages in choosing a commercial building rather than a curbside location.
Commercial buildings often provide visitor security both in and outside of the building, including the parking garage or commercial parking lot. The maintenance staff is at your disposal as part of the lease agreement and many commercial buildings provide cleaning services, including daily trash pick up and snow removal free of charge. Office re-painting and additional services may also be included for reasonable rates. Larger practices should consider having some cleaning staff on hire at least on a part-time daily basis and especially if your practice contains patient restrooms or an employee kitchen.
Curbside locations, especially those with parking lots directly behind the building, can offer handicapped or elderly patients easier access to services. The ability to see these locations from the road can serve as an additional marketing tool to attract patients to your office.
Commercial or curbside, you will want to choose a location that offers patients adequate parking, especially in locations where weather may be an issue. Patients will not hesitate to leave a practice if parking is too difficult or too far away from the building. Many commercial landlords will offer physicians a number of assigned parking spaces exclusively for patient visits. If this is the case in your building, try to assure that the spaces are located close as possible to the main entrance and have ramps or elevator access into the building, especially if they are located on a higher floor of the garage.
Also, make sure that your office space is in compliance with state and federal requirements for patients with disabilities. Your architect and contractor should have a good understanding of these regulations. Don't forget to note the operating times of the building you choose. If you have evening or weekend office hours, you will want to make sure that the building remains open and staffed at these times.
Know your square footage needs before making any commitment to an office space. Many beautiful and tastefully decorated offices fail to meet the needs of the staff. Poor advance planning will eventually hinder practice growth and is usually characterized by a lack of adequate storage space or employee work areas. Consequently, the office appears messy and disorganized and may pose safety hazards. Meet with an architect well before you shop for space. Outline your daily practice flow and your hopes for future growth. Together you should be able to come up with a square footage amount that will meet your needs. Think carefully about how your practice functions on a daily basis and stress your need for adequate storage space and the necessary room to house your computer hardware and phone wiring. Restrooms, labs and testing areas should be clearly outlined and assure room for the number of current and future employees. Request that your architect give you a few possible plans and choose what works best for you.
Once you have found a space that suits your needs, you will be ready to work on your purchase or lease agreements. You may be fortunate enough to find an established space that can be redone for you or you may need to do a complete renovation. Either way, most commercial buildings will offer you a per -square foot allowance that usually has a modest amount of wiggle room, depending on the landlords motivation to move the property. Some buildings will require that you use the contractors they recommend, while others may just ask for state licensing and certifications and allow you to choose your own. Either way, get at least three estimates for your buildout and ask to see locations that your contractor has completed. Make sure that you are paying fair market value for both the space and the construction. It may not be a great idea to choose a contractor who has never worked on a medical space, since they may not have a good understanding of Federal and State requirements for this type of facility.
Your contractor will apply for work permits and should guarantee that electrical and plumbing services are certified and that the work will meet or exceed inspection regulations for the town and county.
Obtaining work permits is often a lengthy process. If you find that your work permit is unreasonably delayed, you may want to contact the town or country supervisor and advice them that patients are waiting to be treated in the space and you would appreciate their intercession on your behalf. These officials are always anxious to assist new business ventures in their community and will often be able to cut through any red tape that is delaying your permit.
Your architect will receive plans outlining specs for plumbing and electrical outlets to be included in your buildout. Be aware that the buildings contractors may only supply a certain number of outlets, lighting and water sources and additional sources for power and water may be at your expense, so check your plans carefully and assess needs well before the work is started. It is always less expensive to add these additions when the walls are open.
Orient your exam rooms so that your sinks, outlets and exam tables work well with your office visits and procedures that may be assigned to a particular set of rooms. Assure that your space will allow for standard sizes of cabinets and sinks to avoid the additional expenses of custom sizes. This is also true for any bathrooms in your suite. Think ahead about seating plans for your waiting room and imagine the types of tables and lighting that you prefer.
Your staff will need sufficient overhead lighting and enough outlets for computers, scanners, phones, adding machines, credit card machines, and tabletop faxes or copiers. Calculate for room under the desk for hard drives, wiring, and the storage of personal items and work tools. Don't forget that the average patient may spend no more than 30 minutes in your office, but your employees will be there for eight or more hours, five to seven days a week and personal space not only makes work flow more efficient, but also promotes a positive attitude. Assure that your front desk space allows for practice growth and future employees. You may want to think about having a separate area at the front desk for phone triage. This will involve an additional bank of phones, seating, tabletops and computers. If this arrangement works for you, you will want to also consider the installation of a glass wall to separate these employees from the patient check-in area.
Tomorrow - Doing Some Work Yourself
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