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Plan For Expansion In Clinic Design

Equine hospital should offer range of services in order to be attractive to clients and grads.

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A good equine hospital needs to offer enough services to be attractive to clients and top veterinary school graduates, says architect Heather Lewis of Animal Arts Design of Boulder, Colo.

“[We encourage] equine veterinarians to build hospitals that offer diagnostics, internal medicine, reproductive services and surgery,” says Lewis, AIA, NCABB. Animal Arts Designs has designed more than 600 hospitals in 40 states, Canada and overseas.

Specialization of surgical services draws clients.

“Each service often requires its own staff and its own space,” Lewis says. “But a hospital that can provide minor surgical procedures, orthopedics and colic surgeries under one roof can become the full-service surgical center for an entire region.”

Brad Jackman, DVM, MS, Dipl. ACVS, owner of Pioneer Equine Center in Oakdale, Calif., says the first step in planning an equine hospital is to determine what a practice can afford. Pioneer Equine has 10 veterinarians on staff and specializes in surgery and lameness.

“First, look at your existing business,” Dr. Jackman says. “If rent is 8 to 10 percent of your revenue, you’ll be making more profit than if rent is 6 to 7 percent of your revenue.”

“Realize that new construction costs more,” he says. “You’ll have to grow your business to be able to pay for the new hospital.”

And build a cushion of extra money into the budget. “Cost overruns are inevitable,” he says.

Second, Jackman suggests, “Design what you like as well as what your practice needs. And then make them match.”

Look for Good Examples

When planning his hospital, Jackman visited equine medical centers nationwide. He took those ideas and designed his facility, considering “what I wanted, what I needed and what we could do financially,” he says.

Jackman’s hospital took about 18 months to build, once construction started.

He recommends that veterinarians hire an architect who knows equine hospitals. He says local architects are needed as well because they know local codes and ordinances, but the locals don’t necessarily know the specifics of building an equine hospital. “Unless people work with horses,” he says, “they don’t always understand why you want things the way you want them.”

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Jackman also found out what not to do. He discovered from other veterinarians to carefully consider traffic flow, room size, drains, slopes and flooring. “Expenses are huge if you want to make changes after construction,” he says.

“Try to plan for all the pitfalls,” he warns. “Some may think it is overkill, especially if they have no experience around horses. It’s not."

“Don’t skimp on safety,” he says. For instance, at Pioneer, Jackman insisted on rounded wall corners, proper matting and out-of-the-way hose rails, all for “the optimum safety of the horse.”

Save Energy

During his planning, Jackman says he took “green building” into account, especially for safety and efficiency. For instance, he explored solar power for affordability and feasibility.

“Green building is a good idea for an equine hospital,” Lewis says. “A lot of green design starts from good, solid design principles such as working with the natural environment instead of against it.”

Practical and affordable green ideas, he says, include:

  • Proper building orientation to reduce the size of mechanical systems.
  • Passive solar energy through proper window placement and shading.
  • Low-water landscaping.
  • Use of locally available materials.
  • Energy-efficient mechanical systems.

“Try to plan for all the pitfalls,” he warns. “Some may think it is overkill, especially if they have no experience around horses. It’s not."
– Brad Jackman, DVM, MS, Dipl. ACVS

Weigh the Costs

For Charles Woodall, DVM, of Aspen Ridge Equine Hospital in Monument, Colo., the most important consideration in building an equine hospital is having the client load to justify the expense. His 5,500-square-foot facility is situated on 35 acres and includes an indoor arena, stalls and runs.

Though he built his hospital as its sole owner, “It would have been easier with a multiple-veterinarian practice to share the cost,” he says.

“It’s imperative to develop a good working relationship with other veterinarians in the area who don’t have hospitals,” Dr. Woodall recommends. “You’ll build up your referral business.”

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Woodall, too, designed his hospital, drawing on years of experience as a practicing and visiting veterinarian working nationwide. He says he would not change a thing about his hospital if he built it today.

Major expenses are diagnostic and therapeutic equipment and facilities necessary to provide basic emergency care, as well as surgical, isolation and exercise requirements, he says.

Lewis, the architect, warns that some “luxuries” may be necessities.

“Clients like a comfortable place to wait for procedures to be finished,” she says, “and veterinarians like to have clients out of the way.” She recommends including a lounge supplied with books and a television, and to consider allowing clients to remotely watch non-emergency surgeries.

Paying for the Project

Lewis says clients are taking the economy into account by planning phased projects that anticipate future  expansions to keep each phase affordable.

“They are focusing on efficiency of space layout to get the most bang for the buck,” she says.

A hospital’s diagnostic area is a good area for future expansion, she says, explaining that “stubbing in enough electrical and data for future diagnostics and orienting the building to accommodate growth are important.

“Local banks are still the most common way to fund projects,” Lewis said. “Going to a veterinary-specific lender can help because these people are more familiar with the costs of building veterinary hospitals and they know that veterinarians as a whole are a really good investment.”

Brian Faulk, senior loan officer at Live Oak Bank in Wilmington, N.C., says the “perception of the hit the equine industry is taking in the economy has caused banks to subject borrowers to more scrutiny.”

“But our bank is still making loans where the bigger banks seem to have shut them down,” Faulk says. Credit scores, the ability to repay the loan and a borrower’s financial state are all part of the criteria used in making a lending decision.

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“Most of the largest equine hospitals have been built over time,” says Chip Mahan, CEO of Live Oak. “Their owners have worked hard to gain market share and are financing their new hospitals through profits.”

Live Oak,  a small, owner-operated bank, deals mostly in practice acquisition and real estate loans for veterinarians.

This article first appeared in the November 2009 issue of Veterinary Practice News.

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