Issue 6 - May 2003

Practicing in a small space can be easy on the
budget and good on the practice
Good things CAN come in small packages!
By K. Jeffrey Miller, DC DABCO

When it comes to chiropractic office space, bigger is not necessarily better! Many successful practices have started and stayed in small spaces. A new trend in chiropractic is to simplify by returning to practice in a small space.

I know several colleagues who have downsized and successfully lowered overhead, reduced stress and increased profitability. And practicing in a small space often sparks creativity and efficiency. Finding ways to make the best use of every inch of space and developing smooth patient flow are paramount in a small office. Necessity truly is the mother of invention.

The following list of suggestions is for those doctors who are just getting started in a small office and for those seeking to simplify by reducing their square footage. The list is not all-inclusive. However, these suggestions should get everyone off to a good start.

• X-ray equipment. If an x-ray machine is key to your practice, skip to the next section. If you are not sure or do not feel you must have an x-ray machine, do not buy one or sell the one you have. Hospitals and diagnostic imaging centers are begging for referrals.

They are eager to work chiropractic patients in, furnish copies of film and provide timely reports. Not owning x-ray equipment is advantageous: A board-certified radiologist provides a report for every set of film. You can reduce square footage or reassign space, since you do not have to house the machine or have a dark room. You don’t incur the cost and upkeep of x-ray and developing equipment. And you don’t need leading, special wiring and extra plumbing or extra storage for x-ray folders.

Outsourcing x-rays comes with a couple of disadvantages: the loss of revenue generated by the use of the machine, possible delays in obtaining results and difficulty in obtaining some views specific to chiropractic practice.• Off-site storage.

If the cost to rent is $13 per square foot, a 1,000 square foot office costs $13,000 per year or $1,083 per month. A 1,200 square foot office costs $15,600 per year or $1,300 per month.

The difference between the spaces is $217 per month. This is a significant difference, especially if the extra 200 square feet is unusable space or space usable only for storage.

You may be able to rent a 10x12 off-site storage space (120 square feet) for less than $79 per month. Old records, old x-rays, Christmas decorations, seasonal items, extra equipment, old tax records and many other items can be stored cheaply off-site.

In the example above, this would mean the savings of $138 per month if you chose a 1,000 square foot office and storage space over the 1,200 square foot office.

Of course, you would have the disadvantage of traveling to and from the storage site and you may have a temperature-regulation problem in the off-site area. You could not store items sensitive to extreme temperatures or moisture off-site unless it were climate-controlled.

• Multi-purpose room combinations. A limited amount of square footage usually means most rooms in the office must serve more than one purpose. (See the sidebar for seven different room combinations.) The most difficult room for most doctors to combine or give up altogether is the doctor's personal office. Sometimes it is hard to set aside our egos in order to commit to the real purpose of the office, seeing patients.

• Room partitions. Some areas of the office should be separated by walls and doors to provide privacy for conversations between doctor and patient, doctor and staff, or staff and patient.

However, some areas require less privacy and can be separated by partitions or cubicles. Partitions can decrease the initial cost of interior remodeling and can be rearranged as needed or for a fresh look. Partitions are particularly useful in creating a therapy suite by dividing a large room into separate bays.

• Wall mounts. Many items used in a clinic can be purchased as freestanding or wall mounted models. For example, instead of furnishing a treatment room with a small desk with a phone, a literature rack, a few hand-held diagnostic instruments and a TV-VCR combination, consider a folding wall desk, with a wall-mounted phone, literature rack and a hospital-style TV stand.

Tables in reception rooms for lamps and magazines can be replaced by overhead lighting and wall-mounted magazine racks. Wall-mounted items save valuable floor space.

Drawbacks include the lack of portability and permanency. You have to be sure where you want the items placed before mounting them.

• Professional help. Stores selling office furniture may provide a designer to help lay out the office. This service is often provided free of charge for prospective customers or as part of a purchase. The same is true for companies that design and install closet systems.

Designers can identify better use of space and recommend appropriate purchases. Please note this differs from consulting an interior designer who specializes only in style and fashion. Function and logistics must be considered first. If you can find someone who can cover all bases, go for it. Many designers have design techniques (mirrors, types of wallpaper and lighting) that create the illusion of more space. Take advantage of as many of these as possible.

• Run on time. A small office that runs behind and is always crowded can be an inconvenience to established patients and prevent referrals by appearing too busy to accommodate more. A small, well-run office, on the other hand, can be a joy for established patients and promote referrals.

Streamline and perfect your office procedures to promote efficiency, be considerate of the patients’ schedules and make room for referrals.

Running on-time also decreases the square footage required for the waiting room and converts the waiting room into a reception room.

K. Jeffrey Miller, DC DABCO is the author of three books and more than 100 articles and practices in Shelbyville, KY. Dr. Miller can be reached at 502-633-1073.