If you have been thinking of starting your own practice as independent clinic, the following steps may help you plan your department.

Physical plan of the facility

Location: Clinic should be located at ground floor preferably and be able to provide convenient access to patients with disabilities. Adequate parking space is essential. The entrance and exit points should have ramp and railing, if required, for free movement of patients as well as attendants.

Area: This depends on factors like resources we can provide to patients, expected number of patients or clients visiting the department daily. Obviously, higher the number, more is the area required.

Flooring: A very important factor before designing a clinic. It must be anti-skid, leveled and insulated.

Infrastructure & Resources

There is no end to the resources one can provide but the basic infrastructure should include:

Electrotherapy modalities: like shortwave diathermy, lumbar & cervical traction, ultrasound therapy, trans-cutaneous electrical neuro-muscular stimulator, LASER, wax therapy, interferential therapy and hot & cold therapy.

Manual therapy: requires a separate cubicle, bed and accessories depending upon the technique one uses or is proficient in.

Exercise therapy: requires some free space with couch, mirror (postural), some floor mats and exercise equipments like dumbbells, gym ball, etc.
It is good to have both free space as well as cubicles to render better services. The number of cubicles required can be judged with the formula

No. of cubicles =         Av. Occupancy time * Total No. of treatment
                                  —————————————————————
                                    Available time * Utilization ratio

Where

Av. Occupancy time = time (in minutes) taken for treatment including change of clothes, clean up, etc.

Total No. of treatment = total number of patient treatment that will require cubicle.

Available time = actual time available for treatment of patients per day in minutes.

Utilization ratio = proportion of daily available time during which a cubicle is likely to be occupied i.e. if a cubicle is occupied for 7 hours out of 8 hours daily the ratio comes to 0.87 ( 7 / 8 = 0.87 )

The following example will make everything clear:

A clinic is to open for 8 hours (excluding lunch and tea breaks) and expects 30 patients requiring treatment in a cubicle. The average time a patient is expected to spend in a cubicle is 25 minutes and a cubicle is occupied for 7 hours (420 minutes) out of 8 hours (480 minutes) daily.

From the above data:

No. of cubicles required = 25 * 30 / 480 * 0.87 = 750 / 417.6 = 1.79

This indicates that we require 2 cubicles.

Utilities & Maintenance

Smooth functioning of clinic will require proper sanitation, regular equipment checks, electrical and plumbing services. This can be tied up with the service providers on monthly or annual basis.

Economic Aspects

The cost of starting a clinic can broadly be divided in two categories viz. the capital cost and the running cost. All this will vary from the type of practice and the resources you are starting with. These factors may help you decide the amount to be charged to the patient:

Time required for treatment and/or consultation
Time of service offered (e.g. regular hours or late night)
Complexity and chronicity of case or service
Any special equipment required
Running costs.

Image courtesy: hawleyjr