Tuesday, September 29, 2009

Rethinking My Professional Life

It's time for me to sign a new lease for my office, and I'm not happy with the terms the landlord wants. Add to that how poorly the building is maintained and that the first floor retail space is probably one-third empty, and I'm thinking of relocating.

I've found a found place to go, but it's way too big....I'll need to find some other folks to share with me. And this has me thinking: do I simply want to relocate my practice as is, or do I want to form some type of cohesive group with a shared mission.

So as I think about the office layout with the freedom to create what I want, let me ask for your help. What's important in a psychiatrist's office? What colors do you like? What makes you love a physical space and what makes you hate it?

And if you're in a group or see someone in a group: what makes it works and what really doesn't work.


moviedoc said...

It's the people more than the space. My lease partner is a CBT psychologist; my office mgr has been with me for 22 yrs. We sublet a third office. No expectations of sharing patients. What I like about the space: the kitchen, office mgr's area, and wooded setting. My office has seating for me, a court reporter and 2 attorneys. And my dog.

Dinah said...

You bring your dog to work? Wow!
Mine have too much energy. But what an entertaining thought.

Sunny CA said...

I like my psychiatrist's office. Warm, cozy, old-fashioned. It's on the second floor in an old building with character which houses a gourmet restaurant on the first floor. It's in an area of yuppie independent shops such as a Mission-style oak furniture store, a specialty bookstore, gourmet grocery, bakery, coffee shop, etc. on the street nearby. Turn the corner and go up the side streets to find Craftsman era large homes that start in the millions of dollars or they did before the prices fell.

My psychiatrist has a office he decorated himself with antiques, and homey stuffed chairs, carpet on the floor, and fine art on the walls. He has told me that the furniture and art were once pieces he used at home and the place has a very warm, homey, welcoming feel. I like it much better than something that looks modern and cold like a dentist's office or lawyer's office. There's a small waiting room which is crowded with 3, but rarely has more than 1 or 2. There are 2 other offices that independent mental health counselors occupy. There's no receptionist. The other 2 therapists have buzzers and my psychiatrist just comes out when he's ready and otherwise the door is shut. My psychiatrist works M-W-Th-F and sublets the space on the other days. I think that one or 2 of the days he's there, he comes in at 7am and leaves at 3pm or 4pm and the other tenant, a psychologist comes after he leaves. Since the waiting room has similar furniture and I have come into the waiting room to find him vacuuming, I suspect he may own the building or perhaps he rented the entire space then sublet to all the therapists, but I have never asked. I love the homey feel. He has a nice reading lamp for reading between clients. There is an old bookcase with doors which hide the contents and artifacts from travels or historic pieces on table tops. There are many-paned windows and a little sun porch has a small desk.

Dinah said...

Sunny Ca: if your shrink's office overlooks the ocean, this is definitely the space I want! Please tell your psychiatrist I will be arriving on Thursday and I'm happy to work around his hours. Antiques, art, and overstuffed chairs...oh my!
Does he have room for my ottoman from Target, my Ikea furniture, and my consignment store lamps?
Sadly, even the wonderful new space is in a modern professional building (no dentists) with a great view of the light rail tracks...sigh.

Anonymous said...

I hate my psychiatrists office. It has big, stiff oversized black leather furntiture, it's too dark in there, the carpet is worn and it's the opposite of cozy. But, I adore my psych. He's the best I've ever worked with (and I have a 20 year history of mental illness.) He's kind, caring and makes me laugh often on even my darkest days. When I walk into that room, nothing else matters because it's all about our good working relationship. I tease him about his "manly" furntiture but I really don't care.

I used to have a therapist with the coziest office with antique furnishings, cozy pillows and it always smelled so good. But in the end, she wasn't able to help me. It felt so comfortable, as did she as she was such a nurturing type. I probably stayed longer then I should have. I'm with a new therapist, and I hate her office. Again, ugly furntiture, battered carpet. Waiting room is hideous. But it's not the furnishings that matter, it's the quality of the therapist. A lesson I've learned well.

(That said, some cozy pillows sure would be nice!)

Anonymous said...

You can never go wrong with the warm, earthy tones. They all match each other and most people like them.
Stay away from the hard, officey chairs...hard to relax in and their are awful!
If you are in a modern building, what a welcome surprise a warm comfy, yet sophisticated office would be.
Use those consignment lamps all over the office, they help with the cozy feel.
Things for people to look at, for those times that eye contact is hard. Looking at their degrees or the spine of their reference books, gets old.
A clock that can be seen by the client is nice. Most are concerned about the time too.

Anonymous said...

Location is more important than aesthetics to me. Of course, above all is the quality of the psychiatrist. Since I have a good one, I would go to a hovel for my appointments as long as it was easily accessible. Because I didn't have any previous experience in therapy, I chose her primarily because she was on my insurance plan and was close to my office. I lucked out and she's great. Her office isn't that "cozy" but that's not really what matters. However, I have to agree with what another anon that mentioned having something to look at when you don't want to make eye contact. My pdoc's offic has a side window between, with a lovely view of another building, but at least it's something. I would also like to see the clock. It's frustrating if I'm in the middle of something and she says, "Times up". If I knew we were approaching the time, I might get to the point faster or reword things.

Sunny CA said...

Ha ha ha, Dinah! No view of the ocean, that's for sure!! The ocean is about 20 miles away. A block away are BART tracks and a BART station (Bay Area Rapid Transit) which is actually helpful for arrival of patients with no car but does nothing for the ambiance so I guess that is equivalent to your light rail and probably intentional on my pdoc's part. That may be a good feature of the space you have in mind. I am lazy so I drive, but location is an issue to think about. Is there public transportation? If you rent a space that's too large will you spend more time keeping the rest of the place rented than you'd like? Can you afford the space if you do not rent out the excess space? If you do not rent to other pdocs, who would be appropriate? Do you have specific people in mind?

My gynecologist rented out one of her examination rooms to a psychologist. The psychologist does "light" advertising in the lobby with brochures and business cards. It's a great union because the gyn is a female who's especially interested in women's emotions and lives and the gyn schedules a lot more time per patient than the average gyn. The psychologist that she shares with, from the promotional brochures seems in harmony with her philosophies.

Your consignment lamps and Target and Ikea furnishings sound fine as long as the seating is comfortable. Lamps are good. Homey with the right wattage. I really like that the 2 chairs available to clients at my pdoc have high-ish backs so that when I feel emotionally exhausted or drained I can lean my head back. There are also pillows. I always use one for my lower back which makes it so much more comfortable.

Previously (over the course of 30 years living here) I had 2 different MFCC therapists who worked in a room in their home. Those felt similar to my current pdoc though specific furnishings were different. The in home scenario is common here due to high cost of rental space so "homey" pdoc offices that actually are in a home are very common.

Rach said...

My shrink works mainly with kids, so his office definitely reflects that.
That being said, having a comfortable sized waiting room is always important... as is natural light.

moviedoc said...

I think my patients really come to be with my dog. He sets a good example for how to relax.

Ladyk73 said...

I think what is most important is warm colors, Lamps instead of overhead fluorescent lights. Carpeting or rugs instead of industrial business office tile.
I think plants make people comfortable, and a window is really nice. I like to see a bookshelf.

For groups, I find them very annoying unless a specific topic is planned. Maybe skills based are better?

Lisa G said...

I'm not crazy about my psychARNPs office--it's always too cold in there, the couch is hard, no blankie, and she sits there with a computer on her lap, typetypetyping away while I talk. It bugs me. My therapist, on the other hand, has a great office. Soft, cushy couches and chairs, a lap blanket to put on your lap (makes me feel safe), and cushy pillows to hold or lean up against. It always smells good in there, and there's soft lighting and no desk. She sits on another couch opposite me. It's earth and ocean tones, which I find very calming. No music, but one of those wave machines playing very softly in the background. Things to hold and touch. The waiting room is a bit hard and clinical, but she shares it with others. She has no receptionist, just comes out and gets me when she's ready. There are noise machines in the hall my the door to mask any conversation from the people waiting. Good luck finding your new space!

talesofacrazypsychmajor said...

Clean and well lit are important. I've been in some grungy dark offices. Not so fun. Besides that as long as the chair is comfy I'm good:) Also being able to see the books on the bookshelf is a plus.

Midwife with a Knife said...

I brought my dog to work, and she was only 8 weeks old. :) She was a very very good girl and just hung out and was amused by my staff. We went down to the pediatric cardiology ward and then over to the peds ER to amuse the kids. Everybody loves puppies!!! And she was a REALLY GOOD Girl.... (sorry for the shameless puppy praise)

Catherine said...

I like open spaces, so here are my suggestions:

-- Windows and as much natural lighting as possible, but have blinds to block if it is too much.

-- Uncluttered as far as furniture is concerned.

-- Earthy tones are nice, but be careful. Tans are good, dark browns and greens make the room look smaller.

One more note: If you keep pillows, please make sure you wash them. I don't think that needs and explanation.

Dinah said...

How do you wash pillows?

Catherine said...

Some pillows you can throw into the wash machine (check the label) or spot clean. Others you may have to dry clean occasionally. The best bet though is to use a pillow cover/slip so that you can easily take it on and off for washing.

Sunny CA said...

What are the other patients doing with the pillows that require frequent washing? I put mine behind my lower back. The pillow behind my back does not need washing more often than the chair as a result of my usage. What do the other patients do with them that "does not need an explanation", but that makes them need washing?

Catherine said...

I was not insinuating anything nasty. Do you realize how many sit in that chair / on the couch each day? And how many of these people do not wash their hands and touch the pillows? Or that may put the pillow behind their heads or upper back instead of behind their lower backs? Mold, bacteria, animal dander, and other infestations such as lice can build on pillows just as quickly as other places.

I'm not a germaphobe, but after seeing the results of a science fair project a child at my school did where she swabbed different objects and reported on the different levels of bacteria found, I was astounded. There are some things I cannot look at in the same way again, and that is one of them.

Anonymous said...

Thank you for the opportunity to comment. I agree with the above about cosiness, warm lamps, books, and good furniture set-up. Two comments: 1) please make sure the couch (usually present) is comfortable and has good upholstery so there are no unpleasant shocks if the client sits down without remembering the upholstery is thin and beneath it, it feels like a board.

Also, I agree with the comments about germs and cleanliness. One would never have as many people in one's living room as typically go in and out of a psychiatrist's (or analyst's) office on a daily basis, yet most people take better care of their living rooms. The number of bodies that sit on a couch on a weekly basis, the pillows that aren't cleaned, the upholstery that isn't shampooed--this wouldn't meet basic cleanliness standards anywhere. So why in psychotherapy? Even psychiatrists and analysts do have their own germs, too.

mysadalterego said...

One goofy thing at one shrink's office was this really pronounced difference in the furniture - he was on this tall chair and the patient had this bench thing with cushions. It felt weird. I mean, I understand he sits there all day and the patients come and go, but I hated feeling like this little kid on a school bench being looked down at.

Anonymous said...

Do whatever you like, but don't paint the walls NHS green.

Turbo said...

In my office I have a $2,000 leather sofa and two $99 comfy chairs that I bought from Target as "placeholders" until I had enough money for "nice" chairs. Universally, my clients remark on how much they love the look of the chairs. They rarely mention the sofa.

(I can point you towards those chairs if you like-- they still sell them.)

Dinah said...

Turbo--I'd love a link to comfy chairs.