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3-Designing your
clinic - make it patient-friendly
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"Always
design a thing by considering it in its next larger
context—a chair in a room, a room in a house,
a house in an environment, an environment in a city
plan. "
- Eliel
Saarinen
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Most doctors starting practice have a limited budget,
so your options when constructing your clinic are
likely to be limited. However, since this is one
of the most important decisions you will make, you
need to give it a lot of thought. Don’t hesitate
to raise funds or take a loan to buy more space
than you think you can afford. Not only will your
investment in real estate be sound, you need to
leave yourself enough space for expansion for the
future as you become busier, since changing your
location is so difficult once you are established.
Unfortunately, most doctor’s clinics are still
very depressing places – and most look just
like any other doctor’s clinic. Spend some
time and energy in designing and building a better
clinic - after all, you will be spending most of
your life here ! If you prefer practicing medicine
to going on weekly sightseeing excursions to look
at suitable sites, you need to find a reputable,
commercial real estate broker to help you find space
for your clinic. Based on an evaluation of your
needs and budgetary requirements, the broker should
produce three to five prime sites in your target
area—containing information on traffic, photos,
locations of competitors, and details on leases
and/or purchase options.
Try to locate your clinic in a site which is close to public
transport, so you are easily accessible to patients. Most
cities have their equivalent of a “Harley Street”
, which is considered to be the “medical heart”
of the city where many doctors practice. If you can afford
a place here, this is a useful “high-profile’
address to have.
Being located in a busy area will help to attract
patients, many of whom prefer doctors who are close
to where they live. Practising in a “medical
office building” along with a lot of other
doctors will help to put you in the heart of all
the medical action, facilitating networking with
doctors, and getting and providing referrals. Of
course, it may also mean that patients may go to
your “competition” in the building,
rather than to you !
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Try to stay as close to your residence if this is possible
– commuting can be hell in many cities today. Many young
doctors start many clinics all over town, and take as many
hospital attachments as possible, in order to attract as many
patients as possible. While easy availability is important,
often this means that they waste a lot of their time commuting.
Not only does this drain their energy, it also is frustrating
for patents, who may find it very difficult to get hold of
the doctor when they need to. Hospital attachments can be
a valuable source of patients , and also allow you the opportunity
to network with colleagues and establish yourself professionally.
The admission and operating privileges they provide are essential
for doctors in surgical branches, who need theatre facilities.
When you start your clinic, make sure you have all the required
permissions. For example, not only will you need permission
from the society if you practice in a residential building,
you will need to make sure this permission is in writing,
so you do not have problems in the future.
While purchasing the premises can be expensive, you can look
upon this as an investment in real estate, which will usually
appreciate in time and is a valuable asset. A less expensive
option is to lease or rent a place to start your practice
. Young doctors who are just starting practice may not be
able to afford a clinic of their own. In such a case, starting
practice in a polyclinic is a very useful stepping stone.
Study the owner’s policies and decide whether they are
good for you and your patients. Does the polyclinic offer
any services apart from a consulting room? Do they have an
efficient receptionist? Is the receptionist capable of handling
your patients? After how many years will the rent increase?
Are the current doctors practicing in the polyclinic happy
with the owner ?
Be careful in selecting an architect for designing your clinic.
Remember, experience counts. It’s a good idea to actually
visit the clinics the architect or interior designer has built
in the past, to ensure that his work is reliable. Also, keep
an open mind, and friends, doctors and patients for suggestions
for your new clinic - they may have seen novel ideas elsewhere
which are worth incorporating.
Strategically placed sign boards outside the building are
extremely important in helping your patients find your clinic.
Illuminated sign boards are even better, since they will increase
awareness of your clinic in the community . If you work in
a large building, make sure that the entrance to your clinic
stands out in the maze of doors and corridors. Keep your building
security guards and lift operators happy ( perhaps by providing
them with free medical care) , so that they take better care
of your patients.
In order that your clinic functions efficiently,
rooms should be built to allow optimal traffic flow
of patients, and medical and clerical staff The
designer’s goal should be to make patient
"flow and function" run smoothly, with
a minimum of disruption and noise. Space is always
at a premium, and you will need a skillful architect
to help you make the most of every inch. Your time
is precious, and your availability is often the
bottleneck in your clinic’s functioning. This
is why it may be a good idea to have two or more
examination rooms, so that you can examine more
patients in a shorter time . Thus, while you are
examining one patient, your nurse can help the other
patient get ready for you in the other room. A time
and motion study has shown that three treatment
rooms are the ideal number for a medium-sized practice.
Visiting the clinics of senior doctors ( especially
those in large cities),as well as the newer 5-star
hospitals will also give you lots of ideas as to
how you can create a pleasant ambience in your clinic.
If you can afford it, go abroad to see the world’s
leading clinics, so you can use these as a model
when designing yours. Remember to wire your clinic
for the future, so that it is ready to accept the
newest telephone and computer networks.
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Medical clinic designers have started to introduce a new and
exciting interior design format called the "therapeutic
environment." These designers feel that healing and recovery
are dramatically affected by colors, finishes, lighting, views,
furnishings, open spaces, and even sounds and smells. These
are referred to as "positive distractions" and have
actually been shown to be healing agents. The practice décor
must project a professional image. Interior designers and
decorators are expensive, but if you do not have a good, imaginative
sense of colour and design, then you will need the help of
a spouse, a friend or a professional. Pictures can be useful
assets in addition to the colour scheme, especially in the
reception room where patients are waiting, since they provide
a talking point with other patients. We have put up the pictures
of some of the test tube babies which have been born in our
clinic, and many patients enjoy looking at these, since it
gives them hope that they can succeed to. You can put up patient
educational posters; as well as a bulletin board, which has
articles on medical topics your patients will find of interest.
Attractive information signs are extremely useful since they
help direct the patient and save a lot of questions. Many
signs are mass produced by firms, or you can have them custom
designed. Such examples include: No smoking; Details of clinic
timings; and payment schedules.
A good way of finding out how your patients feel when they
arrive in your office, is for you to sit in your own waiting
room ! Are you comfortable ? Would you be happy to wait in
this room ? Design your clinic by always keeping the patient's
viewpoint in mind, so that you can build an office that maximizes
your productivity without losing the warm human touch that
characterizes the best practices. Many physicians now have
TVs in their waiting rooms, so that their patients don’t
mind waiting.
Provide for a welcoming atmosphere by positioning your receptionist
with direct eye contact with anyone coming through the door.
To make the reception area seem more "friendly,"
don’t place the receptionist behind a wall or behind
glass. Pictures of you receiving awards, and photos with famous
personalities and celebrity patients can reassure your patients
( and their family members) that you are a competent doctor.
Putting up your medical diplomas and certificates will also
help to reinforce your credentials , ability and learning.
You might also want to put a file which contains testimonials
from patients about your services. A press cutting file which
contains articles by and about you is also impressive. Keep
your practice brochures and patient education pamphlets in
your reception area. Encourage your patients to read these–
and to take them home – this is an excellent way of
marketing !
Patients expect the clinic to be clean, and you
need to be obsessive about this. Make sure all the
cleaning is completed by the time the first patient
arrives. If you fail to find anybody to do the cleaning,
you will have to do it yourself ! The ambience of
your reception area creates clues for people about
what they should realistically expect from the care
and service in your practice. Too elaborate an area
may send a message that care will be expensive,
while an overcrowded room full of grouchy looking
people signals a long wait and a rushed physician.
The seating and the size of your reception area
must be adequate, not only for the patients, but
also for the relatives and friends they frequently
bring with them. As a rule of thumb, if you see
four patients in an hour, you should have twelve
seating spaces ( three times the seating capacity
for the number of individuals you have scheduled
to see in the hour) .
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A telephone line should be available for the patient's use,
as they may wish to ring their office or home. The best option
is to install a pay-phone service, to ensure the phone facilities
are not misused. A rack or table carrying an adequate supply
of general interest magazines is essential. Do not let your
magazines become dusty, torn and two or three years out of
date. Flowers and plants in tasteful arrangements have a welcoming
effect. Silk flowers and plants are a good way of avoiding
continual worry about watering, providing they are not allowed
to become drab and dusty. Background music is popular and
can provide a pleasant and relaxing atmosphere for patients
who are sometimes tense when they arrive. Have a supply of
tea, coffee , biscuits , sweets and soft drinks for your patients
and visitors. A supply of drinking water should always be
available, as should toilet facilities. The toilet is often
the best indicator of a facilities’ focus on cleanliness
and hygiene – make sure yours is spotless and kept clean
. It’s a good idea to use it frequently yourself to
ensure this is done ! A collection of small toys and children's
books is a good idea to prevent boredom.
If you can afford it, airconditioning your clinic is one of
the best investments you can make. A comfortable environment
will not only keep your patients happy, it will also dramatically
enhance the productivity of your staff ! Carpets have become
more affordable, and offer a touch of class to your clinic.
If you use assistants in your clinic, try to provide a private
seating area for them, where they can talk to patients in
private. Patients must have a small private area in which
to change. A simple curtained-off space in one corner is adequate;
or screens may be used if curtaining is not possible. Some
very busy doctors try to improve their efficiency by seeing
more than one patient at one time. This is terrible, and should
be avoided. The least you can provide your patients is your
undivided attention – even if it is only for a few minutes.
Patients understandably hate talking about their problems
in front of other patients !
Your front office is your public face but just having
a comfortable reception is not enough. Your staff
is vitally important, and they can literally make
you or break you. It’s a good idea to provide
uniforms for your staff. Not only does this help
your clinic look much more professional, it also
helps your patients identify your staff members.
Staff should wear name badges; and having pictures
of the staff with their names and designations on
your bulletin board can help to enhance their self-esteem,
because it sends a message that every person on
staff is a respected member of the team. It also
makes it easier for patients to approach a staff
member when they can recall the person's name. The
best feature of a good reception area is an immediate
acknowledgment of people as they arrive. A warm
welcome creates a positive expectation about the
care and service that will follow and builds trust
and rapport. You need to constantly motivate your
staff to present your practice in a positive light.
Staff-patient interactions are crucial because the
reality is that your staff spends much more time
with your patients than you do –an average
patient spends 45 minutes to one hour in the office
and only five to 10 minutes with you. Every interaction
that patients have with the practice has to be managed
and made positive. Investing in good employees involves
more than wages — you also need to provide
them with the best tools for the job, including
computers and Xerox machines, depending upon your
practice needs.
TOP
It’s a good idea to create an office manual which describes
commonly performed office procedures, such as answering the
telephone . It is useful to have “cheat sheets”
and reference pages, which summarise the common queries patients
have . While establishing these systems may seem like a lot
of trouble , having a defined system will help your practice
to grow. The primary responsibility of the front office is
to greet patients— period. Remember that you never have
a second chance to make a first impression, so make sure you
make the most of your space, funds and staff to make the best
impression possible !
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