The Office Design Opportunity

Call it the "Pullman car" phenomenon. Tight, long hallways. Doors to the left and right. Decor that hasn't been updated in years.

Other then a cramped waiting room, the classic railroad car is a pretty apt description of far too many chiropractic offices.

Glen David of Davlen Associates, Ltd., the nation's leading chiropractic office design firm, explained just how much of a difference office design can make in your success.

"Patients come to a [DC]with certain expectations that go beyond the quality of care," he said. "If the office looks and feels like a railroad car, you've already created an impression that might not be the most welcoming or friendly. And many patients are a little wary about chiropractic to begin with."

The Ad Hoc Method

Similar to many in the chiropractic profession, Dr. Carmelo F. Caratozzolo sad he tried to just "make it work" when putting together his first office.

"When we were just starting out, we used pre-existing structures for spaces not intended for a practice," he said. "It was like 'what can I use that is already here?' That was inexpensive initially, but costly in the long run."

"Our older office was very narrow and very long, with choke points between the front desk, examination rooms and adjustment areas," said Caratozzolo, who practices in Woodbridge, Va. "And there were definitely times when all the hot seats in reception were filled and people had to stand. We had to do something if we wanted to grow and just having a bigger building wasn't going to be enough."

The answer became obvious: Move to a larger office and redo it from top to bottom.

"If you don't have the right layout, your practice will stagnate," he says. "I wanted to triple my practice. We were at 500 patients, and that wasn't going to happen if we were standing on top of each other."

Common Problems

An effective design can address the two efficiency killers found in poorly constructed office: workflow inefficiencies, an uninviting atmosphere, and poor staff interaction with patients and each other.

"Our old office had a front desk and an 85-foot long hall. There was no 'airlock' foyer, so in the winter it was cold in the reception room," said Dr. Bryce Koelling, who practices in Fulton, Mo. "As we approached our tenth anniversary, we realized that we had peaked out in our old facility. It was painfully obvious that the structure itself was limiting us."

Larger facilities, per se, are not always the answer to a better patient environment. What matters is whether patients and staff can move around efficiently and communicate rapidly in a facility with a clean, welcoming environment, said both Caratozzolo and Koelling.

These same essential concepts also informed the design of Parker College of Chiropractic's under-construction clinic at Parker Square in Flower Mound, Texas.

"We have clinics the size of small hospitals," said Lawrence Stolar, dean of clinics at Parker College. "I had the idea of growing small. So I got permission to create a new clinic of 2,000 square feet to beta-test new ideas in a place where the steps were fewer, the therapy equipment was nearby and where the doctors' offices are close to the action. Within three months of implementation, our patient satisfaction went through the roof, we had improved doctor interaction with them and a decrease in patient treatment time."

The success of what was called "Pod 40" led the school to try the same approach at Parker Square, which will open in the late spring or early summer.

The Big Fix

Re-designing or rebuilding your office begins with two simple questions, said David. "Right off the bat, ask yourself what are the are clinical and business results you want to want to achieve?"

David said that clients who work with his company typically want to increase their practice by an additional 124 to 175 patients weekly. But increasing patient load to that level almost guarantees that the practice will have to add at least one more chiropractic assistant to the staff. Maybe not, said David.