Jan. 24, 2019

How to start your medical practice. Place, equipment, license

We continue talking about starting your own medical practice. In this article we’ll describe 2 steps: how to choose the premises and equipment and how to obtain a license. These steps are connected, as you won’t get a license unless your premises meet all the requirements.

Learn more about the steps and documents needed to open a private medical practice in our manual here: https://ilf.space/medmanual

Step 4.1. Finding premises

When looking for a place, first you need to decide whether you’re going to buy or rent one.

Buy

If, for instance, you buy an apartment, don’t forget to unregister it as housing stock. In this case, your neighbors might eventually become your customers (patients). Buying is more reliable than rent, which makes you dependent on your landlord, but not every doctor can afford it from the start.

Rent

Primary care doctors most often rent an office in outpatient clinics where they used to work. It’s not profitable for these clinics to keep the whole building, so extra funds from rent come in handy. It’s also a plus for the doctors, since they get a place that patients are already familiar with, especially considering that most medical institutions are located in geographically convenient places.

Such rooms are usually closer to the requirements set by law for medical premises than, say, an office in some business center. On the other hand, to beat other private practitioners, you should consider the quality of service and convenience for your patients, which isn’t always easy to arrange in state clinics. You could treat this as a transition period - start your practice in a place you’re used to and later move somewhere else. However, every factor needs to be weighed first, and you would benefit from a finance expert’s advice when calculating expected income and expenses (monthly and one-time ones) of your medical practice - learn more about it here: https://www.youtube.com/watch?v=u6zhiA6aZLI

Another option is to rent rooms in a multistory residential building, new building or cottage cluster:

  • This allows you to save on rent. The doctor can ask the construction company for deferral of rent until construction is officially over and refurbish the premises in the meanwhile.
  • Mutual benefits. It benefits construction companies when their residents have everything they need right around the corner (e.g. kindergarten, school, fitness center), and this includes medical care. It should be noted that dentists have long been renting offices in residential buildings, which makes them pioneers of the private healthcare market. For doctor entrepreneurs, the benefits take the form of happy and comfortable patients as well as premises that can be tailored to their particular needs.

When choosing premises, make sure they meet Ukraine’s state regulations on construction, such as regulations on minimal area, ventilation, drainage system, lighting, etc. This is important because any inspection would immediately reveal violations and could leave you without a license and practice.

Unfortunately, it’s not that easy to find premises that are fully compliant with state standards for medical practice in Ukraine. In other countries, there are companies that design entire buildings with medical space in mind, to be leased out to doctors. In Ukraine, such buildings are rare but can still be found with proper effort - just write down your specifications and hire a reliable realtor that knows the market.

On rent agreements

Pay attention to the provisions on monthly rent in the agreement: how it is calculated, when and under what procedure the landlord can change it; duration of the agreement and your rights should you wish to extend it; under what conditions the landlord may terminate the agreement; whether you are entitled to compensation for renovation expenses and how, if yes; rent deferral and other nuances of your medical practice.

Remember that rent agreements of over 3 years must be notarized.

If the premises are in communal ownership, the owner will most likely provide his own rent agreement (usually a model contract of the State Property Fund). If it’s one approved by a territorial community, it’s terms may not be changed, if not - a lawyer will help you make adjustment beneficial to you.

Step 4.2. Making sure you have all the necessary equipment

You will find an exhaustive list of equipment that primary care doctors and sole proprietors must possess in the List of Equipment for Healthcare Institutions and Sole Proprietors that Provide Primary Medical Care. As practice shows, doctors that have been working for 10-20 years sometimes do not need certain tools, even if they have them, while the List contains certain expensive types of equipment that must be present even when not used in health checkups (for instance, an electrocardiogram machine), as it’s a prerequisite for getting a license.

You can get the equipment on lease or share these expenses with a partner if yous is a joint practice.

Step 5. Taking care of documentation required for a license

If you’ve found the premises and they meet the requirements and have the necessary equipment, you can start preparing documents to apply for a license. This procedure takes about a month.

The doctor must get registered as a sole proprietor (individual entrepreneur, or FOP) and must have a signed rent agreement for the premises or a certificate of ownership for it.

Then the package of documents must be submitted to the Health Ministry’s administrative services center (for details regarding the documents see the 8 steps manual).

If the documents are submitted not by the FOB doctor, but by their authorized representative, the package must contain a notarized power of attorney for that person. Documents can also be sent to the Ministry via postal delivery service such as the Nova Poshta.

Applying for a license sometimes fails at first due to errors: incorrectly indicated specialization, unknown manufacturer of a particular piece of equipment or its year of manufacture, etc. Human factor also plays a role here: one official might ignore what another would consider a mistake. Bear in mind that the licensing commission sits on Thursdays and the documents should be submitted in advance, after a thorough review, either on your own or with the help of a lawyer.