You have a thriving clinical dermatology practice but would like to add a service that would allow the practice to earn additional income without adding another doctor. Your solution is to break into the cosmetic dermatology realm by adding an Aesthetician.
How do you do this without adding space to the practice? This can be a difficult task because your office is similar to a gallon jug of milk in that no matter how much you want to add to that jug of milk it will only hold a gallon. The first step is to identify how much space (milk) you need for your new service. Once you have a full understanding of your needs then you can see if there are any creative ways to expand the milk jug.
Identify Needs
Having a full understanding of what you need to add to make the cosmetic addition a reality is going to be the most important step. What the service will need will be more than just a space to house it. Below is a list of issues you should understand.
- How much space will the new service require?
- What kind of access to the waiting room is required?
- Do you want a retail component to the new aesthetic service?
- Will the patients be able to understand the path out of the new service to check-out?
- How will payment and on site appointment scheduling be handled, in public at the check out counter or in private?
- What are the equipment needs for the new service?
- Is there any special lighting or heating and cooling needs for the space?
This is also a time that you should take a look at your overall practice needs. Do you have enough space for your practice as it is now, before you add your new service? Create a needs list for both your existing practice and the new service before looking to reengineer the space.
How to expand without adding space
Now that you fully understand your need, how do you make it a reality? The best scenario would be if you have a space that can be transformed to the new function like a storage room, doctor office or staff lounge.
Maybe the new function can share space with an existing function. Often this is a procedure room that can be used for the new aesthetician space and at times still be a procedure room. The following are the typical ways to accommodate the new function without adding space.
- Take over a non-patient space for the new service.
- Combine spaces to act as dual functions at different times.
- Extend the office hours to late afternoon and weekends so that the new service can be offered at different times from the existing functions.
- Take over business office space by combining work areas and going to shift work for those who have been moved.
- Free up business office space by allowing staff to work remotely. This must be staff that do not have daily contact with patients in the office.
Non-Contiguous Expansion
Another consideration, involving expansion, would be to rent more space in the building that you are in for non-patient contact space
Relocating the spaces below can free up considerable space that can be used for new services and generating patient visits.
- Lounge
- Doctor offices
- Back office functions – Administration, Insurance, Billing, etc.
- Storage rooms
- Charts
Converting this non patient care space into patient care space will require additional capacity in the waiting room and check- in. To determine your future waiting room needs calculate the patient volume on an hourly basis, subtract out the exam and treatment rooms patients will be in and multiply that number by a factor to include family members that come with the patient. For dermatology this factor is typically in the 1.5-2.0 range.
The check-in counter needs calculation uses this same hourly patient volume number, then multiplied by the average length to check-in a patient. Four minutes on average should be a fairly close number to expect when you calculate this number for your practice. This will give you the total number of check in minutes you will need to plan for appropriate staffing. If this is more staff than you currently have look to see how you can allow the current staff to be more productive. For instance:
- How often do the receptionists have to leave their station? Can these trips be eliminated/ reduced?
- Are your receptionists answering the phone and making phone appointments? If so, have other staff perform this duty to free the receptionists up to handle more patients checking in.
- How much of their time is registering new patients? Have this done by the added phone staff, self registration kiosks, or web site registration for example to streamline the check in process.
In conclusion, it cannot be stressed enough that you must know fully what your needs are before you make any changes to your practice environment. The changes you make should fulfill the needs of your practice for the next five years. Remember; do not try to fit two gallons of milk into a one gallon jug. A second jug or a larger jug just may be required to accomplish all you want. If you think that you will be adding other services that will require a move in the short term, then now may be the best time to make the jump. The most obvious consideration is that whatever you do must bring in patients and revenue to generate enough income to offset costs and provide profit for the practice.
