Is a home practice for you?

May 6, 2005

Learn the ins and outs from two doctors who love "living above the store."

Ever dream about running your practice from your home? Many doctors do. But pediatrician Frederick J. Piaser of Westbury, NY, and GP Patricia L. Elliott of Rapidan, VA, turned their dreams into reality. And, contrary to some predictions, the reality is not a nightmare.

Convenience aside, the set-up saves them money. "One of the reasons I chose to have a home office was to control my expenses," Piaser says. "The two largest expenses in a practice are rent and salaries. I'm paying less for the home equity loan I used to build the office than I had been paying in rent. I can also take portions of my home expenses as business deductions; and, since I'm not commuting, I have more time to see patients. That produces more income."

Another issue to consider, H. Christopher Zaenger, of Z Management Group in Barrington, IL, points out, is how much time is actually spent in the office. "I actually recommended a home office to a Chicago cardiothoracic surgeon who saw patients only on Friday mornings."

Patricia Elliott began practicing from her home in 1979, when she relocated from Michigan to a rural area of Virginia. "When I moved out to the country, practicing from home saved time and was convenient." It also turned out to be a smart business move. "I was the only doctor in the county for the first several years. As it turned out, a lot of people have moved into the area."

How did these two physicians make practicing at home work for them? Here's what they told us, and their advice for doctors who'd like to follow their example.

Creating an environment that works Planning the physical space was the first challenge Piaser and Elliott faced. "I decided to add 500 square feet to my existing house," Piaser says. "I worked out several plans on the computer based on the best utilization of available space and taking patient flow into account. A local architect drew up professional blueprints. He knew the town's restrictions and took them into consideration."

Elliott, on the other hand, built her home specifically to accommodate her medical practice. Even so, as her practice grew, she found that she needed more space. "I enclosed a front porch to make a waiting room and added three rooms and a lab in the back of the house. I needed building permits, but no zoning variances."

"It's important to hire an architect who's familiar with the requirements of a medical office and the Americans with Disabilities Act. Access, hallway width, lighting, and parking can be significant factors," notes consultant Chris Zaenger. "Local codes and zoning requirements have to be observed, and a knowledgeable architect in the community can save time and money."

Attorney David J. Schiller of Norristown, PA, adds, "I emphasize the importance of verifying the zoning requirements. There may be prohibitions on having employees work in a home office. Or, the zoning board may permit the current owner to have a home office, but not a subsequent owner. Just because a physician or dentist has been using the property as a home office for the past 30 years doesn't mean that you'll be able to if you buy the property." You'll need to determine any such restrictions before you agree to buy.