How much space do you really need?

One of the first questions you have to answer when deciding to expand your practice is: How much room do I need?

The number of paitents you see is important, but it’s not the best way to go about answering the question. What you really need to consider is how many providers you have and at what level they practice.

Three exam rooms per provider is generally considered ideal. However, not all providers will need this many.

“Brand new physicians will need less space until they ramp up,” says Nick Fabrizio, PhD, faculty member at Cornell University’s Sloan Graduate Program in Health Administration and principle consultant with the Medical Group Management Association (MGMA). “They may need only two rooms for a while. First-year residents can probably get by with only one, since they’ll be seeing one to two patients an hour.”

Of course, practices vary. You need to take a look at how long your providers spend with patients and appointment blocks. You may also need to take into consideration upcoming staffing changes, such as retirements and new hires, that could change the pacing in your practice. You also need to account for what services you currently offer, or what you might be planning to add in the future. Unless your practice does a lot of procedures, several physicians can share a procedure room.

A good size for a primary care exam room is 10 feet by 10 feet, but a little larger is better if you can manage it. Studies have shown that patients are less anxious and more likely to open up to their providers if they don’t feel too cramped. You also need to be sure your exam rooms are big enough to comfortably fit a physician, a nurse or assistant, the patient, and a family member. Also be sure you have enough room to meet Americans with Disabilities Act (ADA) guidelines.

If the layout of your new space allows, you can save some room by having a smaller area where nurses take patients’ vitals, weight, and so forth rather than tying up an exam room. If you pursue this option, be sure to create a space that offers sufficient privacy to meet HIPAA guidelines and is ADA compliant.

Make the space work for you

As far as the rest of the office goes, you may need less space than you think. The old-fashioned model of each physician having a private office with a big desk, two chairs, and a door that closes is not only wasteful, but reduces efficiency as well. In one practice Fabrizio worked with, each physician had a 120-square-foot office. He estimates offices were used less than 25 percent of the time.

Consider using a more open plan instead. Fabrizio suggests having small private spaces, such as cubicles or standing desks, where physicians can work with nurses. This makes it easier to encourage collaboration and promote coordinated care among team members. Or, you might try a pod arrangement, where three or four exam rooms are grouped around a team station. This type of layout is also well-suited to sharing computers, which can make effective use of space and equipment, especially for part-time providers and residents.

Keep future needs in mind as well. Do you plan to offer additional services? Do you plan to add providers? Make more use of nonphysician providers? Take a good hard look at your long-term business plan and be sure you have enough room for additional practice expansion. You want a space that suits your present needs but also one that you can grow into.