Planning for the Non-Planners

Edition: November 2002 - Vol 10 Number 11
Article#: 1359
Author:  Wayne Care

Despite decades of evidence, physicians still do not realize that they are businesses and they need to behave as such. They continue to think set-ups can be done overnight.

Of course, every one of us knows better. We have been there and done that, and gotten multiple T-shirts! Rush set-ups are a train wreck waiting to happen. Proper set-ups take long hours, planning, sweating, follow up and most of all, prompt decisions. Talk to your physicians about lead times from Day 1. Stay on top of them, no matter how much pestering it seems. You need answers to get it done right.

Some questions to ask from the beginning:

· Who is making the color selections? (Doctor, spouse, designer, etc?) If it is not the physician, then meet the final decision-maker right away and preach about the lead times required.

· How is the project being financed? Get the credit information and see that it is processed.

· When you put together the list of what is included and get something signed, leave a copy with the physician. Make sure that it includes the color selections. There is nothing worse than moving in furniture, only to have the physician decide that all the colors look wrong and expect you to fix it overnight.

· Make sure that all responsibilities and services are established and worked out up front. For example, is your company going to provide design services, office files, carpets, etc.?

· Dwell on and repeat lead times for set-ups.

· For repeat set-ups (for example, when multiple offices are planned), make a unique set-up book that includes all of the pertinent information.

· Make sure you know everything that the physician may want to do in the office – lab work, diagnostics, etc. -- so that you at least have a shot at the products that you sell.

· Ask questions and listen, and ask again if you are not sure of the answer. And when you are sure, repeat back the answer and get acknowledgement. (Midmark’s LAPR, Listen, acknowledge, probe, respond)

The Set-Up Book

Bring your own set-up book with you to the very first meeting with the physician or physician’s designee for planning. Limit the selections in your book and have loose literature available to leave behind on the key items. If the customer cannot find something they like in those pages, bring in other options for him or her. If you make too many choices available, decisions will inevitably be delayed.

Because of the high quality of both copiers and scanners, create your own book and put multiple items – especially smaller ones -- on a single page. Make sure that all of the color charts are current. One way to divide your book is by category:

· Exam/Treatment Room (s).

· Laboratory.

· Diagnostic Equipment.

· Emergency/Compliance/Other.

If you have pictures of other offices you have done, use them to supplement this material. You may also wish to list some satisfied customers who have agreed to give references.

Have your checklists with you so that you can fill in quantities as you review the pages. (To see what might typically fall into each category and how to prepare your checklists, see “Set-ups or Upsets?”, Repertoire, November 2001.)

In streamlining the set-up book, stick to the brands and products that your company supports the most. Here are some ideas on pages to create.

· Sphygmomanometer: Since mercury is certainly losing its cachet due to safety, show aneroid sphygmomanometers (a wall unit and hand unit).

· Stools: Show pneumatic, regular exam stool, and lab stool with a back,

· Sundry jars: Show a standard set of five unlabelled sundry jars, and mention they can be bought singly and labeled, if it comes up.

· Scales: Show the routine adult scale, a digital, a sliding weight baby scale and a digital.

· Otoscope/Ophthalmascope: Show the wall unit with accessories, the desk unit, and a portable set with case.

· Step-on trash cans: Show one model and explain in the notes on the page or verbally that other sizes are available.

· Lamps: Show minor surgical lamp, an upscale exam lamp, a gooseneck.

When there are options, show the customer the most complete model and explain they can get less.

With such a book, you will find that moving the physician toward making a decision is less cumbersome, more organized and easier. Without a book, you are carrying literature, catalogues and scraps of paper, and fumbling through them. This book proves you are the expert.

In addition to the set-up book, have an instrument catalogue, so the physician can point out which instrument patterns he or she likes. Include information on leasing or other financing, in case that is an option the physician wants to explore.


When a physician splits from another practice, negotiations regarding set-ups usually require both discretion and shorter lead times. This is where the set-up book really helps. If you stock a particular color table, this is the time to suggest that they look at that color. If the physician is still working in the practice and trying to open his or her office on the q.t., they will generally be hard to reach. Nailing down decisions quickly becomes even more important.

The keynotes here are discretion and speed. Discretion is even more important if the physician is leaving one of your current customers.

The Mini Set-Up

A mini set-up is one in which an office is growing, or which is adding a physician. Most times, the physical plant is already known, as are patient flow, color schemes, the location of the reception and billing areas, etc. These are usually the easiest set-ups, but keep in mind that you still need to be alert to any dramatic changes in patient flow, which might affect their efficiency. Watch for the small errors that occur when people think they are merely duplicating previous space and lose sight of the details. Some questions to ask:

· Are the rooms rotated between all physicians, or are they specific to single physicians?

· If they are specific to one physician, does that doc make the decisions on what he or she wants?

· Will additional diagnostic or laboratory equipment be involved?

Final Step: Stocking the rooms

At least three weeks before the set-up date, make sure that the physician has signed off on the opening disposable inventory. The requirements of each practice vary. Some physicians use cloth gowns and drapes and a linen service, while others prefer disposable products. I have not included sizes in the following list, but your final list should. Again limit and advise on choices. How many sizes of plaster are really necessary for what will be temporary? How many sizes of syringe does the physician really need? The accompanying list is a good starting point.

Like so much of life, a good set-up is all about good planning. Limiting choices is not a bad thing; it allows focus. The more prepared you are, the easier you make it for the buyer to make decisions on a timely basis. The faster the decisions, the greater the lead-time. May all of your set-ups be on time, undamaged and profitable!

10 Rules for Successful Set-ups

1. Check and double check the set-up list. If you think an item is essential to the type of practice you're dealing with, ask the physician more than once to be sure he or she does not want it.

2. Give the physician a complete list of items for approval, including colors where necessary.

3. Ensure there is adequate lead-time of items for decision-making and ordering.

4. Make sure the financing is arranged and approved in advance.

5. Handhold the customer throughout the process. Reconfirm any doubtful items.

6. Follow up. Make sure everything is on order and on schedule.

7. Keep the customer informed of the progress and your follow-up procedures.

8. Tell the physician about any expected delays as soon as possible.

9. Ensure that delivery means and times are set in advance.

10. Be there on delivery day to ensure a smooth installation and to handle any last minute glitches.

---Reprinted from Set-ups or Upsets? Repertoire, November 2001

Wise Words About Lead Times

More time is better and less time is worse.

· Optimal: 8-12 weeks.

· Adequate: 6-8 weeks.

· Cutting close: 4-6 weeks.

· Recipe for disaster: 4 weeks or less.