Open room, closed room or somewhere in between?
By Glen David

Since the beginning of chiropractic, architects have designed chiropractic offices using the only model they knew, the medical model. Without understanding all the principles and benefits of chiropractic, designers have created thousands of offices with segregated, closed-room environments.

Although the results have not been detrimental, this design does nothing to support or enhance chiropractic.

The closed-room design is only one type of floor plan; others are available. And each benefits the practitioner in a different way.

The closed-room floor plan is best for providing a number of modalities; the fully open plan facilitates patient education; and the semi-open plan supports education while controlling office traffic and maximizing volume. The best design is one that is compatible with your business and clinical strategies.

If your clinical strategy emphasizes patient education, the semi-open floor plan may be for you. The main purpose of the semi-open plan is to help impart general chiropractic concepts to your patients. Here are a few of the benefits this concept can give to your practice.

• Flow. Using a portable T-wall (or T-bar, L-bar, Y-bar or knee-wall) is the same as painting a double yellow line down the middle of a highway: It prevents traffic jams and even head-on collisions. It provides two separate means of egress: one for the patient and one for the doctor. It also gives patients a place for their personal belongings and the doctor a place to write the patient notes.

• Communication. With proper positioning, the partition allows nonverbal communication between you and your staff, giving you a good sense of what is happening in the practice.

In addition, this design reduces the time a chiropractor has to spend playing psychologist. While a fully open room concept can do the same thing, it may also give your patients the sense that they are not getting your full attention, lessening the perceived value of that visit.

• Education. Adding “hot seats” or “jump seats” to the area just outside the adjusting area allows additional patients to hear the your “table talk.”

Mount a television monitor behind a T-bar area and you provide an educational media center for those waiting while you focus on the person you are treating. Arranging the waiting-room seats in a manner that allows you to make eye contact with the patients also allows you to control when patients become engaged in the education.

• Retention and referrals. By minimizing the number of patients in your waiting room and maximizing the number of patients who are being educated, you can increase your patient visit average. When your patients are better educated and stay longer, they are more likely to tell their friends and acquaintances about you.

• Versatility. With a portable wall, you can transform any treatment area into a lecture room capable of seating dozens of patients for your spinal health and wellness classes.

• Time. Getting the next patient into the adjusting area can happen in less than 20 seconds, compared to as long as five minutes for closed-room designs. This is the primary reason that a twin adjusting bay behind a T-bar has a higher volume potential than a multiple-room system does. Time spent waiting for a patient is opportunity cost.

• Space. The semi-open plan can minimize the size of your reception room and your whole facility, saving you tens of thousands of dollars. For example: Reducing your space by 200 square feet can put $15,000 in your pocket: 200 square feet x $15 per square foot x 5 years = $15,000 in additional revenues.

• HIPAA-compliance. The semi-open concept is as compliant as a closed-room plan. Maintaining patient privacy with this floor plan is a matter of directing traffic. Offer all patients the option to use one of your closed rooms if they need to speak to you about private health matters. Or, better yet, schedule a special appointment so you can address their issues without being rushed.

Glen David is president of Davlen Associates, Ltd., www.davlendesign.com, an office design firm and furniture manu-facturer specializing in chiropractic offices. He can be reached at 631-654-3511.