Office locations

[thefootfixer]

Hi all

Currently exploring places for potential office sites.

Found some decent ones in areas I’m interested in.

One of my main hurdles though is deciding between a professional building (usually what I’m seeing is they’re slightly more costly) vs more of a “retail type “ office (located with other businesses such at PT, restaurants consulting firms etc)


Any pros and cons to each? Both places seem to be flexible with terms and negotiations but wondering what how patients would view a retail type office?

---

Members don't see this ad.

 

[619]

I have seen both types of offices and both are successful. Things from the top of my head to consider

- How far are both places from the hospital? If both are less than half an hour from the hospital then it does not matter. However if the professional building is next to the hospital or 5 mins from the hospital and the retail space is 30 mins or more from the hospital then I will pay more and choose the professional building. I am in a professional building next to my hospital where I do my cases so it is very convenient to see consults or do add-on cases before, lunchtime or after clinic. Oh and don't forget free lunch everyday at the hospital.

- Also, are there any other medical offices in or around the retail office. You don't want to be an island. Also depends if it is a big city or a small town. In a small town, a retail type office will still work because everything is close by, less traffic and not too far off from each other.

-Which office suite is available to you in the professional building? Are you on the 5th floor in a corner or are you going to be in the first floor by the entrance. I will chose a retail office on the ground floor over being at the 5th floor in a professional building.

-How is the parking at both locations. Pretend you are a patient and ask yourself which office is easier to park and get in without hassle or mental gymnastics? I am on the first floor in my building with ground parking at the entrance. I won't want my office to be on the 5th or 10th floor with a huge parking ramp that patient have to walk miles to find my office suite.

-And how big is the space in both places? You don't want too big of a space starting out. The retail space may be bigger and cheaper (and further out from the medical community) but then again why pay for space you are not going to use. 1800-2000 square foot is enough space to have 3-4 treatment rooms. You don't need a 4000 square foot space starting out. Remember you pay per square footage for rent so don't be paying for space you don't need.

-At the retail space, you need to examine the other tenants next to you. You have no control over your co-tenants now or in the future so you can get anybody. In a professional building, at least you know you will always be surrounded by other medical specialty. For example, not trying to be political or pick sides but you don't want your clinic next to planned parenthood because folks are always protesting at the entrance and that will disrupt your business.

I am sure others have things to add. Good luck!

 

[Feli]

Success or failure will usually come down to mainly the ratio of ppl to DPMs.

You can compete anywhere, but that's honestly the biggest factor. Even a strong skills and likable doc can struggle with saturation, and even a putz can do ok if they're the only game in town. Try to find the best of both worlds... be a good and friendly doc with little or no competition.

As you said, hospital or prof bldg suite = higher rent but easy to network with refer docs. Preferable starting up.
Private office = better rent, more space, but harder to network... usually fine once you're established.

Avoid a non-ground level place if at all possible.

 

[deleted1149159]

The only consideration is your budget.

I would say that if the professional building has a good mix of primary care and specialty practices in it, it would be a slam dunk. IF there are no other podiatrists or orthos on that building. Professional buildings tend to be cleaner, and you can market yourself with not only the physicians, but the ancillary staff as well. More expensive, yes, but if done right, more lucrative out of the gate.

Strip malls can be shady and parking is at a premium. You may only be allowed a few spots for your store front. Having a PT next door is a bonus, and start up will certainly be cheaper. That being said, it depends on the demographics and surrounding area as well. If it is on the corner where the professional building is, or a corporate park with lots of physicians in it, that can help you a lot. Without more information, it would be hard to really guestimate.

 

[619]

I would say that if the professional building has a good mix of primary care and specialty practices in it, it would be a slam dunk. IF there are no other podiatrists or orthos on that building. Professional buildings tend to be cleaner, and you can market yourself with not only the physicians, but the ancillary staff as well. More expensive, yes, but if done right, more lucrative out of the gate.

Agree with all that you said except opening up shop next to orthos. Besides local geographic conflicts between ortho and pods which in my opinion is very few, orthos are a great source of referrals once you create a relationship with them. Most orthos specialize in hips/knees, shoulder, hand, spine etc and want nothing to do with the foot/ankle maybe except the trauma stuff. They will be more than happy to refer all the foot/ankle stuffs to the local podiatrist.

Even foot/ankle fellowship trained orthos don't want to deal with ingrown nails, fungal nails, callus, hammertoes, Tinea pedis, warts, diabetic foot exam, diabetic ulcers etc, they will be happy to send all that to the local podiatrist. Sure they will keep all the foot/ankle trauma and big recon to themselves. Truth is, starting out a new practice, your least concern is not dealing with trauma patients but seeing the general podiatry pathologies come to your clinic. It all depends on you to build a relationship with them.

This is me speaking from personal experience when I started out solo. As a new pod, I was out marketing and meeting PCPs, Next to a PCP was a big ortho group with about 35 docs and they have 3-4 foot/ankle orthos. Spoke to the referral specialists to introduce myself and hand out cards. I was nervous at first but when I introduced myself, she asked me if I did ingrown toenails and I said yes. she was very delighted, took all my cards. She said they get a lot of calls for ingrown toenails and their docs don't do them here and she never knew where to refer patients. She usually tell them to ask their PCP. A lot of my ingrown nail referral is from the big ortho group. Sure they also send me the 70 y/o diabetic patient coming in for nails and callus. To me a new patient is a new patient regardless of what they come in for. I want to see everything.

 

[deleted1149159]

Agree with all that you said except opening up shop next to orthos. Besides local geographic conflicts between ortho and pods which in my opinion is very few, orthos are a great source of referrals once you create a relationship with them. Most orthos specialize in hips/knees, shoulder, hand, spine etc and want nothing to do with the foot/ankle maybe except the trauma stuff. They will be more than happy to refer all the foot/ankle stuffs to the local podiatrist.

Even foot/ankle fellowship trained orthos don't want to deal with ingrown nails, fungal nails, callus, hammertoes, Tinea pedis, warts, diabetic foot exam, diabetic ulcers etc, they will be happy to send all that to the local podiatrist. Sure they will keep all the foot/ankle trauma and big recon to themselves. Truth is, starting out a new practice, your least concern is not dealing with trauma patients but seeing the general podiatry pathologies come to your clinic. It all depends on you to build a relationship with them.

This is me speaking from personal experience when I started out solo. As a new pod, I was out marketing and meeting PCPs, Next to a PCP was a big ortho group with about 35 docs and they have 3-4 foot/ankle orthos. Spoke to the referral specialists to introduce myself and hand out cards. I was nervous at first but when I introduced myself, she asked me if I did ingrown toenails and I said yes. she was very delighted, took all my cards. She said they get a lot of calls for ingrown toenails and their docs don't do them here and she never knew where to refer patients. She usually tell them to ask their PCP. A lot of my ingrown nail referral is from the big ortho group. Sure they also send me the 70 y/o diabetic patient coming in for nails and callus. To me a new patient is a new patient regardless of what they come in for. I want to see everything.

Fair enough, but where I've practiced, Orthos go out of their way to burn our profession any chance they get. Or hire Podiatrists to do what they don't want to. You do have a good point, and it is certainly something to look into.

 

[NatCh]

Agree with all that you said except opening up shop next to orthos. Besides local geographic conflicts between ortho and pods which in my opinion is very few, orthos are a great source of referrals once you create a relationship with them. Most orthos specialize in hips/knees, shoulder, hand, spine etc and want nothing to do with the foot/ankle maybe except the trauma stuff. They will be more than happy to refer all the foot/ankle stuffs to the local podiatrist.

Even foot/ankle fellowship trained orthos don't want to deal with ingrown nails, fungal nails, callus, hammertoes, Tinea pedis, warts, diabetic foot exam, diabetic ulcers etc, they will be happy to send all that to the local podiatrist. Sure they will keep all the foot/ankle trauma and big recon to themselves.

Ha, I wish I had that kind of relationship. It doesn't happen where I live. The F&A Orthos here either barely tolerate us to outright hate and slander us. For the ingrown nails, diabetic feet, etc. that they don't want to deal with they turf it to their PAs.

 

[619]

Apparently my case seems to be unique. Wish it were not so. I don't want to be an outlier.

Also want to point out, I am not saying all the ortho docs love me and are the ones sending me the patients. They may not even know I exists. They may like or not like me. I am not drinking beer with them after hours. The referral specialist who I met have no skin in the game (or cares about local ortho-pod beef), his/her job is to fill the docs schedule with pathologies the doctor or PA wants to see. That's why if you call a doctors office, they ask what you are coming in for to make sure you are coming to the right place.

For example, I have a ortho hand specialist who occasionally send me Spanish patients. Spanish patient will call for fingernail pain when they actually meant toenail pain. It is the job of the referral specialist to screen incoming calls properly not to fill up the doctors schedule with "junk".

I also see patients who come in for "leg pain" and they start pointing to their knee. Sure I have the card of the ortho knee doctor for them to go see but then that is a wasted appointment slot for me.

 

[Pronation]

ingrown nails, fungal nails, callus, hammertoes, Tinea pedis, warts, diabetic foot exam, diabetic ulcers etc

Good ole private practice…

 

[619]

Good ole private practice…

Oh can you tell us what you see in your clinic? I bet you only see all the fancy TAR, trimal ankle fractures, IM nail, muscle flaps, nerve grafting, limb lengthening pathologies, big charcot recon cases and you turn away the ingrown nails, hammertoes, warts and nail fungus because you are a HUMBLE foot and ankle surgeon.

 

[wakaflocka88]

Good ole private practice…

I’m in a large MSG and that stuff makes up half my practice. I don’t mind it at all, I mainly filter out nail care that doesn’t meet criteria which has helped tremendously. I maybe do at most 5 nails a week.

 

[Pronation]

Oh can you tell us what you see in your clinic? I bet you only see all the fancy TAR, trimal ankle fractures, IM nail, muscle flaps, nerve grafting, limb lengthening pathologies, big charcot recon cases and you turn away the ingrown nails, hammertoes, warts and nail fungus because you are a HUMBLE foot and ankle surgeon.

I mainly see patients for epidermal nerve fiber biopsies and also for conditions that require me to make them a balance brace. I also have surgical patients, mainly isolated arthroeresis implants.

 

[Utvolsdpm]

I saw a new iped post asking about how to bill for 1st mpj arthroscope. That page is gold.

 

[heybrother]

I mainly see patients for epidermal nerve fiber biopsies and also for conditions that require me to make them a balance brace. I also have surgical patients, mainly isolated arthroeresis implants.

I've added a jewelry display to my practice made out of hardware I take out of patients.

This Christmas give your girl a beautiful pair of Jurgan's ball k-wire earrings.

 

[Weirdy]

Oh can you tell us what you see in your clinic? I bet you only see all the fancy TAR, trimal ankle fractures, IM nail, muscle flaps, nerve grafting, limb lengthening pathologies, big charcot recon cases and you turn away the ingrown nails, hammertoes, warts and nail fungus because you are a HUMBLE foot and ankle surgeon.

I mainly see patients for epidermal nerve fiber biopsies and also for conditions that require me to make them a balance brace. I also have surgical patients, mainly isolated arthroeresis implants.

Cool it. Both of you.

 

[air bud]

I mainly see patients for epidermal nerve fiber biopsies and also for conditions that require me to make them a balance brace. I also have surgical patients, mainly isolated arthroeresis implants.

so this idea of you being a BIGLY time Total Toenail Replacement Surgeon is a facade? Screw you.

 

[air bud]

I saw a new iped post asking about how to bill for 1st mpj arthroscope. That page is gold.

yup saw that one. solid advice

 

[deleted1149159]

I mainly see patients for epidermal nerve fiber biopsies and also for conditions that require me to make them a balance brace. I also have surgical patients, mainly isolated arthroeresis implants.

Tell me, when you do one of those, are you billing for an STJ fusion like 99% of the other Podiatrists that do this???

 

[air bud]

Tell me, when you do one of those, are you billing for an STJ fusion like 99% of the other Podiatrists that do this???

Nah bro. That is textbook talo tarsal dislocation. Look it up just don't use McGlamry, Mann, etc.