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Ode to a Physician Stool

Dan Greenfield | August 23, 2016
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What an Exam Room Fixture Says about Healthcare Furniture and Technology

physician stoolThe physician stool. Humble in its stature and simple in its design. Pretty low tech and for over a hundred years, it has served its purpose with few modifications save an extra leg for stability.Healthcare Furniture

Now consider today’s exam room. Doctors are juggling charts, laptops, iPads, and mobile devices. Electronic devices are as common as a physician’s stethoscope and have fundamentally changed doctor patient interaction.

Which leads me to my central point.

Let’s face it – health tech is cool;  a physician stool is not.  There is a constant demand for the latest and greatest electronic devices. Upgrading your healthcare furniture is much less common, even though new designs exist that make a physician’s job easier, more comfortable and can improve the patient experience.

So why is that?  Many reasons says Michelle Ossmann, MSN, PhD, the director of healthcare environments at Steelcase Health. As in many corporate environments, furniture and the physical space are not seen as a recruiting tool and a way to improve performance and productivity. More specifically, doctors are trained to ignore their own physical needs in the service of treating patients.  And while doctors and hospitals are quick to embrace new treatments and technologies, furniture is not seen as critical to outcomes and improved patient satisfaction.

Where The Traditional Physician Stool Falls Short

Physician stool

Courtesy: Steelcase Health

Overall healthcare furniture has evolved considerably with new designs, materials and construction. The same can’t be said about the physician stool which:

Lacks basic ergonomic support:  Doctors are forced to stand at carts with computers to chart or sit on small stools, lean against a wall or casegood, and place their technology on a counter.

Fails to accommodate today’s technology: With no place to put their computer or tablet, physicians are hindered in their ability to transition quickly between consultation, inputting data, sharing information, ordering labs or prescriptions and performing a physical exam.

The result for physicians  is less efficiency,  less than ideal interaction with patients and increased fatigue and discomfort.

A Furniture Makeover for the Electronic Age

The physicians stool like the exam room is in need of a makeover.

Fortunately there are alternative designs to the traditional physician stool that are ergonomic, can accommodate the electronic needs of today’s physicians and allow for better physician patient interaction.

Physician Stool

We are intrigued by the Node with ShareSurface by Steelcase.

It is a departure from an old model of healthcare when physical exams required minimal charting or typing on a computer.

It reflects findings from Steelcase Health’s research.

Today’s exam room needs to be designed for “mutual participation, a partnership between the physician, patient and family.”

Steelcase Health Node

Steelcase Health Node with Share Surface

It’s features include a swivel-seated chair enables clear, eye-to-eye sight lines between patient and physician when using mobile technology such as laptops or tablets and a built-in, movable arm with a surface that swivels 360 degrees. This allows doctors to input data about the patient during the visit and share information on the screen with patients and families while maintaining a connection with them.

Making the Change

So how we can get off the notion that the classic stool is good enough? Dr. Ossmann believes that the shift in thinking will come down to providing evidence based and clinic studies that demonstrate the benefits of healthcare furniture– from higher CAHP and HCAHP patient satisfaction scores to improved patient outcomes.

For more information healthcare furniture, please contact us to see how we can save you money and ensure you have appropriate furniture for your patient and staff needs.






Medical Furniture – Be Careful Where Your Patients Sit

Dan Greenfield | July 13, 2016
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Medical Furniture Promotes Health and Well Being

Medical Furniture

An example of Medical Furniture – Aviera Metal Chair from Ideon

It shouldn’t come as any surprise that price and delivery dates are the most common questions we get helping physicians procure medical furniture.

Prices for medical furniture are often significantly higher than they expect, and physicians are surprised at the time it takes for delivery. There is a temptation to get non-health grade furniture at a local furniture outlet to save money and time.

Our advice is to pay careful attention to your patients’  needs. Consider furniture as an extension of the patient experience and their care. Furniture can set the tone for their visit and better ensure patient health and well-being.  Healthcare furniture typically lasts longer and is easier to maintain if specified correctly.

For some insight into medical furniture, I turned to my business partner Patricia Fortenberry.  She has more than 20 years of experience specifying and procuring furniture.

The Price

So what goes into the price of medical furniture?  Let’s use patient chairs as an example.


Selecting the right furniture comes down to structure, maintenance, and infection control.

Patient chairs that meet healthcare grade standards should be impervious to liquids and ideally be antimicrobial. They also should contain these design/construction elements:

Maintenance: The ability to clean out between seat and back with fabric which is easier to clean

Support: An inner metal frame for support with metal to metal connectivity

Infection Control: Powder coated or urethane arm caps

Safety: Glides appropriate to the floor surface. If you need castors on a chair, make sure they can lock.

Fire Code: Specifications can vary from state to state

The Delivery Date

When you order a furniture, you have two options: quick ship or “custom.”

Quick ship means a quick turnaround but you have very few, if any design options. Custom in this case means you can choose from a set of options to meet your needs; it does not mean building a chair from scratch, which is impractical and unnecessary.

The average delivery time for a custom chair is 8 to 10 weeks from the date the order is placed.  You need to plan ahead if you want your furniture in place when you office or clinic opens.

Why so long?  Most healthcare furniture is not built and stocked in a warehouse ready to be shipped. Furniture is built on a per order basis.

Some furniture manufacturers offer fabrics;  others don’t. Or they don’t offer a healthcare fabric that you want to use. In those cases, you will need to select fabric from a textile manufacturer and order as “customer owned material.”

All this can be handled by an experienced medical interiors designer with healthcare furniture expertise.

For more information about procuring healthcare furniture, please contact us to see how we can save you money and ensure you have appropriate furniture for your patient and staff needs.

Avoid Medical Office Lease Pitfalls

Dan Greenfield | July 6, 2016
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An Owner Rep’s Perspective on the Medical Office Lease

Medical Office LeaseAs an owner’s rep for physicians in the design and construction process, we have a unique perspective on the medical office lease.

We don’t negotiate leases, but we work with the tenant reps that do.

Our goal is to call out pitfalls that physicians may overlook.

A lot of issues can be avoided by using qualified real estate tenant reps.  We can’t stress enough how important it is to use someone who really understands the medical office space and its unique requirements.

In Austin, Michael Buls and Thomas Allen are two tenant reps we have recently worked with that have a strong knowledge of healthcare real estate.

Of course a great deal of attention is paid to the price per square foot, the length of the lease and tenant improvement dollars which we have discussed before.

But really good tenant reps also keep physicians informed about smaller considerations that can make the whole process move smoothly and eliminate disappointments or inconveniences after you move in.

Seven Considerations to Look for in Your Medical Office Lease

Understand the following seven considerations when leasing your medical office space.

Usable and Rentable Space – One area of confusion is usable and rentable space. Usable space includes the common space – the lobby, bathrooms outside your office. The rentable space is your actual office. Your lease will include both the usable and rentable square footage amounts.

The key takeaway:  Don’t confuse the two.  Also make sure your designer and architect are basing their finish out bids on the rentable space; the fee will generally be lower!

Building Standards and Finishes – Typically there are building requirements governing what finishes can be used and how a medical office space can be constructed. These requirements are dictated by the building owner. Building standards and finishes are not usually listed in the lease, but you should ask for a copy of them when reviewing the terms of the lease.

We have come across situations where the finishes had to be respecified because they didn’t meet the building’s standards. Changes can be often be negotiated with the landlord. But it’s helpful to know what they before a contractor’s bid is accepted to avoid charges from change orders.

Control of Heating and Cooling –  The ability to set the temperature in your medical office space is critical to patient comfort – especially for the elderly.  In some properties, individual offices don’t have control over the thermostat.  Sometimes they’re regulated by the building. Other times, the thermostats are in some offices and not others. When considering a space, it’s important to know how the cooling and heating is zoned and who controls the thermostat.

Parking –  Your lease should list the number of spots (if any) which are reserved for your office. But remember, zoning ordinances for medical spaces often require more parking spaces per 1,000 square feet of office space than non-medical office buildings. This is something your tenant rep should negotiate.

Make certain the building parking meets city code for handicapped parking. Also depending on the services you provide, you may need to have a covered drop-off area outside the front entrance.

Wayfinding –  Signage to help patients locate your medical office space goes a long way in reducing stress and increasing patient satisfaction. Generally, outdoor monument/common area signs are provided and maintained by the landlord;  Interior (inside your suite) office signs are the responsibility of the tenant.

Hours – Pay attention to hours of operations especially if you plan on having evening or Saturday hours. You may need to negotiate terms for off hours use. You may be also have to pay more for heating and cooling the building during off hours.

Move In Day — Finally, negotiating a move in day comes down to timing.

From conception to completion, a typical project should take 6 to 8 months but much will depend on how much time it will take for programming, CDs, and permitting approvals.

On average, estimate a minimum of 60 days for actual construction, Make sure your contractor can meet deadline set in the lease. Failure to do so may require you to pay rent on your new and existing office space and as well as incur penalties for staying past your planned exit date.

For more information about provisions to consider in your medical office lease, please contact us to see if you would benefit from an owner rep on your office, clinic or facility construction project.


Love Seats Are Not Bariatric Seating

Dan Greenfield | June 14, 2016
Tags: , , , , , , , , , , , , , , , , , Furniture, Infection control, Maintenance No comments

New CDC Study underscores need for bariatric furniture

LoveseatIt often surprises us when a love seat or couch serves as bariatric seating in a medical practice space. 

They aren’t an appropriate substitute, and believing otherwise misunderstands the physical dynamics and needs of a bariatric patient.

The findings of a new Centers for Disease Control study underscore the growing need for healthcare furniture that provides safety, comfort and dignity to bariatric patients.

According to the CDC, 38 percent of adults and 17 percent of kids are now obese, which means from a sheer number’s perspective, medical spaces need to do more to accommodate this growing  segment of the population.

Obese patients have a Body Mass Index (BMI) of 30.0 to 39.9. Morbid obesity is typically defined as being 100 pounds or more over ideal body weight, or having a BMI of 40 or higher.  The weight range of obese patients can vary widely, from roughly 250-300 pounds to more than 1,200 pounds.

“Profound Implications”

As providers, you see first hand that Americans aren’t getting any smaller. This number of overweight patients is reaching epidemic proportions and includes a higher number of children. 

This growing patient segment has “profound implications” for the design of healthcare facilities.  So concludes a white paper co-authored by the KI Design & Development Team and Metaphase Design Group.

Standard practice suggests that 10-20 percent of a facility’s seating space should accommodate the needs of bariatric patients. This not only means different furniture but also larger exam rooms and reception areas to accommodate the furniture and circulation requirements.

Underserving the furniture needs of bariatric patients at healthcare facilities is the result of numerous factors. One is in a lack of understanding of the requirements of bariatric patients; another is cost.

Why a Premium for Healthcare Furniture

As designers, we certainly appreciate the need to balance function with cost. We recognize that healthcare furniture comes at premium and gives physicians pause when we provide an estimate for furniture they like and want to use.

Understanding the differences between standard office, patient and bariatric seating may provide insight into why healthcare grade furniture is a good investment – improving the patient experience and increasing the life of your furniture.

Why A Chair is Not Just a Chair

Basic Reception Chair

reception chairWith an eye toward costs, it’s tempting to just purchase a reception chair at a business office outlet. But here’s the concern.

Your standard office chair is not designed for infection control.  Consider that in most health care facilities the furniture is rarely cleaned thoroughly, if at all.  Generally, the fabric is not easily cleaned and maintained, and its arms are composed of wood or other porous materials that can more harbor and transmit infection.  

Patient Chair

patient chair

A chair designed for a healthcare environment is made of non porous materials that limits the transmission of infection. It is easier to clean.  Its fabrics tend to stand up better to the wear and tear of patient demands, and some have an antimicrobial engineered into the fabric.



Bariatric Chair


Bariatric chairs are not just about wider seats. As the KI white paper discusses, they are constructed to carry added weight and conform to a “variability of body shapes and sizes.”

At the same time, they must but be designed to avoid alienating the patients by appearing “industrial and larger than life.” As my business partner Patricia Fortenberry says, “No one wants to sit in the ‘Big Boy’ chair.”

Of particular importance are the movements involved in getting in out and of the chair. Consider the arm height and contour of the seat and back. Bariatric patients will typically have more difficulty with ingress and egress and will rely more on armrests for support and balance. Choose seating with arms and a higher seat height.

In addition, obese and bariatric people can’t sit in a standard chair with arms. Most chairs with arms marketed for waiting areas have an inside seat width of 20 to 22 inches. A minimum of 30 inches is recommended, and 36 inches is preferred.

The added weight also changes how bariatric patients sit. When considering furniture for the bariatric patient consider both Static and Dynamic load.  Larger patients have more limited mobility and can’t “ease” into a chair the way most of non bariatric can. At some point, they will “fall” into the chair and fall into the backrest.

Standard office furniture and most healthcare seating have weight ratings of 150 to 350 pounds, static load.  This means the weight they can safely support without risk of collapsing.  These don’t provide sufficient support and can’t withstand the added stress from larger patients. In most cases, dynamic load isn’t even tested or rated.

A well made chair designed specifically for bariatric needs will have a minimum rating of 750 pounds static load  with a 1400 pound dynamic load.  Why so high? Consider the number of times these chairs will be used in a day and the repeated stress they will be subjected to.

The ANSI/BIFMA testing organization is in the process of revising their minimum standards for healthcare furniture with an emphasis on furniture for bariatric seating.  This should help manufacturers with the general standards for bariatric furniture.

As you can see, there are many considerations that go into furniture for a healthcare environment. More than fashion statement, it contributes to a patient’s comfort and well-being.


Get the Best Contractor Bid for Your Medical Space

Dan Greenfield | June 7, 2016
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What You Need to Know about the Bid Process

General Contractor BidDetermining the best contractor bid is no easy task for any physician unfamiliar with the construction process.

In this post we focus on the bidding process and steps you should take to find a contractor best suited for your project.

It’s one of the most critical decisions you can make when building a medical office space or clinic.

Working with physicians, we want you to avoid common mistakes that can lead to cost overruns and schedule delays.

We need to stress that there are many qualified contractors for your project. The challenge is finding one who balances your needs and his or her business interests.

Evaluating the Contractor

The right order:  A common mistake that physicians make is signing a lease and selecting a contractor before the architect and interior designer have reviewed your space and assessed your needs. In our business, that’s called programming. It’s important that you sit down with an architect and designer first to make sure the space is the appropriate square footage and meets your mechanical requirements.

Construction Documents (CDs):  Construction documents are the drawings, plans, specifications, etc., associated with a construction project. You should have them before soliciting bids. Without CDs, contractors don’t have a complete picture of the project which can affect the final cost of construction and result in costly change orders.

Start Early: Timing can be everything – especially when you are vacating one space for another.  We can’t tell you how many physicians fail to plan early enough and are forced to use a contractor who is not well suited for the job.

From conception to completion, a typical project should take 6 to 8 months. Beyond an estimate of 60 days for actual construction, much will depend on how much time it will take for programming, CDs, and permitting approvals.

Conflicts of Interest: It’s one thing for a landlord to recommend a qualified contractor, but be wary when the landlord has a financial stake in the contractor he or she is recommending. That may sound obvious but it happens more than you think and can result in conflicts of interest.

Three Bid Rule: Accept bids from at least three contractors to keep the process competitive.  Three bids help you better estimate the price and what is needed to get the job done.  Avoid the outlier.  If one price is wildly cheaper than the other two, the contract may be missing items that will need to be added later and impact what you finally pay at completion.

Qualifications: Make sure the contractor has been in business at least two years and preferably five. While it may be tempting to use a friend or relative in the construction business, make sure they are licensed, have an office and most importantly have medical construction experience.

Medical spaces have a unique set of requirements including ADA and HIPAA (and possibly Joint Commission) as well as building codes unique to the jurisdiction where your space is being built. It can save you a lot of time and money if the contractor is familiar with medical construction.

An Owner’s Rep: Retain an experienced owner’s rep who can act on your behalf.  They know what to look for and identify items that have been left out of the bid, costs that are out of line, and when approved finishes have been replaced.

The Bid Itself

Professional: Make sure the bid is professional. It should include everyone on the project team, their resumes, a list of similar projects, and client references.

Line Items:  Every bid should address:

  • General Conditions
  • Site Work
  • Concrete
  • Metals and Steel
  • Carpentry
  • Thermal Protection
  • Doors and Windows
  • Finishes
  • Mechanical, Electrical, Plumbing
  • Project Sub Total
  • The General Contractor’s anticipated overhead and profit.  The number will vary depending  on the scope complexity of project but it’s usually in the range of four to ten percent of the total cost
  • Applicable Sales Tax
  • Total Project Cost
  • Anticipated Number of Calendar Days for Project
  • Clarification and Qualifications that the Contractor Provides (Understand what you are purchasing to avoid change orders during the project) For example, an estimate may exclude voice, data, security cabling work.
  • Proposed Schedule

That is a lot to take in.  Our advice is don’t do it alone.

For more information, please contact us to see if you would benefit from an owner rep on your office, clinic or facility construction project.








Make Medical Space TI Dollars Work Harder

Dan Greenfield | May 17, 2016
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What you need to know when negotiating TI dollars

Medical TI DollarsTenant Improvement dollars (TI allowance) — Often misunderstood, TI dollars are incredibly valuable when negotiating a lease for your new medical office space or clinic.

Tenant improvement allowances are carrots which landlords use to sweeten the lease agreement and entice you to sign.

TI dollars may seem like a gift from your landlord, but they are reflection of how much he or she wants your lease. Due to nature of a medical office space, most landlords expect that some tenant improvements will be required during a finish out.

But unless you know how to take advantage of your allowance and know the rules of engagement, you could lose out on their benefit.

By using an owner’s rep in conjunction with your tenant rep, you can negotiate from strength and avoid costs once the lease is signed and the contract accepted.

Common Mistakes


  • Mistakenly believe TI dollars cover the entire cost of the construction; in reality they hardly ever do. For example, the TI allowance rarely covers furniture, equipment, IT and telecommunications because they are not considered construction costs.
  • Don’t ask for enough TI dollars. As doctors, you are not in the construction business and can’t be expected to know the cost to finish the build out of a new space. Those costs can vary considerably based on the current condition of the space. Is the space a warm or cold shell?  Does the space have specialized requirements for plumbing, radiology, surgery and the level of finishes?  An important consideration is whether the existing space is in good condition. Landlords don’t usually offer TI allowances for what they consider a cosmetic refresh.
  • Don’t realize that the length of lease can impact the size of the allowance – the longer the lease, the more TI dollars are likely to be available.
  • Don’t insist on an itemized list of what’s covered under the allowance in their lease. Once the lease is signed, it’s too late to ask for more money if something was left out.
  • Let the landlord dictate which contractor to use. It is true that the landlord knows the building and is a good position to manage construction costs. However, the relationship between the landlord and the contractor can set up a potential conflict of interest that can eat up your allowance with non-competitive pricing.  The key takeaway:  Always get 3 bids.

3 Lines of Defense to Save TI Dollars

Your Tenant Rep: Your first line of defense is your real estate tenant rep. He or she is your advocate and can tell you what you what is covered by the TI dollars in the lease. It is extremely important they understand the unique demands of a medical space in order to ensure your needs are met.

Your Designer: The second line of defense are your designer and architect. Consulting with them before signing a lease will give you a better sense of the costs.

Your Owner’s Rep: The third line of defense is a owner’s rep. He or she can review the contractor’s bid for accuracy and make sure it includes everything in the lease pertaining to the TI allowance.

It is important to maximize your TI dollars. A forgotten item will cost more to add back once the contractor’s bid is accepted. This revision is called a change order, and they can eat up your TI allowance.

If possible, get the landlord to put the job out to competitive bid. If he or she insists on using their in-house contractor, retain an owner’s rep or project manager to oversee the design and construction process.

Using an owner’s rep helps to maintain quality control, ensure a competitive bid, and protect your interests.

For more information, please contact us to see if you would benefit from an owner rep on your office, clinic or facility construction project.


Is Your Doctor’s Reception Area Worth the Wait?

Dan Greenfield | May 4, 2016
Tags: , , , , Furniture, Maintenance, Medical Interiors, patient experience No comments


Reception AreaTransforming Your Doctor’s Reception Area

Would  a scuffed and stained chair in your physician’s reception area give you pause about the quality of care you would receive? How about marks on the wall?  Or does it matter?

The reception area is not the profit center of a medical practice, but its layout, finishes, furniture and maintenance can go a long way in shaping perceptions and enhancing the patient experience.

At their best, a reception area can be, as a Steelcase white paper describes it, “a Reception areaspace that can offer a smooth transition from physical pain and emotional uncertainty to vital information.”

The white paper was based on observations from an outpatient clinic, but its conclusions can easily apply to a physician office.

At their worst, reception areas resemble a bus station waiting area or holding pen designed to seat the most patients in as little room as possible.

So which of these reception areas are more typical of your reception area experience?  Does a layout make a difference to you?Reception area

According to Steelcase Health, the answer is yes.

Their research identified common reception area mistakes including the following:


Not enough chairs with direct site lines to a reception desk; No room to place personal items or technology devices; Not
enough separation from strangers and no intentional group space for families to gather; Chair configurations which favor large groups rather than groups of 1 or 2.

Site Lines Vs More Natural Lighting

Natural light is considered desirable, but Steelcase researchers maintain the focus should be on balancing sight lines, rethinking density and creating separation and togetherness.

“While natural lighting and views are important, Steelcase researchers observed people orienting themselves toward information sources instead – wanting to see and hear the clinician call their name or see a status update on a monitor. Understanding this balance of sight lines between information and views to the outdoors creates the need for new ways of arranging seating and placing monitors.”

Avoid the Pack ‘Em in Mentality

Ever been to a doctor’s office and seen patients using chairs as temporary tables for personal items and drinks?  Or have you waited in a space that doesn’t comfortably accommodate the number of patients waiting to see their doctor?

It’s time to rethink the layout of the reception area. An uninterrupted long row of chairs may be seem more efficient but it does little to reduce stress or promote well being.

As Steelcase Health researchers observed, people prefer to be separated from strangers and yet close with family members. People even create work-arounds in the space to suit their differing social or privacy needs.

We agree with Steelcase Health and recommend refiguring the space into small group seating areas.

In fact, Steelcase Health researchers found that only 80 percent of chairs are actually used.  Reconfiguring fewer chairs may save space and reduce furniture costs. This reconfiguration also gives patients more emotional space.

More intimate configurations allow families and individuals to have separate areas to support their preferences and behaviors – ranging from family conversations to privately engaging with an electronic device to resting and reading.


Reception AreaPrivacy is a critical component of any reception area.  It is not only a HIPAA requirement; it also puts patients at greater ease. No one wants others to hear what they are saying to a staff member.

As this picture reveals, chairs are often placed too close the check in counter (not too mention that this counter is not ADA compliant).  We recommend that there be at least three feet between the counter and chairs.


Parting Thoughts

Reception areas are only part of the medical office, but they set the tone. Working in an office on a daily basis, physicians and staff can overlook things that patients immediately notice.  Taking a fresh look or using patient surveys can help physicians discover ways to improve the patient experience.

And finally, it’s important to get patients back to an exam room quickly.  Patients tend to perceive time in an exam room to be less than a reception room — even when the actual times are identical.

A Hidden Cost of a New Medical Space and What Physicians Can Do About It

Dan Greenfield | April 6, 2016
Tags: , , , , , , , Construction, Real Estate No comments

How valuable is your time?

Hidden Cost of Building a Medical SpaceAs a physician, lost time is one of the big hidden costs that comes with building or redesigning a new medical space or clinic.

That’s because many physicians mistakenly feel the need to make all the decisions themselves throughout the construction process.

Blame it on a take charge ethos or a belief that a DIY approach may save money. But hiring a owner’s rep may in fact save you money in long run.

Think of it this way. Physicians regularly turn to outside practice management consultants to help set up and run their business. Similarly a qualified owner’s rep can handle day-to-day responsibilities for you. They allow you to focus more time on what you were trained to do – treat patients.

The Hidden Cost of Interruptions

Where can a owner’s rep help?  Consider the cost of interruptions.

Hidden Cost of Building a Medical Space

A study cited by Jeff Davidson in Physicians Practice found that interruptions account for 28 percent of a typical professional’s workday. That’s an interruption every 11 minutes. It can take another 25 minutes on average to return the original task or project.

Now consider a breakdown of a typical physician’s day and the many interruptions that you encounter while trying to see patients.

On a daily basis, physicians are handling telephone calls, emails to mostly interpret test results, prescription refills, lab reports, imaging reports, and consult reports.

With these demands and the steep learning curve necessary to understand the protocols and processes governing construction,

  • Do you really want to be field technical questions from contractors who are bidding on your project?
  • Are you able to review construction documents for accuracy and code compliance?  Do you have the interest?
  • Do you want to monitor contractor payment requests to ensure the work is actually done?
  • Do you have the expertise or interest in visiting the construction site to monitor for quality control?

Enter the Owner’s Rep

Some may argue that a contractor can handle much of these responsibilities. BUT REMEMBER: he or she is representing his or her interests, not yours. Hiring a owner’s rep with expert knowledge of the construction process eliminates any conflicts of interest that come with handing over control to the contractor.

An owner’s rep represents your interests and serves as the liaison between you and the broker, design team, landlords, contractors, and client vendors.

As the projects “eyes and ears,” an owner’s rep provides onsite representation to assure that construction proceeds in accordance with contract documents, on time and within budget.  Working as your advocate, the owner’s rep does much of the following for you:

  • Analyze construct ability (a technique to identify obstacles before a project is actually built to reduce or prevent errors, delays, and cost overruns)
  • Advise you on project delivery systems and forms of contracts
  • Serve as a single point of contact for contractors, architects and designers
  • Represent you at construction meetings
  • Monitor the project schedule and budget
  • Audit quality assurance/quality control
  • Evaluate the contractor’s payment requests
  • Provide weekly project reporting
  • Facilitate issue resolution

They can help you select the architect, review your lease, assist with permitting, conduct construction site visits, identify construction document discrepancies, manage submittals and change orders, and ensure compliance with regulations and codes.

And in the end, they help ensure that the final space is designed and built according to your plan.

Pay Attention to Their Medical Experience

If you are going to retain an owner’s rep, make sure he or she has medical experience. In addition to running the project more smoothly, an owner’s rep understands the unique needs of a healthcare space — helping you avoid having to explain, for example, what HIPAA means or the precautions of working in an occupied space.

If the construction process sounds like a lot, it is, and we advise you to not do it alone. There is no need to.

Healthcare Marketing Doesn’t Stop at Your Door

Dan Greenfield | March 23, 2016
Tags: , , , , , , , , , , , , , , , , Healthcare Marketing, Medical Interiors, patient experience, Retail Medicine No comments

Interior Design as Healthcare MarketingInterior Design, Healthcare Marketing, and the Patient Experience

When it comes to healthcare marketing – you are spending many dollars these days on a digital strategy to get patients in the door. And rightly so. Patients are increasingly going online to get medical advice or find a physician.

But marketing doesn’t stop at your web portal or the door.

When a patient enters your clinic or office, BAM! interior design. Almost instantly your patients look around and make a judgment call about the quality of your care. The walls, the colors, furniture and how the office is maintained set the tone for experience to come.

Interior Design: The Prize Inside!

Interior design is like the prize inside a cereal or Cracker Jack box to extend your brand

Medical Interiors

Patients notice as this word cloud from Yelp postings indicates


But as articles like 5 Focus Areas Hospital Marketers Must Perfect in 2016 reveal, many discussions about healthcare marketing don’t address interior design. This is not a criticism. Interior designers need to do a better job in making their case as brand consultants.

Interior Design and the Retail Experience

Think Apple and Starbucks; they understand the importance of the in store experience. Like it or not, healthcare has to follow suit and embrace going retail as Melody Jones at Perficient said in an interview. It has no choice. Consumerism is transforming how patients select a provider.

Certainly it’s a focus for urgent care providers. Industry expert Alan Ayers with Practice Velocity wrote me:

“A big issue with urgent care today is its lack of differentiation—consumers generally view all urgent care centers on an equal plane. Because urgent care is a “retail” business that must capture the attention of drive-by traffic, a facility’s location, signage and aesthetics should be considered part of its overall marketing strategy.”

Making the Healthcare Marketing – Interior Design Connection

In a conversation with Thomas Hofstetter, managing partner at Points Group, we agreed that a large part of the problem is demonstrating ROI.  Physicians generally regard interior design — chairs, carpet, paint — as a cost, not an investment or a marketing opportunity.

Another challenge: Interior design often becomes part of the furniture.

Nina Grant  vice-president-business-development at Practice Builders described one experience she had.

“Many years ago, we designed a beautiful branded campaign for a trusted and experienced plastic surgeon.  After many weeks of tweaking the brand, we were there!  Just the right look and feel for this high end demographic. Until that is, I visited the practice realized their reception area was old and dated, paint cracked and chipped, and their team mismatched, road weary and not carrying the imagery necessary to instill the spirit of enhanced beauty.

“Physicians too often miss the reality of their spaces.  They rush through their reception areas heads down and files/coffee cup in hand and straight to the exam rooms.  Every physician and every office manager would be well-served to look at their space as a prospective patient might.  The result?  A major shift in case acceptance, profits and lifestyle.”

Where Healthcare Branding and Interior Design Intersect: Three Examples

I don’t want to overstate my case. Interior design may not always be front and center but consider how these healthcare marketing professionals have integrated their brand into their physical space.

Nationwide Children’s Hospital

Take Nationwide Children’s Hospital in Columbus, Ohio. Its mission and overall design philosophy are consistent with my business partner Patricia Fortenberry who was part of the Dell Children’s Medical Center’s design team.

Donna Teach is its chief marketing and communication officer and a member of the Board of Directors of The Society for Healthcare Strategy & Market Development (SHSMD).

As she explained, the physical space is embedded in the brand. The space  evolved  in 2012 to align with their campus expansion. “Everywhere you look, you see butterflies and objects in flight. Butterflies instill optimism; they are ambassadors of hope.” And you’ll find the butterflies woven throughout the hospital and on its website.

The interiors are designed to be an immersive, museum-like experience for patient and parent alike.  TheHealthcare Marketing physical space serves as a “distraction” to help relieve the high stress of a pediatric hospital.

Their motto is “When a child needs a hospital, everything matters. “At a time when hospitals are competing for patients and promoting the value of the healthcare experience, everything includes the physical space.

Austin Regional Clinic and Austin Diagnostic Clinic

Here in Austin, the Austin Regional Clinic and Austin Diagnostic Clinic are two of the largest healthcare providers.

Austin Diagnostic Clinic

Raquel “Rocky” Epstein is marketing communications director at The Austin Diagnostic Clinic (ADC).

ADC’s branded orange and crimson colors have been incorporated throughout its website and buildings and play an important role in enhancing the patient experience. They are intended to convey “a sense of vibrancy for our staff and patients as part of our wish for them to have a vibrant, healthy life.”

The choice of color even made it onto a wall in their call center – outside the patients’ view. Rocky noted its positive effect in giving employees “a lift in their voices” when communicating with callers. It’s a reminder of interior design’s reach and influence. It impacts staff and patient alike and extends beyond the reception area to include the corridors, the exam rooms and even the bathrooms.

Austin Regional Clinic

Where ADC’s colors are crimson and orange, the color palette at Austin Regional Clinic is purple.

But explains Heidi Shalev, its director of marketing, communications, and customer service, “don’t expect to see too much purple.”

Their brand is closely tied to their patient experience. And over the past decade they have increasingly focused on making sure their brand is integrated into their clinic space.

Their interior design varies from clinic to clinic to convey that experience. Material selection and layout reflect physician preferences, demographics and the landscape where each of their 21 clinics are located across central Austin.  High ceilings, natural materials, even barn doors are incorporated into the design mix.

Concluding thought:

Clearly healthcare marketing professionals exist who understand role of interior design in their branding strategy.  As these examples suggest, branding an interior is not just about a color, a logo or a layout.

Good interior design, like good marketing, must resonate with patients and staff.  It needs to instill confidence, reduce stress and promote a healing environment. At its best, interior design is more than a physical manifestation of the brand; it can impact outcomes.