Agree with all. Why such a large recovery room or having one at all?
I’ll be solo starting off with the plan to add a mid-level as soon as possible, likely 9 months in. Yes, IV sedation will be available for certain procedures.
How many square feet is that build out total? Is it optimized for 1 physician and 1 mid-level?I'd do something like this...
That was helpful, thanks. What are the cons to IV sedation other than longer recovery times? I feel that it would be useful for SCS trials and MILD.
More overhead--RN, crash cart, vitals monitoring, O2, IV supplies, lock box for narcotics. And payers don't always pay for 99152/99153
Good points. Do you find that you’re able to do trials and MILD without IV sedation? Are patients still satisfied? 90% of my patients in fellowship get IV sedation.
I personally think 1500 sq ft is plenty, especially if you're not including the waiting area. My office space is bigger but I rent out the space I don't use. I have about that size office including my waiting area. I have a small foyer, a waiting room, small reception area, bathroom, one fluoro room, and 3 exam rooms. One exam room doubles as the post-procedure suite. I had up to 3 employees at one time and this still worked out well. I now have one employee and it's plenty of space. I'll try to scan my blueprints if I can find them later.
That’s extremely helpful. I like the idea of using an exam room as a post procedure area. Hopefully I can fit 5-6 exam rooms, especially considering a mid-level. I may still opt for a small recovery area as I would hopefully do ketamine infusions 1-2x a weeek.
MILD, Vertiflex only pay in facility. SCS trial is no problem with local. Kypho too. PO meds for these if anxious. Similar level of discomfort as RFA.
This is my office. My county allows this but yours may not. They may require a stamp from an architect and something drawn to more detail. Typically, the more urban an area is the more reqs and the more of a pain. The more costly, red tape, etc.
The old adage location, location, location will determine that.
Sure. So what is the typical cost?
Completely depends on the location. You can't compare renting in NYC to rural Kansas. Just look at how many sq ft of living space you get for your money in these places.
I appreciate this immensely. I will work on something similar to this with an architect. Hoping to have 5-6 exam rooms but we will see. After looking at this, 1,500 sq feet will do nicely.
Ahhh good to know about MILD. We do our procedures in our "office" that's inside of a hospital. That's probably why we get away with doing MILD in the "office". We always do Vertiflex in the OR. Good to know. You can do kypho with just local? That's awesome.
Hi OP, off topic question but do you plan on starting from scratch? Finishing fellowship and starting to build your own patient base from ground zero? (buying established practice is alternative) If so, how would you cover expenses (life and business), obviously being as lean as possible. Are you in a underserved area? Are you going to work gas shifts on the side?
Yes, starting from scratch. Nope it is actually a somewhat saturated area in the midwest. I plan to build my own patient base from ground zero by offering a better product than my competitor. I will be able to offer the complete range of interventional procedures that most pain doctors are unable to. I believe this will help me stand out. I will have a business loan to cover expenses and will work some gas shifts on the side.
Well best of luck to you and hope it works out, but I have news for you most referral sources won't give a damn about whether you do the latest interventional procedures. They care about how quick you get them in and will you take over their meds.
Prescribe or that’s it unfortunately …. Sad truth of the specialty.
If you're going to show your architect use this one. This one I believe is closer to the final version. Keep in mind an architect will likely charge you well over $1000 for the work. If you'd like to cut costs you might want to consider doing the drawing yourself. Consider calling your local officials and asking them if you can do it yourself? You can use graph paper to help draw it to scale. You can also make your rooms smaller if you'd like as mine are probably too big. I own the building and it's 8,000 sq feet so having enough room is not and was not an issue for me. Most people are not in that situation. Also, consider investing in a commercial building and renting out the remaining spaces. This has worked out great for me. My building will be paid off in 2026 or 2027 and I make over a 25% per year return on my investment, and that's without including the rent my medical practice pays.
Listen to this piece of advice very closely. No one cares about what procedures you do. They also don't care about where you trained or what letters are after your name. They don't care if you're anesthsia, pmr, neuro, NP, DO, MD, PA, AAABCDEFG. They care about you making their lives easier. Keeping their patients happy will make their lives easier and get you word-of-mouth referrals. Plus, appreciative patients make you feel good about what you're doing.
Agree strongly. Marketing “the latest procedures” is good for direct-to-patient marketing - they like the idea of advanced technology and you can hype yourself up to differentiate yourself from the competition. You may be able to snag a grand rounds talk if there’s a local training program too. But for PCPs and surgeons referring to you it’s about access and making their lives easier. Hand out your phone number. make sure referrals are scheduled promptly. If you want to court spine surgeons, consider allowing them to send you procedure orders directly - same day new-patient consultation and procedure.
I'm sure this happens but I believe this is illegal and a violation of anti-trust laws. If you can prove this I bet you would have a pretty strong case against the hospital. Could be a gold mine for you.
Definitely illegal but very difficult to prove. My local area hospitals does this and so we live off of word of mouth etc.
would you able to share this again please. image is not viewable.I'd do something like this...
