I’m often asked by doctors, “What type of floor plan is best for a chiropractic office?” The question usually comes from a doctor looking to discover some kind of magical design concept that will transform his or her practice into something greater. While the desire to find the top floor plan is well intended, the reality is that there is no “best” floor plan. There are simply too many variables involved in designing an office to crown a single design scheme as the “best.”
Although a universal floor plan doesn’t exist, there is a concept that is gaining in popularity among many doctors. Most doctors refer to it as the “open office” concept. As the name implies, an open office has few, if any, interior walls and makes use of a single large space for various activities.
Removing most or all of the walls that typically make up treatment and therapy rooms allows the open office concept to be highly efficient. Instead of individual rooms, treatment and therapy tables are typically arranged in a large single room or open space. In addition, other office components such as the seating area and reception desk can be incorporated into the open environment.
The advantages of utilizing such a design are numerous. First, having no walls means having no doors, which means the doctor and staff can move freely from patient to patient without any obstructions. This convenience is particularly helpful in a fast-moving, high-volume type of practice.
Secondly, the open design concept offers the ability to educate patients more completely and with greater efficiency. This is accomplished by conveying a wide array of information to several patients at once. A doctor can talk to each patient about a certain condition (in general terms) while being overheard by all other patients. For example, patient “A” may be receiving treatment for low back pain while patient “B” is being treated for headaches. When patient “A” hears the doctor talking to patient “B” about headaches, he or she becomes more educated about the versatility of chiropractic care. This “broadcast method” of discussion is a terrific way to educate patients about a variety of conditions that they might not otherwise associate with chiropractic treatment.
Also, the open design concept offers lower overhead. An office without walls requires approximately 25% less total space than an equivalent office with walls. When you figure the cost of rent and utilities, less space means lower monthly overhead, which can add up to thousands of dollars over the course of many years.
Another advantage includes lower build-out costs. Constructing a multi-room office can cost tens of thousands of dollars or more. An open design plan can drastically reduce those costs by eliminating material and labor expenses.
Certainly there are some drawbacks to the open design concept such as the issue of privacy. Treating patients in the unclosed area severely limits what can be discussed. For instance, a doctor will not be able to discuss certain matters that might be personal or embarrassing to the patient. Similarly, patients may hesitate asking the doctor important questions for fear of embarrassment. However, these concerns can be easily addressed through certain design features and specific office policies.
Any version of the open office concept should include at least one enclosed treatment room that can be used for patients wanting a higher degree of privacy. The room can be a dedicated treatment room or an examination room or private office. Incorporating a private room allows patients who feel uncomfortable being treated in an open environment to have the privacy they prefer.
Furthermore, there must be an understanding between the doctor and staff members that personal or embarrassing issues should not be discussed in the open area. All such matters should be addressed confidentially in a treatment room or private office. Patients should be reassured that any time they feel the need to discuss a matter that is personal or embarrassing, they can do so by asking. When they do ask, simply direct them to a private room.
Working in an open design office also requires unique communication skills between the doctor and staff. There should be a few verbal and visual signals (usually key words and gestures) that can be used to effectively communicate procedures, traffic flow, time allotment and patient requests.
In addition to good communication skills, the open environment concept demands that the doctor and staff exude a high level of confidence around patients. If the doctor and staff are uncomfortable working out in the open, then how are patients likely to feel about it? Probably not very comfortable. Patients will sense that something is not quite right even though they might not know what it is. Therefore it is absolutely necessary that the doctor and staff be completely comfortable working without the security of walls and doors.
Let’s look at an example of the open design concept in the context of a high volume office. This open style office plan is incorporated into a 1,500 square foot strip mall space and has several noticeable design features. First, note how the seating area and front desk area are essentially one seamless functional space. This design concept reinforces a contemporary style by eliminating the traditional reception room “box.” Instead, the seating area seamlessly flows into the front desk and treatment area. In addition, the front desk features a wide-open, wrap-around design, thus eliminating the tradition of a receptionist sitting behind a sliding glass window.
Also, notice how the front desk is purposefully positioned so the person working behind it can view all areas of the office. This feature is particularly helpful in a busy practice. The person at the front desk has the ability to direct patient traffic, give and receive instructions and assist the doctor when needed.
The treatment area is equipped with five adjusting tables, which also double as therapy tables. Their arrangement within the open space allows the doctor and staff members to efficiently move from table to table. After each patient signs in at the front desk, they are directed to a designated table. Specific patient placement allows the doctor to move from patient to patient in an orderly manner.
The plan shown here offers two options to patients requesting privacy. The first option involves treating or consulting with patients in the examination/treatment room. The second option is to treat or consult with patients in the doctor’s private office.
Of course, the open design office is not for everyone. Some doctors feel too uncomfortable treating and talking to patients out in the open. For those doctors I recommend utilizing a more traditional office design featuring individual treatment rooms. However, if you are comfortable working in an unobstructed environment, then the open design concept may be a practical choice. An open style environment can offer greater efficiency, lower construction costs, lower monthly overhead and more flexibility in educating patients.