Hanging with Hafen: When it comes to your building, bigger isn't always better

Sometimes it seems like the more you chase a good idea, the more you end up chasing your tail.

Here at Animal Arts, we work pretty hard to solve problems that arise during projects, to do more with less, and to solve issues by taking a new slant on an approach. This morning, I was working on the design for a veterinary clinic located in a small lease space. The more I worked on it, the farther I seemed to stray from a design solution. But then I thought back to a truly remarkable clinic I saw a long time ago.

We were working with a veterinarian in the Northeast who wanted to replace his existing lease-space clinic. We ended up designing a fun little farmlike enclave that featured boarding in an overgrown barn and a veterinary facility that looked like an expanded farmhouse. But what has really stayed with me over the years was this doctor’s original clinic.

The practice was located in an older, working-class neighborhood in the Rust Belt. This was a “real” neighborhood with a corner bar and a local grocery store. It was a place where old ladies gathered each morning with their tethered Pomeranians to talk about the neighbors.

The clinic itself wasn’t much, but it had a big window that faced the street. At most a thousand square feet in size, it essentially had only two rooms: front and back.

The front included the reception counter, medical records, a bench that stretched along the entire front of the property and three freestanding exam tables. The back included everything else. One doctor and two technicians ran the place. And all of the patient exams took place on those three exam tables right in front of everyone.

“Good grief,” you might think. “How can that be?” That was my reaction too. But in truth, I think this was probably the best venue for performing medicine that I’ve ever seen.

The little old ladies with their Pomeranians would come through the door, check in with the receptionist, and then take a seat on the bench directly across from the exam tables. If Doc Goldman (I just made up that name) was performing an exam, they got to see what he was doing and hear what he was saying. This was veterinary theater. And while they watched, the old ladies kibitzed.

Doc Goldman’s performance was an educational experience, better than any educational video you could buy today. The ladies watching and eavesdropping learned by seeing what he had to say. When their turn came at the exam table, they’d ask, “Doc, don’t you think we should check for ear mites on Muffy? After all, Marty’s dog had them.” This was a retail sales bonanza. If Marty’s dog needed a medicated shampoo, didn’t Muffy need one, too?

While they waited, clients knew Doc Goldman was working hard because he was as busy as could be right in front of them. And for the Doc, it was a study in time management. If all the seats were taken on the bench, he could tell that things were backing up, so he’d work faster. With fewer on the bench, he knew he could take more time to educate clients about his recommendations.

The setup also provided a lesson in crisis management. If a fractious animal came in, a technician could whisk it into the back. While the client waited, he or she still had plenty to watch. If there was a battle over the bill at the reception counter, Doc could easily step in to patch things up. If an emergency came in the front door, other clients could understand just by watching that this case had to take priority.

In the back, things were almost as simple. The team had a treatment table, a radiography unit, and a surgery table. The aseptic environment might have been a big lacking, the radiography room wasn’t enclosed, and there was only a tiny closet for isolation. But it was a study in team effectiveness.

The place wasn’t very pretty, but Doc Goldman knew his clients and his team thoroughly. The practice didn’t carry the stress and overhead of 40-plus employees, and it didn’t cost a fortune to build. Doc probably had his overhead covered by the second week of the month.

You might not want to duplicate Doc Goldman’s clinic in today’s world, but you could use his model to create the ultimate “wellness clinic,” a small space with mostly outpatient work and no need for full-blown surgery capacity. You could create a more efficient medical area with compact lab equipment, digital radiography units with less scatter and mobile shielding alternatives, laminar flow air systems to isolate areas without building walls, and ultrasound imaging.

Veterinary practices don’t have to be mega-hospitals with lots of overhead to be outstanding. You can practice top-notch medicine in a small facility. Your building might be bigger than Doc Goldman’s, but as long as it’s based on what’s important to you—be it the animals, your staff, or the neighborhood—it can be a remarkable clinic.

Veterinary architect Mark Hafen, AIA, is a Veterinary Economics Editorial Advisory Board member and co-owner of Animal Arts in Boulder, Colo.