A guide to set up an ideal clinic for doctors

A guide to set up an ideal homoeopathy clinic

Dr R Valavan, BHMS, MD (Hom), MD (AM), MBA

Often the topic of setting up a good homoeopathic clinic comes up among freshers and interns. There have been articles emphasising the merits of clinical practice as an important career opportunity after a homoeopathic graduation and post graduation. Once the graduates complete their education, with fresh minds they intend to start their practice with enthusiasm, with available resources. But they lack proper guidance on setting up a new clinic. With the recent increase in the number of homoeopathic practitioners, some ideas for setting up a clinic would be (a) an useful start for the freshers, and (b) will also meet the expectations of the patients. Some basic points have been discussed in this article.

Location – easy accessibility
Regardless of the city, town or village, the clinic should be in a well connected area or should be easily spotted. Many Indian cities are constructing metro trains. People setting up clinics in such metros may consider choosing a place near proposed metro station. Before choosing a location, an assessment of different areas on the population like awareness of homoeopathy, lifestyle, common illnesses, etc. and also connectivity, dears and nears of the fresher and other points will help to pin down. A location with good number of homoeopathic pharmacies, good number of homoeopaths, followers of homoeopathy have to be considered.

Infrastructure – simple yet professional
A clinic should desirably have minimum two components, a waiting room and a consultation room. If budget allows, a reception area with receptionist will give a better look. Otherwise a waiting room with a minimum of 2-4 chairs or a sofa with a centre table and some health magazines and pamphlets will do the magic. In between the two areas, aluminium partition will give a better look, but with minimum budget one can start with modest curtains. The colour of the wall should be pleasant to the eyes. There are attractive wallpapers available in the market, which can also be considered as an option. Care should be taken about the availability of power all throughout.

Doctor’s chamber should have a comfortable and neat table, with doctor’s chair on one side and 2 chairs on the other side for the attendants and a stool for the patient. Essential instruments such as stethoscope, sphygmomanometer, tongue depressor, thermometer, knee hammer, torchlight, inch tape, height measuring scale, weighing machine, BMI calculator, etc. should be kept handy. Instant glucometer, otoscope are other optional instruments. All the important books required for the reference have to be kept in a readily accessible manner.

The dispensing area may have a rack with step-like fashion which would be helpful to pick, medicate and dispense medicines easily in case a homoeopath doesn’t have an assistant. Different size of containers like ½, 1, 2 & 4 drams can be kept ready based on the need. Pills and lactose can be stored in big containers but for easy dispensing they can be filled up in small and handy jars. Butter papers can be cut to required sizes for ready use.

Publicity – make a statement

The name board should be simple and impressive with the doctor’s name, degree, contact number, timings and website. Inauguration by itself is an opportunity for publicity. A simple invitation to a good number of people would make aware of people about the clinic. Apart from the known circle, all the neighbours of new clinic have to be invited. A newspaper pamphlet insert on the same day about the inauguration will help. An inaugural discount or a free camp may be organised. Further, periodic newspaper inserts, information on the locality newspaper/magazine, news flash in the local cable TV, regular camps would help to create awareness of the existence of the clinic in the locality. It should be a ‘news item’, not an advertisement. Word of mouth publicity would take time but long lasting.

Computer and soft tools – make things easier
A computer is no longer a luxury, but a necessity. Homoeopathic software would make the record keeping, case analysis, repertorisation, referring materia medica easy. Many options of homoeopathic softwares are available. Depending on the budget, one can choose either free or paid software from the range of around 10,000 to over 100,000. OpenRep is a free software available with minimum required applications, which is sufficient for a beginner. Maintaining the patient register and income are easy with MS excel or the likes. With these applications, one can easily manage and maintain income and expense. See model patient register and income register in the picture.

Paperless office – a convenient and effective way of administration
If one owns a computer, patient’s case records can be kept in softwares as mentioned above. It also helps to maintain daily patient’s register in MS excel, which is always better for accurate calculation. It is less time consuming, gives fast analysis of income and expense, rate of growth, etc. It is always better to have periodical analysis of the income and expenditure. Even after every activity like pamphlet distribution, free camp, etc. an analysis would give an insight on the result of every activity and will guide further course of action. It is also useful to identify the non-season months, when the patient flow is low, to plan annual vacations.

Fee structure
Fee structure should be transparent and convenient. It should be displayed in the reception area. There are different practices followed. A standard consultation fee plus medicines charges would be ideal. Some physicians charge a single component fee including both. Patient is asked to re-visit when the medicine finishes. Now the trend is to fix annual packages. But it is not advisable for beginners. A model fee structure has been given.

Code of ethics – following good practices
It is always better to follow the standard medical ethical practices and the specific Code of Ethics prescribed by the Central Council of Homoeopathy (CCH) since beginning. As a responsible homoeopath, it is his/her duty to fulfil the Declaration and Oath taken during the time of registration at the homoeopathic council. It helps to maintain the morale of homoeopathy. It helps to keep the physician’s dignity on high. Declaration and Hahnemannian Oath as per CCH Code of Ethics Regulations are in the box.

Connecting with the patients – way of talking and the role of social media
A good connection with patients would yield good result in maintaining footfall. Good communication skill helps. A good doctor will be a good counsellor. A pleasant and caring attitude is halfway to cure. People with shy nature may attend a few personality development programs. Apart from pleasing talk, technology helps to get in touch with patients. A good social (facebook, twitter, Google+, etc.) media profile with regular updates like health tips will remind patients. Periodical SMS on important occasions will also help. Apart from them, there are many tools available today. Many mobile and online apps help sending automatic reminders to the patients on their visit days, apart from birthday and festival wishes. A whatsapp group will also be helpful. Owning a website has become cheaper and even free. Google gives a completely free website with domain name for 1 year with their innovative campaign named India Get Online. Their website http://www.indiagetonline.in may be referred for more details.

First time patients – much care to be given
A specific bilingual pamphlet (English and local language) for new patients with information on homoeopathy is good. It should define clearly the scope and limitations of homoeopathy, frequently asked questions (FAQ), dos & don’ts, etc. For ready reference, website of Central Council for Research in Homoeopathy may be referred for FAQs. Considerable time has to be given for new patients in order to make them understand homoeopathy, clear their doubts, etc., apart from time consumed for elaborative case taking. Some specific time slot or day may be earmarked for new patients.

Patient’s file folder and prescription pad – cosmetic but helps to maintain good image
An attractive file folder with name of the clinic and doctor, timings, contact number, website/blog, if visiting in different places then the addresses with days and timings, etc. will be smarter idea. Cost of such folders with printing starts even from Rs. 10/-. To compensate this expense, first time consultation charge may be kept little high. A folder will also help to keep the diet guides, laboratory reports, etc. A prescription sheet should contain the required details and instructions for the patients. Giving open prescription increases confidence of the patient on the doctor. Many physicians refer placebo in the prescription with different codes like Sacharum lacticum, Rubrum metallicum, Nihilinum, etc. There is no obstacle to give prescription.

Relations with professional colleagues of different disciplines – joining hands
Maintaining good relations with other colleagues help in many instances. If a patient is referred, a neatly written referral letter would be ideal. It looks professional and helps to maintain cordial relations with the colleague to whom the patient is referred. To honour the referrals, many prefer to complement. It is better to avoid politely such unprofessional things in order to maintain the dignity of the system and the doctor concerned.

Certification/accreditation – recognition of the clinic
If anyone wants to get the certification or accreditation from responsible bodies for his/her clinic, it is possible. Apart from ISO, etc. National Accreditation Board for Hospitals & Healthcare Providers (http://www.nabh.co), a constituent board of Quality Council of India (http://www.qcin.org), is the responsible Government body to give accreditation to homoeopathic clinics. Very recently the board had circulated draft Standards for Accreditation of Homoeopathy Clinics for public comments. Once the standards are in place, the accreditation process will be streamlined. Getting such accreditation will help the patients to claim the medical insurance or reimburse the medical expenses from their employers.

Career development
No career is stopped with the graduation or post-graduation. Same is true for homoeopaths. In order to cope-up with the present competitive world, one has to upgrade the educational qualifications. Time and again http://homeobook.com newsletter has been bringing information about the educational qualifications after BHMS or MD (Hom). There is no limitation and one can spread the wings across different medical and allied areas. Couple of nice compilations can be glimpsed here: http://homeobook.com/health-related-courses, http://homeobook.com/post-graduate-courses-after-bhms.

Expansion – planning the growth through chain clinics, online consultation and mobile & remote clinics

One has to grow in his/her career steadily. As the name and fame of the doctor rises, a proper planning helps to sustain and even to reach higher growths. The growth should be inclusive in all aspects like financial stability, infrastructure, facilities provided, connectivity, utilising modern tools and technologies, etc. Over a period, a chain of clinic may be planned with properly trained junior physicians. Online consultation is another option through which geographical boundaries are broken. It helps to retain and reach new foreign clients. Physicians successfully run mobile clinics (through customised vans) with a junior homoeopath, driver cum assistant, dispensing kit and a laptop with data connection. Once the case taking is over, the junior physician along with patient chats face to face with the senior physician through skype, facebook etc. Senior physician interviews the patient and gives his expert opinion/prescription. It saves time. Sitting at one place, different clinics are managed.

Filing income tax return – a proof of income
Even if the income is not taxable in the beginning, it is better to file the income tax return to have income proof. It will help to get loans from the banks especially for expansion, construction/purchase of house, etc. Further, it helps to assess the income year after year.

Hope the article is enlightening to beginners. Comments and feedback are welcome through the below comment box or may be sent to the author at: drvalavan@yahoo.com.

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