When Gary LeRoy, MD, FAAFP, signed on as medical director of a community health center in Dayton, Ohio, it consisted of a single physician and dentist, a nurse practitioner and a handful of other employees housed in a 5,000-square-foot former grocery store.
Today, the center—now known as the East Dayton Community Health Center—bears little resemblance to the facility LeRoy joined 16 years ago, despite being in the same location. For starters, it’s doubled its size by expanding into formerly vacant space in the rear of the building. It now employs two physicians, two nurse practitioners, and nine staff members.
Equally important, the building’s retail-like ambiance has been replaced by a welcoming environment, due in part to the abundant natural lighting provided by skylights. The waiting room has plenty of comfortable furniture for adults and a play area for children.
In addition, LeRoy says, the center improved its efficiency by changing the way patients flow through the building, and created work pods where physicians and support staff can talk without being overheard by patients.
“We basically redesigned the building from the ground up,” recalls LeRoy, now a board member of the American Academy of Family Physicians. “Everybody drew up their wish list of what they wanted to see in the facility. Then we sat with the architect and said, ‘how can we realistically create the components everyone is asking for?’”
As a result of its makeover and expansion, East Dayton now serves about 15,000 patients annually and has been designated a Federally Qualified Health Center. It also hosts community classes on health and stress reduction. “We decided that since we’re a part of the community we should provide services of use to the community,” LeRoy explains.
While East Dayton’s overhaul may have been more extreme than most, it was far from alone in undertaking it. In a 2016 survey by the Medical Group Management Association (MGMA), just over half of respondents said they either remodeled, added space, moved, or made some other change to their practice space in the past two years.
Ken Hertz, FACMPE, principal consultant with the MGMA, says those numbers don’t come as a surprise. “Given the rapidly changing healthcare landscape, practices and physicians are coming to see it’s vital that they continually reinvest in the business by updating their space, changing the aesthetics, introducing new technology and so forth,” Hertz says.
Reasons for practice makeovers
So what are some of the tell-tale signs that a practice may need a makeover? They fall into three broad categories, experts say: space, appearance, and productivity. Of these, space—or the lack of it—is usually the most obvious, since it’s readily apparent when a practice can no longer accommodate the needs of its patients and providers.
David Zetter, CHBC, founder and lead consultant of Zetter HealthCare in Mechanicsburg, Penn., cites the example of a client, an urgent care center in an Orlando, Fla. strip mall just outside Disney World.
“Every time I’ve walked in there, the place is packed,” Zetter says. “They’ve got patients standing outside or sitting in their car waiting to be called because there isn’t enough room in the reception area.”
Fortunately, Zetter adds, an adjoining storefront came available that the client plans to buy, even though it’s more room than the center currently requires. “There’s a perfect example where somebody realized, ‘I’ve got to do something about this situation,’ and he’s going to spend a lot of money on it to do it right. But he’s confident, given how busy he is, that he’ll get a return on his investment.”
The need to freshen its appearance, especially in the patient waiting area, is another frequent catalyst of practice makeovers. That’s especially the case, experts note, given that the waiting area is where patients form their first impression of a practice. Worn-out carpeting, lack of comfortable seating, outmoded decor, absence of Wi-Fi, and use of fluorescent lighting are all indicators that some serious remodeling is in order for that space—and likely the rest of the practice as well.