BLOG: If you want to up your game, remodel your office
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In running a medical practice, like any business, the easiest thing to do is stay the same size, neither shrinking nor growing significantly.
You replace employees who leave, you keep current on your skills but don’t significantly expand services, and you have a tried-and-true culture that serves your loyal patient base reliably year after year.
But during a time when the aging population is expanding and becoming more knowledgeable, the desire from patients to see subspecialists with unique expertise is growing. At the same time, the margins for operating a practice are thinning. It makes sense to give patients what they want and create economies of scale by adding subspecialists who can grow your practice by expanding into the niches of your specialty.
Growing a practice requires more of everything: people, equipment and space. If you wish to grow, planning for space is often the first and most important step. In my 25 years of practicing at Harvard Eye Associates in Laguna Hills, California, we have expanded our main office no less than five times, each time undertaking a significant remodel. We have learned several lessons through this collective experience.
- Plan early for space. If you rent, talk with your landlord about desiring contiguous space. Assuming your building can accommodate it, expanding into neighboring suites is far more efficient than being fragmented, so plan early. Landlords love tenants who plan to stay a long time, growing their commitment to their location. Usually, they are willing to offer rights of first refusal for contiguous space or options for lease extensions at very favorable terms.
- Expand more than you think you need because you will run out of space sooner than you think. More than once, we have solved this problem by creating a floor plan with a larger-than-necessary billing and administrative space. Offices are laid out to be future exam rooms. Then, as we grow clinically, we displace the administrative staff to smaller or offsite spaces as needed, and we use their former offices as clinic space. In our most recent move to a 27,000-square-foot facility 2 years ago, we took over the entire floor of a large medical office building. Instead of building out the entire space, which was far more than we needed, we reserved 7,000 square feet for temporary storage. Now, just 2 years later, we are easily able to expand into it as we grow by 20% per year.
- Hire an architect who understands your specialty. As ophthalmologists, we hired Eckert Wordell, a Michigan-based medical architecture firm that has planned space for many eye care practices. Not all specialties use space the same way. The added cost of a specialist was a great investment.
- Grow by adding subspecialists in lacking areas. This quickly fills the schedule of new doctors with patients who already exist in your practice. Patients are generally happy to transition to these new doctors because of their specialization, and they can develop a following of their own, if they have the right personality. Get them the equipment they need to practice first-class medicine, and treat them as an equal, offering partnership to those who show they are fully committed. They will reward you with loyalty.
- Enjoy the improvement in practice culture that you will inevitably see when you expand and remodel your space. When staff are working in a newly remodeled space, they stand a little straighter, speak more kindly and behave more professionally. They act like they are working for the best because the office conveys that image. Patients also appreciate a new facility as a sign of practicing modern medicine.
Nothing is more exciting than cutting the ribbon on a new facility and seeing your practice grow with new space and new doctors who bring energy, expertise and expanding revenue to make your practice healthier. In an era in which the viability of independent private medical practices is challenged by many external factors, which has been a continuing trend as long as I have practiced, growth has been a strategy that has paid off, over and over again.
Read more blogs from John A. Hovanesian, MD, FACS, here.
Follow @DrHovanesian on Twitter.
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