Setting up stand-alone rheumatology clinic: What to consider; how to do it?

Suresh Adimulam MRCP, CCT (Rheumatology)
Dr. Adims Centre for Rheumatology and Pain Management
Visakhapatnam, Andhra Pradesh

Key considerations for a beginner

The name of the clinic is your identity, so spend time deciding on it. Consider the population, other medical facilities, laboratory, Imaging, and competition. The ground floor is the best, otherwise lift is mandatory. Evaluate prominence on the main road, parking, and waiting area. The Display board should contain your name and qualifications preferably in both English and the local language. You need to pay advertising tax depending on the size of the board.

Prepare a logo for all your stationery. Obtain a trademark of your logo and tag lines. Have the visiting cards, prescription pads/Letterhead, Case files, Envelopes, etc. prepared.  Have your own website with your qualifications and the conditions that you treat. Keep a couple of computers with printers, scanners, an internet connection, and appropriate software. Considering having daycare beds in your clinic as it would facilitate you and your patients for infusions.

The pharmacy is a key part of maintaining a proper rheumatology set-up. The minimum space required is 10*10 sqft. You also need a full-time pharmacist to man the shop and dispense the medications along with a good software system. It would be sensible to keep a laboratory in your premises. Buy the correct equipment and have qualified staff. You need proper waste disposal systems in place and NOC from the pollution control board.

You need to have a 10*10 square feet room for the X-ray equipment and a smaller room for the processing and film printing room. The room needs to have 12 inches brick walls and lead covering for doors and windows along with a few lead aprons.  If you plan to keep ultrasound facilities, then following stringent guidelines should be met;

  1. Each machine is coded to a dedicated address and should not be moved.
  2. A log of every patient scanned should be maintained.
  3. Display a board saying sex determination is illegal.
  4. Tariffs should be clearly displayed.
  5. Register with the district medical and health officer (DMHO) prior to purchase.

Other mandatory documents for a clinic include;

  1. Municipal license
  2. DMHO clinic registration
  3. Pollution control system and certificate
  4. Waste disposal system and certificate
  5. Fire safety certificate
  6. Pharmacy license

Planning the initial investments

Banks are willing to lend doctors loans without a security deposit based on your qualifications.
While signing for rental agreement, remember the following in mind,

  1. Keep the deposit to the minimum
  2. Pay through cheque or DD only.
  3. Register the agreement.
  4. Monthly maintenance amount to be mentioned.
  5. Keep an exit clause.

Imaging and Laboratory facilities can be postponed initially if you have financial constraints. In that case, you can collaborate with a well-equipped diagnostic centre nearby.

Establishing Interdisciplinary communications and improving referrals

Spend time with other specialists, refer cases to them, and conduct CMEs with IMA bodies. Meet local societies of interrelated specialties and conduct CMEs. Do not hesitate to contact your colleagues or seniors for any help or a second opinion.

If you are a risk taker, open to challenges, and motivated enough to start your own clinic, private practice gives you the opportunity.

Good luck!