In this episode of “DPC Pediatrician,” Dr. Phil Boucher and Dr. Marina Capella dive into selecting the right space for a Direct Primary Care (DPC) practice. From envisioning your dream setup to understanding the practicalities of square footage, location, and lease agreements, they share personal experiences and expert tips to help you make informed decisions. Whether starting small or planning for growth, this episode is packed with actionable advice for building your ideal DPC practice space.
Link to Podcast: Finding the Perfect Space for Your Pediatric DPC Practice
Welcome to DPC Pediatrician. We’re Dr. Phil Boucher and Dr. Marina Capella, two DPC Pediatricians who are on a mission to share our love of direct primary care with you. Hey everyone, welcome back to another episode of DPC Pediatricians. Today we’re talking about space. It can be difficult to know how much space you need for your practice.
0:22
And it’s something where you really don’t wanna like over or undershoot because it’s kind of a big thing to move and move and move. And so we wanted to talk through what to think about and what to consider when it comes to space. So can you start and tell us what it was like for you
0:37
when you were starting your practice? Like where did you look? What was your calculus? And then I can share mine.
0:42
Yeah, great question. So I kind of talked to a few DPC family medicine providers in my community to kind of get a sense of like what I needed. I also had read some books and seen the DPC docs posts. And I knew that there was a variety of possibilities.
0:58
One of the doctors in my community that I talked to, he had a really nice setup where it was basically like a two room space. And one room was kind of a waiting room and had his sort of desk in it. And then there was a door into another room that he used as his exam room.
1:13
And I thought, oh, I really love this setup. But there were some downsides, like he didn’t have plumbing into the office. And there was a Yeah, yeah. So a lot of it was really limited by just what I could find in my community.
1:39
I looked at a lot of listings and a lot of them were just sort of these single offices that were meant for massage therapists or for mental health therapists, but they wouldn’t really work for me because they didn’t have the plumbing and they didn’t have enough space to really grow into.
1:55
And realize the plumbing, like that’s one thing that I never really thought about or considered, but actually being able to put stuff down a drain is an important practice thing.
2:04
Exactly. Exactly. So I got lucky and I called an agent about a listing I had seen online. And he said, well, you know, I don’t think this is really going to be a good fit for you. Maybe it’s too big, but I have this other property that is not even listed yet. And it’s a medical office.
2:22
Why don’t you come see it? And so I went and I saw it and it was wonderful. It was this 1500 square foot office with a nice waiting room, a nice reception area, a break room, a doctor’s office, three exam rooms and a little lab and bathroom in the back. And it’s not big.
2:38
1500 square feet is not huge. And I thought, well, you know, it’s kind of big for right now, but it gives me that space to grow into. And it gives me the space to have another provider to kind of share the burden over time. And at first it definitely felt too big.
2:54
My first year when I was really slow, it was just me. It felt like too much space. But luckily, I ended up partnering with another pediatrician who wanted to open her own pediatric DPC. And we ended up sharing the space. So we saved on costs. We split the rent. We split the utilities, the internet, all that stuff.
3:14
And it’s worked out really beautifully for us for the first three years. And we will be moving soon into a new building. But it was a perfect space for all of this time. So I’m curious with you, Phil, how did you find your space in the beginning?
3:27
How did you assess what your needs were and then look for what you wanted?
3:31
Right. I think for practices, it can be difficult to like, I think you have to kind of envision, okay, what’s the first year going to look like? And then what’s the fifth year going to look like? And see if you can figure out a way to find a place that works for both of those,
3:44
or at least isn’t too big and isn’t too small and is just right for starting, but then growing as well, which it sounds like you threaded that needle. Yeah. really well with what worked out. And that I think the big picture is work with somebody to figure that out, like with a commercial real estate agent,
4:03
because they know about all of the properties and they know what’s a good fit and can do a lot of that legwork for And so I think that that’s something that at least worked really well for me coming from, okay, I’m working. I don’t have time to go scout out all these places.
4:17
And I don’t know where all the places are or what is going to be required. And so for me, it was, okay, I want to be on this side of town. because this is where we live and I want to be close to my work.
4:29
And this is kind of where my patients that I’m leaving are located at by and large, finding that specific kind of area of town first and foremost. And then what are the surrounding businesses and what is the space available? For me, what we did is we started in a location that like speaking to the sink thing,
4:47
it did not have plumbing. And we knew that going into it. And we knew it would be a somewhat temporary spot for us. So we were there for our first year while our final place was being built out. But we just made do with shared restroom. And we got water from there.
5:03
And we had like the little water spigot, like the things where the Culligan man comes and delivers water. Yeah. But that worked perfectly fine. So I don’t think it’s like a must. And I definitely think DPC or private practice, whatever, you don’t need a sink in every exam room.
5:34
And I think that’s one of the things that we often overestimate is the need to have that. And then you underestimate the expense of having a sink in every exam room when you go to build. And you’re like,
5:44
oh,
5:44
this is way more expensive to get medical grade plumbing into every exam room when really we can put one in the hallway or one in every few rooms or something like that. And make it work. And so that was one thing that saved us a lot of money.
5:57
And I realized like, we don’t need a sink in every room. That’s silly to spend all that money on that because people can use Purell or they can go to the hallway to watch their hands and what they need to. And so our first space had two exam rooms, a therapy room, an office,
6:15
and then kind of a shared waiting area. And it was probably around 900 square feet. And that was perfect for our startup size. And so I think if you like ideally for a practice that’s starting, you have at least a couple of rooms and they can be multipurpose rooms or they can fit different needs.
6:34
I’ve seen some cool videos of people that have like a room where they do most of their chatting with the patients. And then they go back to a different room for the exam, which is kind of cool and homey sort of set up to it.
6:45
But we had two exam rooms so that if somebody showed up, then there could be somebody that was waiting. And then we did have a therapist, which we still have, integrated in. So she needed a room as well. And then we had to have a room for our…
6:55
Kind of a shared area for my office manager and nurse to work in. And then I had an office as well. And so that was kind of how the initial setup was. And then we moved into a space that we built that has about 3000 square feet.
7:08
It has five exam rooms and two of those are used as therapy rooms instead of. Yeah. exam rooms and then our offices and everything like that. So we expanded, but I think in the big picture, when you’re starting off somewhere between 500 and 1500 square feet is probably the
7:23
right amount of square footage for your practice based on what you are hoping to do and how you’re hoping to grow. Not everybody wants to grow into a huge space or have a huge clinic or have multiple people and employees and those sorts of things. So I think it varies by the person quite a bit.
7:37
And it sounds like, I know you were telling me before we started that you’re in the process of Moving into a big building and all those sorts of things.
7:44
Yeah, exactly. I just finished the purchase of my own building. And that’s sort of been a dream that was kind of in the back of my head for a long time. And I thought it wouldn’t happen this quickly, but fate brought it, you know, into the landscape. Yeah. It all worked out. And so we’re excited.
8:01
It’s a house that was converted into commercial real estate a few years ago. It used to be a birth center for a while. So it kind of has a cool history. And then it belonged to an interior designer who did a beautiful job kind of maintaining the historical aspects of the house.
8:16
So it’s this kind of slightly Victorian house and with a really cool staircase and It’s exciting. I think going into that, it’s going to feel very welcoming and very homey as opposed to a standard clinic. So it’ll kind of help my practice and Margie’s practice stand out.
8:33
And we hope to have it kind of as a shared pediatric wellness space where I have like pediatric OT and pediatric mental health and lactation. So it has space for all of those things for our exam rooms and then a and work out of the space as well. There’s space for a garden.
8:54
There’s a creek that runs through the back of the property. So it’s really, I’m really excited about the potential there, but it’s a lot of work and it’s been a lot of headache to acquire it. So it’s a work in progress.
9:05
Well, I can’t wait to see all the pictures of that as it comes to, you know, moving in and all those sorts of things. Cause that sounds awesome. I really like creating a place that’s all-encompassing, too. And so I think that’s what you’re going for with having those other clinicians that
9:23
are available in this space as well and creating a place where people come. We just had a patient yesterday that needed to see speech. Yeah. I told her the different options and she had heard that we have a speech therapist in our practice.
9:36
And she’s like, I know I could use insurance, but I just want to come here. My kids know it. It’s a totally the vibe that we’re going for. Your staff are wonderful. It’s peaceful. It’s quiet. And we’ve gone to the other speech places that are loud and chaotic and not as accommodating.
9:51
And so just being able to offer those things in clinic is a really cool way to stand out and take really good care of our patients. Yeah.
9:58
Yeah, absolutely. And it sounds like we have kind of shared visions in that regard that you’ve created a big enough space that you can have other practitioners also out of your space. I’m doing the same thing. But I want to acknowledge what you said earlier, that that’s not everybody’s vision. I think that a lot of DPC pediatricians
10:16
their dream is really to have a micro practice. And there are so many different ways to do that. There are some of us who operate out of our homes, a couple of us. There’s a DPC pediatrician I talked to recently, Dr. Lindner, who rents one exam room out of an allergist’s office.
10:33
And that has worked really well for her for two years. There are people who just have really tiny offices and that’s completely fine. Or Do home visits, right? So you don’t have to have the same vision as Phil and I, just rest assured. Whatever your vision is, is completely fine. And there’s always opportunities to pivot.
10:50
So just like Phil found a space for his first year that worked well enough, you can do the same thing. I think just be careful with like, make sure you review your lease terms with someone because you don’t want to get stuck in a lease that doesn’t end up working long term and then you feel stuck.
11:08
Yeah, for sure. That was really how it worked out well for us, which I didn’t kind of go into too, is we were working with a commercial real estate company that was building out our space and put us in one of their other properties for that first year.
11:24
So that worked out really well as a way to keep expenses lower in that first year. And then they, I mean, they wanted us to move into the space. So they were happy to make it work from a lease perspective, but of getting things transitioned over. But that would be the biggest thing is like,
11:39
don’t get yourself locked into something where if you decide I want a bigger space, I want to go all virtual or home-based, like that you’re going to be stuck with it for a long period of time.
11:52
Absolutely. I’m curious, how did the build-out work? So did they pay the expense of the build-out in exchange for a certain term lease? Because I didn’t do that.
12:01
So it was basically over a 10-year lease that they paid for the build-out. And they have a ton of medical and dental and all sorts of practices inside their real estate. So I felt really comfortable that they would take good care and talking with other dentists and stuff. They’ll do
12:17
updates, just, Hey, we think your space could use a refresh. Let’s remodel and update the paint and all those sorts of things. So people, they take really good care of all of their clients. And so it made me feel really comfortable working with them and then being able to build out the space that we wanted.
12:32
Yeah.
12:34
And yeah, yeah, it worked out super well. And that wasn’t something that I realized as I was going into it, that that was even a possibility of like, hey, can you build this space? Like, I don’t want to take out a loan to have a huge mortgage on this place. Yeah,
12:46
we’ll just build it into your lease agreement so that you have the space, but also not have the huge mortgage.
12:53
upfront expense yeah that’s amazing that’s i’m glad you found that and i think you know people do build outs in in smaller spaces as well so it just is a matter of negotiating with the person you’re leasing from that being said some offices are
13:08
not willing to do that it’s just kind of when i took over my office it was very clear that they just wanted me to take it as is so all the decor and any upgrades were just up to me but in exchange for that they gave me a better deal
13:22
And in fact, they gave me reduced rent for the first few months because I said, hey, I’m brand new. Like I have no patience. So they gave me a reduction for the beginning. So you can negotiate to some extent.
13:34
I wish that I had like looking back on it. I feel like, well, especially the way commercial real estate is now post-pandemic. There’s a lot of empty spaces. And so I think it’s definitely a buyer’s market. And so then you can ask for more.
13:48
And the worst thing that they can say is no or go fly a kite, but they still have these empty properties that they need to fill. And so you can negotiate it where, hey, this is my first six months. Can we do a reduced payment for the first six months and then go from there?
14:03
Or, hey, can we get some extra signage or those sorts of things? as ways to improve yourself and make it a sweeter deal for you.
14:12
Absolutely. Yeah. And earlier you alluded to location. I think that’s really important. Find a place where you’re happy driving to every day, a place where you feel like you’re going to have good visibility or decent visibility. Mine ended up being across the street from a lab core and a hospital.
14:29
And that ended up being lovely because I could just send my patients who needed blood work in the beginning over there. But yeah, just, you know, take all of those things into consideration in addition to the space itself and how much you need. But ultimately,
14:42
how much you need is really up to your own vision and make sure you kind of follow what you want. You don’t have to do it exactly the way that anybody else did it.
14:53
Love it. Great discussion. And hopefully this helps those that are trying to figure out what to do when it comes to space for building their dream practice.
15:02
Absolutely. All right. Until next time, everyone.
