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 By Neil B. Gailmard, OD, MBA, FAAO, Editor July 7, 2004 - Tip #129 
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Office Design Tips


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Some of the best optometric office design ideas come not from architects and designers, but from veteran ODs who have lived through various designs (good and bad) in the real world. I'll put myself in that group. I've progressed through various office settings from my first startup office of 750 square feet in a medical complex to a second story professional building in a shopping area, to my current 10,000 square foot freestanding building. I've also had the opportunity to tour many of the top practices in the country, which always results in many good ideas.

So here is a non-exhaustive list of random design tips to consider as you remodel, expand or build new.
  1. Reception room. Also known as the waiting room, make this area large enough for families and drivers who come along, patients waiting for pupil dilation (unless you have an inner holding area) and future growth. Ideally, a patient washroom should be located immediately adjacent, but with some buffer or divider to provide privacy. Consider your practice philosophy as you decide how to position the frame display area. I prefer a reception room that affords a view of the optical, but is completely separate from it. The first impression is often the reception area and I like the feel of a completely professional, medical office. Consider a coffee counter with sink, a water cooler, and cable TV in this room.

  2. Business office. This area should interface with the reception room, and I prefer an open design without barriers like sliding glass windows. One good design provides a counter at the reception room for check-in and a second, more private, inner counter off the clinical area for check-out and payment. Typically, the business office houses file cabinets for patient records, although usually there is only room for very current files. A storage room in a remote are of the office is usually needed for more files. This is where the value of electronic medical record software is obvious. I also like to see a private administrative area next to the business office. This area could have a private office for the office manager and additional desks for an insurance clerk and general administration. A photocopier and a mailing center can also be located here.

  3. Pre-test and special procedure rooms. Plan for more of these than you think. Most patients will go through this room, even if you have multiple exam rooms, and it's not a good idea to keep a patient in the pre-test room too long or else it becomes a bottleneck. I like to limit the number of tests that can be performed in the pre-test room to about 3 or 4. A 10 by 12 foot room works well, and a sink should be included for contact lens handling. In addition to the basic pre-testing (such as IOP screening, field screening, auto-refraction, lensometry) additional small, single-use rooms may be considered for visual fields and nerve fiber analysis, since these tests take a little longer and are best done without the distraction of other people.

  4. Exam rooms. Gone are the days of 20-foot long rooms. I used to have them and I actually think shorter rooms look and feel better, while saving valuable office space. I think an ideal size is about 10 feet wide (you can get by with as narrow as 8 feet) by 12 to 14 feet long. Refraction mirrors are easy to set up and they work great. I originally made my exam rooms 10 X 20 feet, and several years ago I shortened four of them by 7 feet by having a new dry wall partition installed. This made the exam rooms 10 X 13, and created four new 7 X 10 special testing rooms, which we use for fields, nerve fiber analysis, retinal photography and corneal topography.

    We spend a lot of time in these rooms, so I'd make them comfortable and big enough for a couple of side chairs for family members. I like a refraction desk or counter which can handle a computer monitor and allow additional room for a scribing technician. Plan for at least 2 exam rooms per working doctor and then allow for some more rooms for growth. Doctors who work out of 2, 3 or 4 exam rooms are very efficient, with technicians getting patients ready in one room while the doc is in the other. Don't forget that several pre-tests, such as acuity, blood pressure, color vision and even the case history, can be performed by a tech in an exam room - freeing up a pre-test room.

  5. Technician workstation. This is a valuable behind-the-scenes area for technicians to work. Located in a central spot in the clinical area, this multi-purpose room is for staff only. It may contain a large counter and wall cabinets for central drug storage and hand instruments. A lensometer and radiusocpe is handy here, and an ordering desk with a computer for ordering contact lenses and other supplies. A contact lens lab and inventory storage may also be kept in this area.

  6. Optical dispensing. Consider giving this area a separate entrance and parking area, if possible. I like having the optical separate - but not too separate. We operate our optical under our practice name and within the same business organization, because patients like knowing we are responsible for all aspects of their care, and they like writing one check. Internally, we can walk from the clinic to the optical with no feeling of separation. But the separate entrance and a second reception desk allows us to serve a large number of patients who drop in for eyeglass pick-up or repair without appointments - and it has helped us build our walk-in optical sales, filling Rxs from other doctors and selling non-Rx sunglasses.

    If you have room, consider building special dispensing stations, with built in countertop desks to work across and mirrored partitions to separate patients who are having adjustments. This frees up dispensing tables for frame selection. The dispensing tools and sink can be positioned nearby, saving steps for the opticians.

  7. Optical lab. My main tip here is to have one. I'm still a believer in doing in-office lab work because it gives us control over our products, and reduces cost of goods. A finishing lab makes sense for practices of any size, and in-office surfacing or lens molding is within reach of many larger offices. More on optical labs next week.

Best wishes for continued success,

Read Past Tips Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week


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Send questions and comments to neil@gailmard.com.

Dr. Gailmard offers consulting services to eye care professionals through Prima Eye Group; information is available at www.primaeyegroup.com.
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