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Designing Your First Office

Choosing the Right Location

Recognizing the need for the right location is key to choosing a potentially successful site for your first practice. Consider the following factors when beginning to look for office space:

- Hours of operation
- Accessibility needs
- Parking requirements
- Signage needs
- Space needed versus space available
- Build-out requirements
- Building code restrictions
- Lease or purchase price
- Terms of contract
- Monthly maintenance costs
- Variation in regional business practices
- Image associated with location
- Vehicular traffic patterns
- Surrounding environment

Any doctor who's experienced the thrill of opening his or her own practice also knows how important it is to do things right the first time. The first step into private practice can be quite intimidating and one area many new doctors seem to have trouble with is office layout. Designing an efficient and cost effective floor plan is something that doesn't come naturally to most chiropractors, so it's not surprising that many of them struggle with the endeavor. With this installment we begin a series of articles covering the process of designing your first office.

As exciting as starting a practice can be, the process can also be quite intimidating. There are so many decisions that are crucial to success and so many details that must be carefully considered that most doctors panic and simply duplicate what other doctors have done. This approach may or may not be the best given the various types of practices and various levels of success that exist today.

Among all the decisions and considerations is the topic of office design. What kind of office space works best? Where should the office be located? How much space is needed? How much will it cost for construction? What kind of floor plan is best? These are important questions to ask when designing your first office. Answering them correctly can lead to practice success. Likewise, answering them incorrectly can lead to practice failure.

The Planning Phase
The proper way to open any practice, especially the first one, is to do extensive planning (the planning phase). The planning phase begins with a general question, "How do you intend to practice?" For example, do you want to see a high or low volume of patients? What type of adjusting technique will you be using? Do you want an open layout or private rooms? Will you be administering physiotherapies; if so, what types? Will you be taking x-rays? How will records and files be stored? How many employees will be needed once the practice is at full capacity? The answers to these questions will help move you through the planning phase and on to a finished product.

As you begin to plan the details of how you intend to practice, you'll be able to visualize the kind of office you will need. For instance, if you plan on seeing a high volume of patients, administering various physiotherapies, taking x-rays and accepting insurance payments, then a 600 square foot two-room office located in a remote part of a small town will not work. On the other hand, you may not necessarily need 3,500 square of space located on the busiest street of a densely populated city either. The idea is to visualize how you intend to practice so that you can begin looking for office space that is suitable to your vision.

The goal of any planning effort is to make as many decisions as possible on paper first­­before any commitments are made, contracts are signed or money is spent. The best part of designing your first office on paper is that it's cheap and easy. If you make a mistake, forget something or want to change something, you can do so without any problem. By the time the planning phase is over you should have completely planned, constructed and worked in your office before it's ever built.

Now, you may be asking, "How do I do all of this planning on paper?" Well, planning your first office on paper mostly involves trying different combinations of key elements to see which ones work and which ones don't. For instance, try different floor plan scenarios to see what is most cost effective and efficient. Compare various combinations of decor to determine the effectiveness of each one. In other words, don't just make up your mind about the exact things you want in terms of layout, equipment and decor. You may find that certain ideas or components won't work in the context of other ideas or components. Too often new doctors have a predetermined way of thinking about how their practice should be designed. This type of thinking usually results in a doctor trying to fit a round peg into a square hole. You can eliminate this mistake by remaining open to many different ideas and then trying them on paper to see which ones work best together.

As you continue planning, you'll want to consider other important issues such as equipment and furniture requirements, record storage, decor, interior and exterior signage, sound and lighting, parking and accessibility and of course, costs. Some of the issues will be covered in upcoming articles.

To Buy or Lease?
In most cases, the option to buy office space is a consideration for established doctors only. Few if any new doctors opening their first office have the financial resources and proven track record needed to buy a piece of commercial real estate. Therefore, the question to buy or lease leaves only one answer: to lease.

Though ownership may be the ultimate goal, leasing actually offers benefits that ownership does not. For instance, lease payments are fully deductible, which means they can be used to offset taxable income. Another advantage of leasing includes flexibility. If you decide that the location you chose is not a good one, you can usually break the lease or wait until it expires and then move to a better location. However, keep in mind that breaking a lease can only be done if the lease agreement allows such an act. Most lease agreements that can be broken usually contain a clause that results in some form of a financial penalty for exercising that particular entitlement.

How Much Space?
There is no secret formula for determining how much space you'll need for your first office. For some doctors, a 300 square foot one-room space may be all that's needed. Meanwhile another doctor may require several thousand square feet. In most circumstances, the amount of space you end up with will be determined by the configuration and availability of office or retail space.

Most doctors agree that finding a good location is more important than finding the exact size of space they desire. For instance, a space that may be a little too small, but is in an excellent location is a better choice than the right size space in an unfavorable location. Obviously, the ideal situation is to find the appropriate amount of space in a great location.

A typical start-up office ranges in size between 1,000 and 2,000 square feet with the average being around 1,200 square feet. Offices built fifteen to twenty years ago tended to be a little larger-around 2,500 square feet or more. Recent trends within the profession indicate that many well-established doctors are remaining in or moving to smaller offices in an attempt to increase efficiency and decrease overhead expenses. There are some very large offices being constructed today, but they tend to be multi-doctor and/or multi-discipline facilities that incorporate rehabilitation services and retail products.

The key to choosing the right amount of office space is to realistically anticipate patient volume at full capacity. For example, if you want a low volume practice (1 to 30 patients per day), then 750 to 1,200 square feet will work. A medium volume practice (30 to 60 patients per day) requires 1,000 to 1,500 square feet. High volume practices (more than 60 patients per day) usually require 2,000 square feet or more. Any practice that incorporates special imaging or rehabilitation equipment is going to require an additional 300 to 1,000 square feet of space. Likewise, a multi-doctor practice will get a little crowded in any space less than 1,200 square feet.

Find the Right Location
As most small business owners and commercial real estate agents will tell you, having a good location is crucial to business success. In some cases a business will succeed or fail based almost solely on its location. Perhaps that is why most corporate-owned businesses (grocery stores, fast food restaurants, convenience stores, etc.) devote so much time and money to choosing a good location.

Finding the right location for your first office is no less important. Even though the process is fairly straight forward, there are some basic criteria that should be met. For instance, make sure the location has adequate signage so people will know you're there. Research studies indicate that potential patients look for easy access and plenty of parking. Also, make sure the location is easy to find. You and staff members should be able to quickly give simple directions using recognizable streets and landmarks.

Don't forget to consider the "psychological" impression a specific location might have on the public. For example, locating your office next to a yogurt shop, liquor store, copy center or music store, may not give the impression of professionalism that you desire. On the other hand, locating an office near insurance agents, a dentist, real estate agents, a consultant, lawyers or other health care providers may, by psychological association, give you the professional image you want.

Generally, most consultants agree there are a few location types or situations that should be avoided. For example, you should avoid any building that still resembles its old identity such as a gas station or restaurant. If you do choose such a site, make sure that you perform a complete interior and exterior makeover. Also, avoid office space located anywhere other than the ground floor. Market research indicates that patients prefer not having to use stairs or an elevator to visit their doctor. Most consultants also agree that downtown locations of large cities should be avoided unless you know to how to market to that specific population.

Choose a Layout
Choosing an exact layout is difficult until you have found a specific location. However, once a specific location is found you can begin by sketching a few different layouts on paper. It helps if you create a scaled template of the existing space using graph paper. After the template is complete, simply make several copies of it and begin drawing different layouts.

If you're stuck for ideas or not sure where to begin, think about hiring a consultant. An office design consultant can save you time and money by addressing specific problems and requirements for your style of practice. If hiring a consultant is beyond your means, then try visiting as many other chiropractic offices as possible. Doing so should provide you with an array of ideas and possibilities that can be used in designing your office.

In the next installment, I'll discuss making the transition from the planning phase to the construction phase. s

John D. Hickey, DC is the author of "The Chiropractic Office-A Guide to Cont-emporary Office Design" and "Chiropractic Market-ing by Design-Strategies for Practice Success." For more information, call 1-800-500-4635.

   
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