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Monday Aug 26, 2019

Moving Practice Has Been Good for Me, Staff, Patients

Sometimes you can turn a challenge into an opportunity.

[young woman with moving boxes]

About five years ago, I relocated from Fort Worth, Texas, to Austin, joining a family medicine practice as an employed physician. When that practice closed a year later, I decided my best option was to return to my roots as a solo practice owner.  

The biggest challenge was not changing jobs again but finding affordable, available real estate quickly in one of the nation's fastest-growing cities. The only available built-out medical space was a clinic that had been built in the 1990s for a colorectal surgeon.

That previous tenant performed procedures, so the exam rooms were large (and each had its own bathroom), but nothing else about the location was ideal.

As a young physician, I once attended an efficiency seminar focused on how to best design a clinic. Whomever designed this particular clinic space clearly was not in attendance.

The nurses' station was nowhere near the exam rooms, which hampered communication, wasted time and clogged the hallways. The entire office -- exam rooms and waiting room included -- had two windows, making it a rather somber place to spend a long workday.

The bigger problem, however, was finances. In my first year, property taxes increased 29 percent. (Did I mention that Austin is growing?) From 2013-18, home values here have increased 33 percent. According to the Austin Board of Realtors, the number of homes sold and the median sale price have both increased eight years in a row. The Lone Star State has no income tax, so it relies heavily on property tax. As the demand for housing and commercial properties have skyrocketed, so have property taxes and rent.

So, what's a family physician with less-than-ideal office space and rising overhead to do?

In any other industry, a business owner might pass the cost on to consumers. But as a solo doc, I don't have the ability or clout to renegotiate more sustainable payment from insurers. This is one factor driving services out of central cities. There are also already urban underserved areas in many inner cities, and this is what we are seeing happening in Austin as far as access to primary care.

The clear solution to my problems related to both office design and costs was to move. Again.

With more time to search for a good landing spot, this time around I found a landlord who was willing to alter a space to fit my needs. And by moving just 10 minutes from my previous location, I was able to lower my rent 40%.

We're still on the public bus line, which is important for patients in a major city. We're also near two major highways and have better parking. The nurses' station is more centrally located, which has improved our communications and efficiency. Although our new space is actually 200 square feet smaller than the old office, several patients have commented about the new, "larger" office. They definitely have noticed that it is filled with more natural light, which is a benefit for everyone.

Packing and moving is never fun, but providing more efficient care with lower costs in a better working environment has made it well worth the effort.

Erica Swegler, M.D., is a member of the AAFP Board of Directors.

Posted at 02:29PM Aug 26, 2019 by Erica Swegler, M.D.

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