Licensing of a medical office: documents and procedure

In our country, private medical offices appeared not so long ago. The fact is that private medical practice was impossible for a long time due to numerous obstacles from officials.

Even now, most doctors put off the idea of ​​starting their own business because they remember the problems that existed. And yet, in recent years, there has been an increase in the number of such institutions, and the question of how to open a private medical office worries the minds of more and more doctors. It turns out that progress in this direction is still taking place.

Medicine is a delicate matter

Previously, in order to obtain permits to practice medicine, many problems had to be solved. Currently the situation has simplified. But starting such a business is still not at all easy, because only a person with a large amount of money can afford to open a private doctor’s office.

Many specialists believe that by leaving the state clinic and starting to work for themselves, they will get rich very quickly. In reality, everything turns out to be not so fabulous. Some people, thinking about how to open a private medical office, do not even imagine the costs it requires. For example, opening a small (only a few jobs) dental office will cost you at least two million rubles. And the investment will pay off no sooner than after two or three years.

If this does not scare you and you still want to start such a business, our article is intended specifically for you. In it we will talk in detail about how to open a medical office legally.

Search and preparation of premises for opening a medical center

The best option for creating an enterprise in the healthcare sector is to use premises that you own by right of ownership. Therefore, if funds allow, it is advisable to purchase or build the necessary space from scratch. This option will lead to an increase in initial costs, but in the future it will significantly reduce operating costs and avoid the risks associated with running a business in rented premises.

As for the territorial location, it is, of course, better to open such an enterprise in the central part of the city, preferably in close proximity to municipal medical institutions (clinics, hospitals). However, it should be borne in mind that medical centers are allowed to be located only in residential areas, green or suburban areas away from industrial, business and utility enterprises.

The law also establishes requirements for the parameters of premises for the provision of medical services. Thus, the ceiling height in the building should not be less than 2.6 m. The minimum area of ​​a doctor’s office with a specially equipped workplace (gynecologist, urologist, etc.) should be no less than 18 square meters. m. Separate requirements are imposed on the intensity of natural and artificial lighting, water supply and sewerage, finishing of walls and ceilings, ventilation system, etc.

To simplify your task, before opening a medical center, it is recommended to order a preliminary sanitary and epidemiological examination of the premises. After analyzing the conclusion of the study, you will immediately understand how suitable the areas you have chosen are for placing a center on their territory, and what needs to be redone and corrected.

Application for registration

Such a document is drawn up in the prescribed form. It will need, among other things, to indicate OKVED codes. For a doctor who wants to open a medical office, one of the following codes will be suitable:

• 85.1 “Activities in the field of health care.”
• 85.12 “Medical practice”.
• 85.13 “Dental practice”.
• 85.14 “Other health protection activities.”

The applicant's signature must be notarized, so you must contact a notary with the completed application.

Application for a license

A doctor who wishes to obtain a license to practice must submit an application to the licensing authority, and along with it, copies of documents confirming the right to dispose or own the premises in which the medical office is equipped, and all the technical and material equipment necessary for medical practice.

In addition, you need to submit copies of educational documents and documents that confirm qualifications, work experience, and so on. The same papers will be required from all employees servicing medical equipment whom you engage as office staff. In addition to everything, you should provide a copy of the sanitary and epidemiological report issued by Rospotrebnadzor. How to get it will also be discussed later.

Staff

Please note that only people with specialized education and work experience of at least 2-3 years can work in a private medical institution, just like in a public medical institution. At certain intervals, doctors and other medical personnel must undergo certification, for which they also present supporting documents. Don’t forget about health certificates for each employee.

Pay special attention to the selection of an administrator. The mood of visitors and their feedback will largely depend on his communication skills, appearance and politeness. Such a person should be friendly, be able to put people at ease, provide the necessary information upon request, and have organizational skills.

If you yourself are not a doctor who is opening your own practice, but are hiring an outside specialist, then be sure to make sure that his work is adequately rewarded. Otherwise, a good professional will quickly be lured away by competitors. And as you know, clients go not so much to a certain establishment as to find a doctor. Therefore, when a good specialist leaves, there is a risk of losing most of the patients.

The total number of people on staff will vary depending on the size of the center and the focus of the establishment. So, you may need:

1. Administrator.
2. A doctor with a specific specialization.
3. Laboratory assistants.
4. Nurses.
5. Cleaning woman.
6. Accountant.

Tax system

Registration as an individual entrepreneur imposes obligations on you to pay taxes. A doctor who provides medical services in a private office can use the simplified tax system. This system provides for only two objects of taxation: simply income or income minus expenses. In the first case, the tax amount will be determined by multiplying the income received by the tax rate of 6%. In the second case, the tax amount will be equal to the difference between income and expenses multiplied by the tax rate (15%).

When drawing up a business plan for a medical office, you should calculate which facility will be more profitable. To do this, you need to take into account the concept of cost. If you use rented premises and equipment, then it is more profitable for you to choose income minus expenses as an object, because in this case you will constantly incur material costs. If you own the premises, the equipment has also been purchased and there will be no need to make large expenses in the near future, it would be more advisable to simply choose income as an object.

Purchase of equipment

The need to purchase this or that equipment and the amount that will be needed for this will depend on the specifics of the medical services of your future center. So, if you are going to open a dentistry in order to equip an office for one specialist, you will need from 800,000 rubles.

Opening a diagnostic medical center will cost more. The purchase of an ultrasound machine alone costs an average of 1,000,000 rubles.

An obstetrics and gynecology center designed to provide consultations, diagnosis and treatment of major gynecological diseases will require at least 2,500,000 rubles. for the purchase of equipment. In addition to basic medical equipment, it is necessary to separately purchase furniture, auxiliary medical products and consumables.

Important! Medical equipment, furniture, equipment and inventory - all this must be permitted for use in Russia in accordance with the established procedure. All medical products must be certified. Their performance characteristics must comply with general safety standards.

It should also be taken into account that all medical devices are subject to mandatory state registration with Roszdravnadzor. During this procedure, all documents for equipment, research results, examination, and, as necessary, clinical trials are checked. Based on the results, a registration certificate is issued. Remember that modern medical equipment of high quality will always indicate to customers the respectability and seriousness of your enterprise.

Place to rent

Before renting premises, carefully study the Sanitary Regulations, because you will not be able to open a private medical office everywhere. Medical practice involves the use of premises with a certain footage (depending on the specific specialization) and interior decoration.

All communications must be present in the office (electricity, water, sewerage). It is advisable that the premises be located on the ground floor of the building. As a rule, all private doctors try to open medical offices in the city center. The optimal location is near transport routes or metro stations.

Buying a medical center franchise as a way to organize a business

One of the options to get a profitable business in the healthcare sector is to purchase a medical center franchise. A franchise is a transaction based on mutually beneficial cooperation, concluded between a successful developing company with a positive image and a well-known brand (franchisor), on the one hand, and a beginning entrepreneur (franchisee) on the other.

The relationship is as follows: you, as a franchisee, enter into an agreement with the franchisor, pay a lump sum fee and receive comprehensive support in opening and running a business, a ready-made business plan, use an advertising campaign, train yourself and train your employees, etc. The center is actively working, generates income, and you transfer a certain amount of royalty to your partner’s account every month.

This option of starting a business in some cases allows you to save a lot of money, since franchisees have good opportunities to contact equipment suppliers at competitive prices, use a well-known brand and a well-functioning work scheme in general. Thus, if you want to build a successful business within a large network, consider opening a specialized medical center (for example, for children or for married couples) as a franchise.

Equipment for medical rooms

This is the most expensive part of starting your business. It’s even scary to think how many devices need to be purchased in order to equip even a small doctor’s office. At the same time, all equipment must be specialized; you cannot even buy ordinary furniture.

So, for example, the cost of a doctor’s chair intended only for receiving a patient (a different chair for a special examination will be needed) is at least 20 thousand rubles. It's just one chair! Judge for yourself what the total cost will be. Yes, a medical office is not a cheap pleasure. The business plan should be drawn up as efficiently as possible, calculate all the expenses and think carefully about whether you can afford them.

We present only indicative prices. Surely, you want your services to be in demand among the population, and for this you should provide people with high-quality care, which, in turn, requires the use of medical equipment from serious manufacturers working according to Western standards. Modern equipment is very expensive.

An ultrasound machine will cost you no less than 5 million rubles, diagnostic devices cost from 300 thousand to two million rubles, prices for dental units range from 450 thousand to 2.5 million rubles.

Opening a treatment room

Before opening an institution, you must clearly understand and follow the instructions of the sanitary and epidemiological station.

Requirements for the treatment room

All requirements for the treatment room are recorded in section 1 of the SanPiN Requirements.

Among them are:

• The area where the treatment room will be located should not be less than 12 sq.m.
• All surfaces of the premises (floor, walls, ceiling) consist of material that is resistant to moisture, as well as cleaning and disinfection products.
• The room must be well ventilated, therefore, supply and exhaust ventilation is necessary.
• Temperature regime: winter - no more than 23 degrees, summer - 25 degrees.
• It is necessary to take care of artificial and natural lighting.
• Requirements for medical furniture are presented. Outside and inside, it should be made of smooth material that can be washed and disinfected. The surface of chairs and couches for clients is made of material with reduced thermal conductivity.
• Sinks must have a special surface that is easy to clean and disinfect. There should also be liquid soap and hand sanitizer, contactless washing, etc.
• There should be no Staphylococcus aureus in the room. The content of medications should not exceed the maximum allowable.
• The presence of an irradiator against bacteria and viruses (must be turned on).
• To clean the premises, there must be special cleaning equipment with the appropriate label.

Business registration

To work in this industry, you must register with the tax service as an individual entrepreneur or LLC. In addition, you need to obtain a registration certificate, as well as an extract from the register of entrepreneurs and legal entities, OKVED codes.

For the normal functioning of the treatment room, it is necessary to purchase and issue a seal. A personal bank account is required to make money transfers with clients and customers. In addition, you can purchase a franchise from a large laboratory (which is better and faster), or enter into an agreement with a laboratory for the delivery of biomaterials.

Room

There are no requirements as to whether you purchased the premises or rented them. When selecting a building, it is necessary to take into account a number of characteristics.

Firstly, everything must comply with safety standards. The area of ​​the premises must be more than 100 sq.m. and have its own entrance.

Secondly, the treatment room should be located near transport hubs to create convenient conditions for clients and customers.

Equipment

The cost part is in the business plan, the sign indicates what must be included in the list of equipment at the treatment room for receiving tests.

Staff

The search for personnel must be carried out with special care, since the activities of the entire business depend on their professionalism.

The business plan needs to provide for one courier and two nurses who should work in shifts, as well as a cashier-administrator. Personnel must be selected taking into account their education, experience, and qualifications.

The larger your business, the more employees you will need. If you intend to provide any specific services in the future, you will need to hire additional nurses and doctors.

How should staff work?

Nurses must have a presentable appearance. You should not wear bright makeup; your nails should be short.

Clothes must be clean and ironed. Hair is gathered in a bun under a cap. Shoes should be comfortable and can be washed quickly. Clothes must be changed regularly (or when soiled).

When communicating with colleagues, you need to maintain a businesslike tone in order to maintain a healthy microclimate in the team. Relationships should be friendly, there should be no intrigue.

When communicating with patients, you must be careful and professional. Due to the fact that the nurse directly interacts with the patient, she must be able to support the client, reassure or convince him of the correctness of the decision. Speech must be clear and behavior must be correct.

Obtaining a license for a treatment room

To obtain a license in order to start a business providing services in a treatment room, you need to send an application to the relevant authorities, as well as a number of documents:

• Papers that confirm the registration of a legal entity.
• Constituent documents.
• Conclusions of the sanitary company, fire department.
• A document that confirms that you and your staff have a license to provide medical activities.
• Receipt for payment of state duty.

Services

In the treatment room, a number of manipulations are carried out, and intravenous injections are also administered. Besides:

• Prepare and collect the intravenous injection.
• Blood is drawn for subsequent biochemical testing.
• The client's blood type is determined.
• A blood transfusion is performed.
• A puncture of the cavity is performed.
• The systems are prepared and installed.

In a room designed for intramuscular injections, agents are administered intramuscularly and subcutaneously. For invasive manipulations, work is carried out that violates the integrity of tissues and blood vessels.

Franchising is the solution to all problems

Getting a franchise to operate is a pretty good deal. With the help of a franchise you can solve many problems (advertising costs, etc.).

For the first time, the Invitro franchise was sold in 2005. Today, this company has more than 800 regional offices throughout the country and the CIS countries. We also have our own laboratories.

first provided its franchise in 2010. Despite strong competition with Invitro, it quickly won its place in the market.

Neither Hemotest nor Invitro have requirements for partners regarding medical education. These companies, on the contrary, provide quite good support to their partners, both in advertising and in cost calculations. Companies create special places for a medical administrator who supervises the partner in terms of medical issues, as well as a manager who helps with the economic side of the work.

Searching for initial investments is not included in the work of franchising, "Invitro"). Assistance is provided only in accounting and legal support.

Franchise cost

The franchise price for both companies is different.

To enter the market with Gemotest you will need about 50,000 rubles (for a city with a population of less than 50,000 people), and for a city with a population of 500,000 or more people - about 250,000 rubles.

The minimum threshold for Invitro is an amount of 300,000 rubles, for opening an office in Moscow - up to 700,000 rubles.

The contract with Invitro is concluded for three years, and with Gemotest for 5 years. The fee is paid once at the time of signing the contract. Royalty in the first case is 28,000 rubles per month, and in the second: 1.18% of the initial turnover, then 2.3%.

Each of the companies works together with partners, helping them in carrying out their activities.

Invitro has serious requirements for the premises. It needs to be located “on the first line”. The activities of each company are quite regulated, from the appearance of the staff to the design of signs.

Franchise Economics

Both companies have three important elements that make up their revenue:

• Obtaining biomaterial.
• Agent's commission.
• Additional services (ultrasound diagnostics, ECG, specialist appointments).

In both organizations, you need to additionally pay for the first point; these amounts remain in the franchisee’s account. Visitors must additionally pay for laboratory tests. The franchisee takes the money for himself, but at the beginning of the month he transfers a large amount to the account of the parent organization. The size of the agency agreement at Invitro is no more than 35% of revenue (Moscow), 40% for regions.

In Hemotest it depends on the growth of the franchisee’s revenue (50% for research worth less than 100,000 rubles, 36% for 1,300,000 rubles).

The amount of additional services varies between 5-10%.

These companies provide significant assistance to their partners in finding clients. This includes conversations with doctors, advertising campaigns on the Internet and mass media.

Average business return values ​​depend on the location of the franchisee. In Moscow the period is longer, since almost everywhere there are already several offices of both companies. It will take at least two years to pay back the money invested.

Treatment room financial plan

To organize a treatment room for collecting tests, we do not need large investments. The authorized capital can be no more than 2 million rubles; for a business in the medical niche this is a small amount.

Monthly costs will also be relatively small.

The net profit of such a business, as statistics show, unfortunately, is not so great. In the best case, the profit will be 80,000 rubles per month, in the worst case, 10,000 rubles. The payback period in this case is approximately 12 months.

It may not be the most profitable business, but it will have a long life nonetheless. There is only one option to increase profits - marketing, or initially you need to look for a good passable place.

Monthly expenses

Every month you will have to pay contributions to the Health Insurance Fund and the Pension Fund. Their value depends on the minimum wage. A single tax will need to be paid quarterly, while a declaration under the simplified tax system is submitted once a year. You can calculate the tax amount and fill out the declaration yourself or hire an accountant for these purposes.

You will also have to make payments to DIZO for rent. These are only mandatory government contributions. In reality, the costs will, of course, be much higher. These should include staff salaries (if any), costs for repairs and maintenance of equipment, costs for the purchase of consumables (medicines, drugs), payment for security services, communications, advertising costs, utility bills, and so on.

We hope that from the article you learned all the necessary information on how to open a private medical office. Good luck in your endeavors!

Laboratory and treatment room

A laboratory is an institution in which specialists analyze collected biomaterials. The treatment room directly collects and sends material for analysis.

If you decide to create a full-fledged laboratory, you will need a large level of initial capital. At the same time, opening a treatment room will be cheaper.

Scaling a laboratory is much easier in the monetary format, since in order to increase profits there is no need to purchase equipment or rent premises. The work will require treatment rooms that will cooperate with you.

At that time, scaling a treatment room is much more difficult because in order to increase profits you need to open new rooms, which entails the formation of risks in attracting additional clients to new places.

The choice in favor of one business or another depends on the initial capital and the goals you are pursuing.