Designing Your First Office
By John D. Hickey, DC

Part Three in a Three-Part Series

In the May and August columns, we examined some of the key elements involved in the initial design and construction of your first office. Now, in this final installment, we take a look at what it takes to create an effective environment in your new office space.

Friendly and Functional
In the final phase, the focus is on creating the proper type of office environment. That means taking all the necessary steps to create a friendly yet functional office that's designed for success. Marketing research proves there is a direct correlation between a patient's attitude and the environment in which the patient is being treated. Colors, patterns, lighting, and sound all have an effect on how well a patient responds to treatment.

The first thing you need to realize is that a chiropractic office is more than just walls, furniture and a few pieces of equipment. A chiropractic office is the physical environment where the profession and the public interact. Each chiropractic office represents a portal of entry to the chiropractic profession.

Much of the public's perception of chiropractic is based on how they perceive a doctor's office. Given that fact, it only makes sense that a chiropractic office should do more than just exist. It should be designed and used as a perception-building tool. It should promote, educate, and enhance the public's perception of not only the doctor, but the entire profession.

So, how can all that be done on a budget? After all, most doctors opening their first office are limited financially. Certainly some compromises will be in order. However, that doesn't mean creating the proper environment shouldn't be a priority, because there are many affordable and practical methods you can use.

Shedding Some Light
Let's begin with the subject of lighting. When opening your first practice, you should design and implement lighting primarily based on function. Using lighting for effect or to create an ambient mood is something usually reserved for large retail stores, restaurants, or well-established medical practices. However, there are a few low-cost steps you can take that are both functional and creative.

Consider these recommendations:
· Use consumer-grade, standard incandescent or halogen lighting to create a sense of warmth and a calm feeling in the reception area. You can use the same technique in treatment rooms and the doctor's private office or any area where the doctor wants to be perceived as "friendly and warm."
· Use low-cost, ceiling-mounted fluorescent lighting in areas such as hallways, storage rooms, restrooms, break rooms, and business offices. Creating a specific lighting effect in these areas is not as important as cost savings.
· Use as much natural light as possible. It's a cheap source of light, and it has a psychologically positive effect on people.
· Use fluorescent task-lighting in areas where detailed work is performed, such as the front desk, writing stations, and file rooms. Avoid placing or aiming fluorescent lighting at or near computer monitors, because the reflection will increase eye strain.
· Dark rooms obviously require two sources of light - one for normal use and one for developing films. To minimize the possibility of accidentally exposing film, have one light controlled by a traditional light switch and the other controlled by a pull string.
· In areas where X-ray view boxes are being used, implement fader-style switches for the room lights. They can be dimmed without turning them off completely. This capability offers patients a more comfortable environment in which to view films.
· Avoid expensive lighting fixtures. Anything needed in a chiropractic office can be purchased inexpensively at a local retail store. Also, avoid trendy lamps or light fixtures, since they tend to be in style only for a year or two.

The Element of Sound
Sound is both a functional and creative element often overlooked when designing an office. Granted, it's not a design element that should consume an enormous amount of time and money, but it should be adequately considered and implemented into your first office.

Consider these strategies:
· Keep the volume of music just high enough to minimize the sounds (mostly conversational) coming from other parts of the office. Patients should not be able to hear the doctor or staff talking to another patient or an insurance representative.
· Choose the appropriate type of music for your office. Marketing data indicate that an "easy-listening" type of format is preferred by most patients.
· Place speakers in areas where patients spend a considerable amount of time, such as the waiting room, hot-seat area or therapy room. If your budget allows, install a volume-control switch for each area.
· Avoid placing speakers in work areas such as the front desk, doctor's office, business office, storage room, exam room, X-ray room, dark room, and break room. Music is not essential in these areas.
· Some office spaces tend to have a sound echo or reflect. This can be a real problem in a doctor's office, since patient privacy and confidentiality are essential. If this is the case, consider installing sound-absorbing materials such as foam panels, carpet, or drapery on all large, flat surfaces.

Air Quality
Of course the quality of air you, your staff, and your patients breathe is extremely important. Even though you may not have complete control over the quality of the air coming into your office (i.e., air conditioning and heating), you can certainly control it once it's there.

Here are a few tips:

· Do not allow smoking in your office. Regardless of how you feel about smokers and their "freedom," the fact is that a majority of patients will be turned off by the smell of cigarette smoke in your office.
· If you or a staff member smoke, you will need to implement a smoking policy. For example, smoking should only be allowed outdoors (someplace away from patient entrances), or in a designated room equipped with an air-purification machine.
· Keep the office smelling fresh and clean by using inexpensive air fresheners, such as mildly scented candles or electric plug-ins.
· Be aware that sometimes normal office "smells" such as food, X-ray film-developing chemicals, damp carpet, etc., may be offensive to patients. Ask a friend (not a patient or staff member) to carefully evaluate your office for any undesirable scents.

Choosing the Décor
Decorating a business is not like decorating a home. Home décor is mostly an expression of someone's personal style and taste, while business décor is an exercise in meeting or exceeding the expectations of customers. For chiropractors, that means decorating in a way that enhances your professional image.

Here are a few ideas to get you started:
· Don't hire an interior decorator. A less expensive way to gather ideas is to visit the offices of other professionals such as dentists, cosmetic surgeons, bankers, etc. Find office décors that you like and borrow the concepts.
· Choose neutral colors such as off-white, light green, beige or cream. Light pastel colors are easy to work with and patients expect to see those shades when they enter a doctor's office. Of course, you should avoid bright, vivid colors such as red, yellow, orange, purple or blue.
· Choose colors and patterns that match. Start by choosing a main theme color such as light green. Next, choose an accent color like beige or complementary shades of green. Begin looking for items such as furniture, window blinds, artwork, etc., that contain shades of the colors you have chosen.
· Choose carpeting that is dark and high-quality. Carpeting is an item in which an investment in quality is worth the expense.
· Avoid using mirrors as decorative items. Mirrors are fine as a functional item in restrooms and dressing rooms but are not considered appropriate as décor in a doctor's office.
· Add some "life" to the office by incorporating various high-quality artificial plants and flowers. These accent items are inexpensive, colorful, and easy to maintain.
· Another way to liven up an otherwise sterile office environment is to incorporate various wooden elements such as desks and chairs.
· Keep everything in neat order by implementing a variety of organizational tools such as stack trays, hanging folders, shelving, etc. Patients perceive a disorganized office as a disorganized doctor.

Interior Signage
There are two types of interior signage that should be incorporated into a chiropractic office. The first type, called "informative signage," is used to inform patients about matters such as how to pay for services or reschedule an appointment. The second type, referred to as "instructional signage," contains proactive language designed to get patients to take action: for example, a sign that asks for referrals.

Here are some guidelines for implementing both types of signage in your new office:
· Use the "less is more" rule for all signage. For instance, make sure each message is conveyed in the fewest words possible. "Wordy" signs are usually not read, which makes them completely ineffective. Also, don't make the mistake of having too many signs. Bombarding patients with a deluge of signs only confuses and frustrates them.
· Make sure each sign is appropriately sized and located for easy reading.
· All signage should appear professionally produced. It simply doesn't make sense to spend a lot of time and money designing and building a first-class office, only to have it spoiled by a few cheap-looking homemade signs. There are a variety of chiropractic suppliers that sell professional-looking pre-made and custom signs.
While there are a variety of sign messages to consider, only a few are considered to be essential and effective.

Here's a brief must-have list:
· A "welcome to our office" sign placed near the entrance helps create a positive initial impression.
· Signs that explain various treatment benefits should be placed above or near each treatment and/or therapy table.
· A sign that asks for referrals is a great way to subtly plant the thought in the minds of patients.
· A waiting-room resume containing bulleted information about your education and experience is a terrific way to build trust and credibility.
· A sign stating your office's financial policy should be placed near the front desk to help patients understand their payment options.
· A "let us know if you might be pregnant" sign is a must in the X-ray room.
· A changeable, marquee-style sign placed near the front entrance is an inexpensive way to keep patients updated on special events and policy changes.

Brochures and Posters
Brochures and posters have come a long way during the last few years in terms of quality and availability.

Here are some tips for buying and implementing these educational and marketing materials:
· Avoid buying and displaying every brochure title available. This approach to conveying the scope of chiropractic is almost always misunderstood by the public. While we, as chiropractors, understand the comprehensive benefits of chiropractic care, the public perceives a huge array of brochures as too overwhelming. The result is a loss of credibility.
· Use fewer brochure titles but place them more frequently throughout the office. This is a strategy commonly used in the advertising industry. The idea is to create a condensed and focused message and then repeat it over and over until the audience remembers it.
· Avoid using brochures that are laden with text. Even though patients may appear interested, they rarely take the time to read an entire brochure. Patients perceive text-heavy brochures as too difficult or complicated to read.
· Limit the number of posters as well. A small selection of professionally framed and appropriately placed posters is all you need.

Dress Code
The final stage of creating the proper office environment is to develop a policy for proper dress for the doctor and staff. Never underestimate the power and influence of clothing. Right or wrong, good or bad, people judge other people, especially in the work environment, by the clothes they wear.

Here are some recommendations:
· Choose clothing appropriate for your patient base. A doctor practicing in a small farming community should consider dressing slightly casual (i.e., a polo-style shirt with dress pants and loafer-style shoes). A doctor practicing in the downtown area of a large city should probably dress more formally (i.e., a business suit, or at least a shirt and tie).
· Avoid wearing scrubs. I'm aware that many successful doctors wear them. However, the fact is that patients perceive scrubs as something a surgeon wears, not a chiropractor. It confuses them and can lower your credibility.
· Do not allow a casual dress day. This type of policy completely undermines the consistency of dressing appropriately the other four days of the week. It's like saying to patients, "We only believe it's worth it to us to dress appropriately 80% of the time."

No matter which aspect of creating the proper environment you're dealing with, remember to keep things simple, clean, and well-executed.

Dr. Hickey is an office design consultant and the author of "The Chiropractic Office-A Guide to Contemporary Office Design" and "Chiropractic Marketing by Design-Strategies for Practice Success." For more information, call 800-500-4635. Dr. Hickey's e-mail address is johndh@socket.net.