Build big and plan ahead

All doctors who plan to build hear from colleagues who've been there before that they should build bigger than they think they need to. Drs. Kate Knutson and Steve Barghusen took those words to heart-working in an extra 3,700 square feet for future expansion. Here's what they learned:

• Build much bigger than you need. "Over and over we heard doctors say they'd built a 3,000-square-foot facility five years before, and they've already outgrown the building," says Dr. Knutson. "So we thought about how big a hospital we wanted and tried to anticipate where we'll be in 20 years. To help determine the size, we brainstormed all the services we might like to add someday and left as much space as possible for those."

Dr. Knutson says building beyond your means is a bit scary. "Because we didn't finish out the entire building, we're paying for space that's not making us any money yet," she says. "But I'm thrilled every time we go to a conference and hear people say, 'I wish we'd done that!' Anticipating our future needs will pay off in the end."

• Plan for expansion. "We had future expansion top-of-mind when we designed our facility," says Dr. Barghusen. "We envisioned this expansion being a multistage process that would take place over a number of years, letting us take advantage of trends in the profession and accommodate the special interests of our doctors."

In the finished area, Drs. Barghusen and Knutson left space to add a surgery table and overhead lights; installed plumbing for a second wet table in the inpatient treatment area; and left space for a special procedures table. They also installed the mounts for overhead exam lights to go above those tables. And they created space for a dedicated oncology and chemotherapy area.

The 3,700-square-foot unfinished area opens to the outside, has access to the parking area, and is tied to the rest of the hospital by a corridor that can be secured to control unauthorized access to the hospital. "We left the floor unfinished to allow plumbing or other utilities to be laid down first," says Dr. Barghusen. "We can make this space an independent facility, such as a specialty practice, or expand our current facility."