How much space do we need?

ByJohn B. Pinto

For the average general ophthalmology practice, and before considering optical or ambulatory surgical facilities, it’s typical to generate $500 to $1,000 in annual collections per square foot of office space. Said another way, at the usual intensity of utilization, with each doctor seeing 40 to 60 patients per day, 3 to 4 days per week, most practices need a square foot of floor space for every five new or established patients seen each year.

You can obviously beat these numbers with longer operating hours, visiting part-time doctors and more efficient scheduling to reduce the uncomfortable crowding that ensues with excessive patient waiting time. Every competent medical space planner has his or her own way of looking at these ratios and should observe each doctor in a clinic before remodeling or designing new office space.

This doesn’t mean you can’t live outside the norms. I had one solo client who insisted that his architect provide 12 exam rooms because the current eight rooms he was using weren’t enough. He then proceeded to run a very efficient 110 patients per day, with minimal waiting time, using certified tech staff as active extenders. His patients were delighted, and his profits were exceptional. It was clearly a wise and affordable use of space in his case, even if it represented overkill for most. At the other extreme, I’ve served numerous clients who are most comfortable working out of just two exam rooms, with some achieving 50 or more patients per day.

I can report from the front lines that as fees continue to soften, both of these facility extremes are quite likely to survive. I believe that high-volume/lower-margin “assembly lines” and low-volume/higher-margin “boutiques” will both continue to find willing patients. Each service model has its own space requirements and its own economic boundaries.