Expert Advice Part Deux. What To Look For When Considering Office Space For Your New Clinic

In a recent post, I wrote about what a physician ought to consider when deciding on a site for their new practice. If you missed it, click on the previous post and you will find it.

In this post, we are unpacking practical wisdom as it relates to office space. This wisdom, however doesn’t come from me (I know. Sorry to disappoint). The practical wisdom comes from Dr. David Horowitz.

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Dr Horowitz is a pediatrician in North Carolina. He recently posted the content you are about to read on the AAP’s Section On Administration and Practice Management (SOAPM) listserv.

After reading Dr. Horowitz post, two things came to mind. First thought was, this is great insight. I wish I would have had this advice when we were looking for office space. Second thought, I think Dr. Horowitz has done this a few times.

I reached out to him and asked permission to post his post here on PediatricInc. I don’t need to tell you his answer. Otherwise, I would not have a post.

Below are Dr. Horowitz comments, questions and insight one should have in mind when evaluating office space for a new medical practice. Enjoy.

  1. Do not underestimate square footage. As as with computer hardware, you often need 25-50% more than you think you will.
  2. Will you have room to expand?
  3. How many exam rooms will you get? Peds is a high volume (ideally) practice. 3 exam rooms is probably necessary. If you are fast 4 is better. With a full schedule, 2 will slow you down significantly.
  4. Is the rest of the office kid friendly? Just like you would with your own toddler, you need to look around the office from a kid’s perspective to find hazards.
  5. Are the sharps containers on the counter where the kids can reach them?
  6. Is the trash out of reach in the exam rooms? I have had the situation where a 3 year old got into the red bag trash.
  7. If sharing office space with another doctor, will the clinical staff be competent to deal with kids or will you hire your own?
  8. Is there enough parking for seeing 4-6 kids per hour.
  9. Is the waiting room big enough to accommodate an additional 8-15 people per hour as no kid travels alone.
  10. Vaccine storage space: is there a medical grade refrigerator?
  11. At minimum you need a fridge with a temperature monitor and stable temperature and not one that the staff keep their lunch in.
  12. General storage space: will you have any. This is one area where you need twice as much as you think you do, even though it is expensive on a per sq. ft. basis.
  13. Lab and x-ray availability: is it kid friendly and how far away is it from your office?
  14. Will the billing be handled in-house or will you outsource?
  15. If billing is done in-house, will the biller have a space to work?
  16. EMR vs Paper charts: it is much easier not to have to switch from paper to EMR, but paper sure is cheaper up front when one is starting out and income may be an issue. This means you need room for charts.
  17. If you go with EMR, does the office have the needed speed for data transfer and adequate wireless set up?

Thanks Dr. Horowitz for your insights. Even though this list isn’t meant to be comprehensive, I think it provides valuable, practical and shovel ready (as they say) advice.

Do you have anything to add to this list? What are some of the pitfalls you encountered that may help others steer clear as they begin this journey?

Expert Advise: How To Chose The Right Location For Your Practice

We’ve all heard the saying, location, location, location. The 3-rules of real-estate. But how can we be certain if the location we are choosing for a new medical practice is the best one?

Susanne Madden, practice management consultant, provides practical commentary on what docs looking to find the best location for their practice should consider.

When it comes to opening your own pediatric practice, you don’t have to be a seasoned business person to know that location matters.

But knowing location matters is one thing. Deciding  which location is the best choice for a practice is  another matter.

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Common sense tells us to not open a practice in an area that is saturated with pediatricians, but how do you define saturated? Is 1 or 5 or 20 competing offices too much? What if there is only one practice in the area but the practice has 25 pediatricians?

Is proximity to a hospital better than proximity to a school? Should one consider number of daycares and schools in the area over the number of OBs?

If you are opening your second office, perhaps these questions aren’t difficult to answer because you’ve already navigated these waters.

But if you are flying solo, in other words, deciding to open your own practice, these can be daunting questions to answer.

Susanne Madden is the President and CEO of The Verden Group. The Verden group advises physicians on a variety of practice management issues. Among the services is coaching doctors to set up their own practices.

I recently caught up with Susanne. I asked her if she had any words of wisdom or practical advise for doctors opening up their first office and are weighing location options. As usual she had great insights.


Susanne cautioned that there is so much to cover to adequately address office location because office location isn’t just a location question. Branching out involves setting up a whole new practice!


Susanne advises physicians looking for ideal office space to first consider convenience  before proximity to a school or OB group, for example. Being close to a school is helpful, but it’s important to make sure the office is along regularly traveled route.

You don’t want to be 1-mile from the largest school but in the opposite direction of where folks are headed to/ from home and work.


When it comes to competition – the number of pediatric practices already in the area – Susanne thinks it is best to find a location far from other practices.

And I agree. Ideally you want to be the only game in town. But realistically this can be a big challenge for someone opening a practice in an urban area like Chicago, New York or San Francisco.


Other considerations must be evaluated in addition to the location challenge when one doesn’t have the option to open far from other practices. The considerations, however, depend on the circumstances.


If there is one big group nearby and not much else, that could work really well. The new practice potentially can draw patients that don’t enjoy a big group experience (provided the new practice markets itself as the alternative to that).

On the other hand, if there are a lot of solo / small practices around, then the new practice needs to figure out what they have that the competition doesn’t and make that distinction their central marketing strategy.


Susanne reminds physicians the importance of market research. Knowing the area factually, will help physicians answer many questions, she says.

If the area is growing and the market demographics suggest that there is ample demand and not enough supply, then opening a practice where other pediatricians practice could work just fine.


Most property manager or landlords require lessee to sign a 5-year contract. When we were opening our practice, I remember the 5-year lease stipulation terrified us. I wondered, what if our new office doesn’t survive five years?

Fortunately, we were able to negotiate a 3-year lease (instead of a 5-year lease) and a few other accommodations to help us get up on our feet. Consider negotiating with your landlord lease terms. More often than not, they will be willing and able to work with you.


Share space with another physician is a great way to start. Susanne points out that staying lean initially will mean the practice can branch out later without being saddled with having to build volume quickly in order to pay debt.

New practices that are sharing office space with another physician, Susanne recommends to not sign more than a year-to-year sublease. The idea is that once the practice reaches capacity, it will be easier to move the practice and their patients to their own location.

Susanne was kind enough to send over a few resources she had so that physicians could glean more information on this topic.

Setting up a practice support pages:

AAP resources:

Medical Economics Resource:

To learn more about Susanne Madden and the work she does at The Verden Group, click on the links. If you prefer Facebook, you can also check them out there:

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