How to design your clinic the right way?

Dr Mansoor Ali 

Starting your first clinic can be challenging and exciting at the same time. A BHMS/BAMS/MBBS degree with an internship or practical work experience will give you enough confidence and know-how to set up your own clinical practice.

We will give you proper guidance and useful tips in setting up a new homoeopathy clinic.

 Background knowledge required to establish a practice 

• The principles of Homoeopathy
• Basic medical sciences
• Clinical subjects
• Communication skills

Requisites according to Hahnemann

Aphorism 83

• The physician should be free from prejudice.
• He must have sound sense.
• He should be attentive.
• He should faithfully record all the deviations

Qualities of physician in chronic case taking

Aphorism 98

• Circumspection
• Tact
• Knowledge of human nature
• Caution on conducting inquiry
• Patience in an eminent degree.

In the past

• Doctor was God
• Supreme authority

Now

• Patient as a customer
• Doctor as a service provider “Customer is the KING”
• The Patient : Types
• Difficult to deal with : Demanding, annoying, unrealistic, loud and objectionable.
• Desirable: pleasant, easygoing, intelligent, accommodating and knowledgeable
• Others: timid, questioning, unprepared, lacking in knowledge and uncertain about what they want or need.

“We Have to handle all”

Medical/clinical expectations of patients and relatives 

To have clinical core competence. 

• Cure rate does matter
• Good clinical methods
• Exude confidence
• Evidence based practices
• Proper documentation.
• Good legible prescriptions, a detailed prescription/discharge summary, certificates, prompt issue of papers for Insurance/re-imbursment
• Clear explanation for administration of medicine to ensure compliance.

Non medical expectations

• Honor the appointments. Appointment system should be accurate but flexible.
• Communicate well with them in day to day language. Medical words should be avoided.
• To listen to their problems patiently and give them enough time. Master the art of listening
• Show personal concern for the patient.  

Patient Expecting from you 

• The patient’s experience in the clinic forms the reputation of the doctor.
• The patient expect punctuality, caring attitude, empathy, friendly environment, respect and courteous communication
• Every time you interact with patients call them by their names.

Factors affecting expectations

1. Nature of medical illness.
2. Past experience in the same set up.
3. Experience with other doctors.
4. Financial and social standing.
5. Level of education.

Know Your Needs

When deciding to set up an independent practice the basic requirements are

• Knowledge
• Instruments & Medicines
• Large number of patients
• Financial support

Location for your clinic –prime importance

Size of Clinic 

• Doctor chamber
• Pharmacy/Reception
• Waiting room
• Parking area
• Staff necessary

Basic Requirements

• Good Interior with light & ventilation
• Examination Room
• Dispensing Room
• Fees Collection
• Registers & documents
• Waste Collection, Dustbins
• Sink, Tap & Toilet

Basic Equipment

• Stethoscope
• BP Apparatus- Mercury type
• Percussion Hammer
• Torches
• ENT  set with Head Mirror
• Weighing Scale
• IV sets, scalps & IV stands
• Foreign body remover
• Ambu bag

Reception Area

• Set up and design impresses the patients about the quality of treatments offered.
• The lobby is made of stress-free and comfortable for the visitor with a TV set, music systems, lighting etc.

Interior Design

• Attention must be given to ventilation, air quality, noise pollution, cabinet for files and medicines
• The flooring surface not only enhances the look of the clinic but also contributes in creating a comfortable feeling
• The design chosen should make the rooms look more spacious and comfortable.
• Painted walls are cost-effective and easy to clean
• Visit few clinics before you starts and discuss the pros and cons
• Service of an interior designer

Front office

• Sitting arrangement – Comfortable – since you have to sit a long time in your clinic.
• Sitting arrangement for Receptionist & Pharmacist
• Reading materials including magazines for children
• Attractive painting
• Toys and baby chairs
• Quietness & Privacy
• Drinking water, Toilet
• Advance Booking – they will not reach on time?

Select the right chair – you have to sit a ling time comfortably without strain  

 

Newer concepts

• Facility for recording the case
• Paperless clinic
• Give more attention to First time patient
• Good relation with doctors of other system
• Tie-up with nearby small hospitals
• Free treatment  – not recommended

Hiring the staff

• Three crucial factors :- compatibility, education and experience.
• Discuss and clarify on salary, compensation, benefits if any, work timings, etc. in detail and only then hire the applicant.
• Review their performance and compensate them with incentives at regular intervals.
• Address their issues from a neutral point of view.
• Hire fresher and train them as a viable option.
• Avoid students and workers – opt retired hands
• Less manpower
• Support from your family – train your family on dispensing medicines – useful when pharmacist on leave

Homoeopathic Pharmacist

• Most important quality is – Trust worthiness
• Random check on reliability needed
• An eye Cash dealings
• Pre-packing of medicines required to dispose patients on time

Medicines 

• No compromise on quality
• Sealed bottles
• 30 ml enough
• Use Genuine Vehicles
• Quality packing and bottles

Fee structure

• There is no fixed fee charged by the doctor.
• Some change less fee to attract more patients, while others charge for the cost of facilities offered.
• Charge your patients reasonably.
• Highlight the benefits and the salient features of your services.
• Sometimes patients complain of the charges being higher than a general physician.

Chain Clinics /Speciality clinics

• This involves sharing of time, space and equipment by two or more doctors.
• Practice independently at different timings, though occupying the common space.
• Issues on medicine purchase and maintenance need clarification before preparing the contract.
• Focus on an area what you excel

Trend

• More and more clinics with state of the art facilities are coming up every day.
• This reflects the confidence of the treating homeopath and boosts the satisfaction of the client.
• Many of them with ISO and NABH certification & other Accreditations
  

Create a Brand 

• You too can develop a singular identity through branding and create an edge over the competition.
• Create simple and distinct ID cards.
• Always carry them with you and distribute them to the people you interact with.
• Brochures or newsletters can be circulated to the patients with treatment details, significance and salient features.
• Stock recent magazines and newspapers highlighting importance of homeopathy in various disorders.

Infrastructure

Should reflects Professionalism

A patient’s first impression of his physician can be made within the first few minutes of entering the clinic.

Implement Air hostess philosophy in designing a clinic – hair hostess doing the same nature of work as of our house maid – but the salary, social reputation, dress code are different – so start attractive clinic – that give more reputation to you and homoeopathy.

Update yourself

• Update yourself with the latest news on nutritional aspects
• Make arrangements to give advise to patients on emergency visit.
• Train your staff in communication skills to deal with the patients effectively.
• Make your web site more patient friendly and interactive in nature.

Punctuality

• Reach the clinic on time.
• Don’t make the patients wait for you.
• In case of unavoidable circumstances convey a message to the concerned patient through staff.

Dress Code
Dress for the job you want,  not the one you have.
Let your dress reflect professionalism.

Refer case ! 

• Refer at the right time
• A satisfied customer will bring 1 or 2 patients
• A dissatisfied customer may result loss of 10 patients
• Create a rapport with neighbouring doctors & hospitals

Customer Service-Inference

• Up to 60% of dissatisfied patients will not return
• Dissatisfied customers will tell 8-10 people. 13% will tell 20 people
• It costs 5X as much to attract a new customer
• Seven of ten complaining customers will do business with you again if you resolve issue
• If you resolve a complaint on the spot, 95% will do follow gain

Accreditation

• Certification/accreditation
• Recognition of the clinic
• National Accreditation Board for Hospitals & Healthcare Providers (NABH)
• Quality Council of India

Clinical Establishment act
The Clinical Establishments Act(Registration and Regulation) has been enacted by the Central Government to provide for registration and regulation of all clinical establishments in the country with a view to prescribing the minimum standards of facilities and services provided by them

Web: clinicalestablishments.nic.in/

Taxes to pay 

• Professional tax
• Income Tax
• Daily book
• Bill
• Registration of clinic

Work Out 

• Expenses
• Investment for future
• Money to Help the People in Need – Charity 
• NEVER use credit card, always use the debit card, because we must use the money we have, not the money someone else is holding!
• 15% expenses towards advertisement

Buying a running clinic ? Evaluate the Practice

• Check on the following few facts before buying:
• Is the practice active and flourishing?
• The financial status of the clinic in the last 3 years.
• The reputation of the clinic.
• The difference in the net and gross practice income.
• The average fees charged from patients.

Good relation with other doctors & systems
Maintaining sound relations with other doctors is a vital component for a successful marketing plan for a new practice. This ensures referrals from them, which forms the crux of a bustling medical practice.

Attributes of good medical professional

• Clinical Competence
• Communication skills
• Ethical behavior
• Duty, accountability, taking  responsibility
• Respect for patients, colleagues and health system
• Self improvement, passion for excellence
• Humanistic  Values

Dr Mansoor Ali KR
Professor, Govt. Homoeopathy Medical College. Calicut

PPT on how to set up a clinic 

More useful articles on clinic design
https://www.homeobook.com/category/clinic-setup/