PracticalDermatology

For most dermatologists, the practice is the place where they will spend the greatest amount of their time. Therefore, it is important to think of the space not just as the place you see patients, but rather to imagine its many and varied uses. Some practices are necessarily and unfortunately limited in their ability to redesign space. However, as we experienced first-hand when designing our new practice, design experts are able to optimize and utilize space in creative ways, so it’s important to keep an open mind. When you think about what you want from the practice in terms of your experience, staff experience, and, of course, the patient experience, you can identify design priorities and then create a space that you actually enjoy working in. In a time when we increasingly see that dermatologists are frustrated and overworked, creating a better work environment that increases efficiency, eliminates clutter, and sets a comfortable tone can go a long way toward making each work day more satisfying.

Go With the Flow

Flow is an essential aspect of any practice. It’s easy to overlook how frustrated staff and patients can become when office flow is less than ideal. In some practices, staff literally walk in circles through the day, which has an obvious impact on their morale and outlook. We considered our own experiences in other practices where we’ve worked and that we’ve visited in order to think through the flow of our practice.

Our new office space of about 3,800 square feet is a good size for our needs, but it is shaped awkwardly—imagine one-half of a heart-shape, rather than squared off. Still, we were able to optimize the space and create primary “zones” that flow into each other but are also appropriately distinct: the front end or patient reception and check-out area, the patient care area, and the administrative/staff area. We were able to position our lobby and our staff quarters to create access points for the staff to reach the patient care area without running through the lobby constantly or interrupting patient care.

Achieving the best flow, we learned, may require sacrifice. Despite our best efforts to reimagine the space, we could not create a separate check-in and check-out area, which is something we envisioned from the start. However, we are very happy with the space we have now, which is working out well in practice.

We were able to position our product display case to help create a separation between the check-in and check-out areas, and this may prove to be beneficial in terms of highlighting our product offerings, as well.

Special rooms or resources require special consideration. For example, we positioned our photo room at the beginning of the patient hallway, since that’s the first step of the patient encounter, oftentimes. We placed the sample closet near the exit of the patient space, so samples could be given to patients on their way out.

Our offices are located at one end of the hallway, so as not to interfere with the flow of patients in the exam room area. And we created a well-lit staff room with work stations so that staff can work and/or take breaks in a large, uncluttered, comfortable space. The space is protected from patient view, but it offers easy access for staff to the exam rooms and the reception area.

Cut the Paper Clutter

While the mention of electronic medical records (EMRs) yields varied reactions from dermatologists, the notion of a paperless practice remains attractive to most, at least on a theoretical level. Our goal was to be as paperless as possible. For one, limiting paper charts means that significant amounts of space need not be allocated for records storage. Additionally, it means fewer opportunities to find piles of papers and overflowing files at various points in the office. There is a psychological benefit to not being greeted by a mountain of paper work. Digital health technology is definitely the wave of the future, and we wanted to be onboard.

We felt it was important to choose an EMR company that also works with our practice management software (we settled on EZ-DERM). We have three iPad check-in stations. Our communication with patients—from appointment scheduling and reminders to consents, prescription orders, and billing—can all be handled electronically. Besides reducing clutter, this all-in-one digital approach can improve efficiency for us and our staff.

Get More: Watch Ground Up Now

Drs. Terrence Keaney and Lina Naga recently opened Skin DC. Take a tour of their new practice and watch their journey from concept to concrete on GroundUp. Click the image below to watch it now.

Also in the digital/paperless arena, we installed digital wall boards (Outcome Health) that allow us to use imaging of skin and different disease states to educate our patients as well as provide information while they’re waiting for the doctors to come in. The digital approach is efficient, takes up no space, and eliminates the need for potentially messy brochure cases in each exam room.

Set a Tone

We refer to our reception area as the living room. We purposely designed a space that was warm, comfortable, and inviting. We don’t want patients to spend a lot of time waiting, of course, but we do want them to be comfortable when they do wait. In addition to choosing wood accents and rustic textures, we also chose warm colors, and capitalized on our high ceilings and large windows to emphasize a feeling of openness and light with a modern flair.

We have a coffee and water station, and we even included a bar-height ledge with stools where patients may wish to work on their laptops while waiting to be brought back to the patient care area.

Importantly, the overall look of the practice is one of welcome and warmth, rather than the stark, “sterile” white of many modern practices. This sets patients at ease—reducing overall practice stress—and also creates a comfortable space that we and staff look forward to working in each day.

Own Your Space

For so many dermatologists, the joys of patient care are sometimes superseded by frustrations of practice management “chores.” When physicians feel like they lack control over certain facets of patient management, it is essential to take ownership of those things that you can control. Optimizing the office space to make it more efficient, comfortable, and welcoming for the physicians, staff, and patients is a reasonable place to start. Not everyone has the benefit of designing and building a practice from the ground up, as we recently did. But modifications can often be made to improve flow, reduce clutter, and enhance day-to-day practice.