How to open a private medical office? What you need to open a private medical practice: equipment, documents and SES requirements. How to open a medical office

In Russia, private medical offices began to appear relatively recently. So far, there are a lot of problems with the organization own business in this industry due to imperfect legislation and a number of bureaucratic obstacles.

Nevertheless, a lot of doctors are asking the question of opening their own medical center. To open medical office from scratch, you should have the necessary knowledge and skills.

Registration of activities and obtaining a license

On initial stage you need to collect a package of documents and go through the procedure for registering activities in the authorities state power. Obtaining the status of an entrepreneur involves the payment of a state duty, which is only 800 rubles.

This amount payable in public institution at the registration address of the person indicated in the citizen's passport. Further, the algorithm of actions on how to open a private medical office is standard.

If the entrepreneur is registered in one place, but is going to conduct business not at the place of registration, the registration procedure still takes place at the address indicated in the passport.

An application for registration, a receipt for payment of the state fee, a copy of the passport are submitted to the tax department. The original document proving the identity and place of residence must be with the applicant.

Every doctor who wants to start a private medical practice knows that a license is required to run it. The process of making it is quite complicated. First of all, you will need to find a room, rented or owned, that will meet all the standards and requirements of the sanitary and epidemiological service.

After that, the doctor planning to open a medical office must submit a package of documents to a special licensing authority, which includes:

1. Application for a license.
2. Copies of documents confirming the availability of the premises and its material and technical equipment for conducting medical practice.
3. Permits from the sanitary and epidemiological service and the fire service.
4. Documents confirming the medical education of the doctor, his work experience and qualifications.

An appropriate package of documents for opening a medical office will also be required from hired employees who will be involved in the work and perform the functions of a junior medical staff and service medical equipment.

Important aspects regarding the choice of premises

A private practice room can be arranged as follows:

• Like an addition to a residential building.
• In your own house or apartment located on the ground floor, after transferring the property to a non-residential fund.
• Renting an office medical institution. This option has some good points: availability of a minimum material and technical base and suitable premises, as well as a guaranteed permit from the sanitary and epidemiological surveillance service.

Before opening a medical office, you should study all SES requirements. Depending on the type of medical practice, the room must be of a certain area, it needs to be renovated and there is a connection to the power grid, water supply, and also the sewer system.

Many doctors open offices in the city center, in places of transport interchange, in close proximity to offices and shops, focusing on the large flow of people in these places.

It is also necessary to solve the issues of garbage collection and planned disinfection of the premises. After passing checks for compliance of the premises with all requirements, the entrepreneur receives a conclusion and permission to conduct private medical practice, which must be notarized.

Additionally, permission from the fire department is required. It is issued on the condition that an alarm system is installed in the room, it will be equipped with anti- fire safety. To do this, you will need to spend another 8,000 rubles.

In addition, the medical office must be equipped with an evacuation plan in case of fire, and its employees must be familiar with fire safety rules.

Medical office equipment and staff

Scroll necessary equipment varies depending on the chosen field of medical activity.

Each office must be equipped with:

1. Washstands with running water;
2. Couch, chairs, cabinets and cabinets for documents, medicines and tools;
3. means of disinfection;
4. Clean towels, bathrobes.

This list will require investments in the amount of about 300 thousand rubles. The cost of the necessary medical equipment for the office varies from 5 to 15 thousand dollars.

Most large sums it is necessary to invest in the equipment of the dental, gynecological, and ultrasound rooms. It is cheaper to open a massage room, the cost of investments will be about 400 thousand rubles.

The main worker in the medical office is a doctor. He must be qualified and experienced. Also among the necessary staff is a nurse, administrator, accountant. It is necessary to allocate up to 200 thousand rubles a month for the remuneration of all personnel.

Profitability of the medical office

The organization and opening of your own medical practice will require significant investments. Starting capital is 15-25 thousand dollars. Monthly expenses for renting space, wages and disinfection of the premises will be about $5,000.

The effort will not pay off immediately. It will take several years, during which the authority of the cabinet and the doctor will be developed, the number of patients will increase.

Considering that daily medical consultation If 10 people apply, you can calculate the approximate net profit of the office, which will be about 3 thousand dollars - this is how much you can earn in the first months of work.

Profitability depends on the number of patients, experience, qualifications and authority of the doctor. All this will become the guarantor of successful medical practice.

photo from lb-f.ru

The need for qualified medical services oh there is always. In Russia, the number of private medical and beauty parlors is increasing, many doctors prefer their own business and individual practice to the bureaucracy of public hospitals.

The most promising are medical offices working in the field of dentistry, gynecology, urology, cosmetology, plastic surgery, radiation studies(ultrasound, x-ray,).

The process of opening a medical office includes several stages.

1. Search for premises - for example, renting an office in medical institution or office building.

2. Design entrepreneurial activity in the Federal Tax Service with a certificate (issued within five days). Activity code 85.1 ( medical practice). At the same time, you need to submit an application on the method of calculating taxes (clause 3).

3. Choice of taxation method. Accounting for the work of medical organizations is carried out according to a simplified scheme. Two options are possible: 15% from the difference between income and expenses, or 6% from income. In the second case, you do not need to conduct a rigorous calculation of costs, and such a scheme is usually more profitable. An application for choosing a simplified taxation system must be written and submitted immediately, when registering a business.

4. Registration with the Pension Fund and the Regional Statistics Committee.

5. Licensing of medical activities - list required documents provides the relevant department of the regional Ministry of Health, and most of them are possible only if there is a lease agreement for the premises. According to reviews, from the main documentation it is most difficult to get permission from the Sanitary and Epidemiological Supervision - it is faster and easier to apply not to government agency, but to an authorized commercial structure. After collecting all the documents, a fee is paid, the licensing organization appoints an expert.

An approximate set of additional documents that an expert may require (depends on the profile of the office, staff and services provided):

• purchase and service agreements medical equipment;
• contract for the performance of work by third parties medical organizations(for example, laboratories);
• log of checks by specialists of the dispensation;
• an agreement with a specialized medical institution or clinic for the provision of emergency assistance with complications;
• documents on the education of doctors, assistants and assistants who will work in the office.

If the check ended successfully, the permit is issued within a month. From the very beginning, the procedure can be simplified by contacting a specialized company, ordering document verification or turnkey licensing. Re-licensing is carried out after five years.

After obtaining permission, it is necessary to acquire a book of accounting for income and expenses (need to be registered with the Federal Tax Service), strict reporting forms and a journal of desk audits.

For employees, you will have to pay contributions and submit annual reports to social funds (pension, social and health insurance), lead work books. On average, the payback period for a private medical office is 1.5–2 years.

* Calculations use average data for Russia

500 000 ₽

Minimum starting capital

Up to 2 years

Payback

20%

Profitability

Many doctors who work in public institutions sooner or later think about the possibility of opening their own private office. Private medical practice is a relatively new phenomenon in our country. Although the opportunity to open their own offices has appeared not so long ago, more and more doctors are entering private practice.

What do you need to open a medical office?

If previously obtaining various permits was associated with various problems(mostly of a bureaucratic nature), now the procedure for their registration has been significantly simplified. However, to open a private medical office, considerable investments are required, and not all doctors who want to work for themselves are ready for this.

This type of business has another, very significant drawback: with relatively large investments, the payback period for a private office is at least two years. Not all doctors have the opportunity to wait that long. However, the increase in the number of private offices suggests that such a medical practice can still be a profitable venture, especially in the long term. Sooner or later, any specialist working in a foreign company reaches the "ceiling". In the case of your own business, the options for development are practically unlimited.

So, let's consider in more detail the procedure for opening a private medical office. First of all, you need to choose a suitable room for its location. Well, if such a room will be in your property. Someone even uses their house or apartment (or a separate part of it) for an office. However, in order to open an office in an apartment, it must be transferred to a non-residential fund. It goes without saying that this apartment should be located on the ground floor of an apartment building. To transfer it to a non-residential fund, you will need to obtain the consent of all the residents of your house. In principle, the process of collecting signatures is not difficult. But, firstly, it takes too much time (you will have to go around the apartments more than once to find all the owners of the house), and, secondly, it is likely that some tenants simply will not agree to put their signatures (especially those whose apartments adjacent to yours).

Another option is to rent a separate office (preferably one that matches your specialty) in a medical facility - more convenient, and in some cases much more profitable. In this case, you will have much less problems with various regulatory bodies. In addition, you will have to spend less on advertising, because your potential customers will come to you themselves. Especially this option is convenient for dental offices. But experts advise pediatricians to look for separate room. Many parents come to the children's polyclinic solely to obtain the necessary certificates and do not want to visit it again because of fears that the child may become infected there from other children.

To rent an office in a medical institution, it is necessary to conclude a lease agreement with the DIZO of the city administration. This will take about four to five weeks. When drawing up documents, it is recommended to indicate the exact schedule of your work: days and times, in otherwise you will pay rent for 24 hours a day, and this can result in a round sum in the end.

How to register a medical office

To run your own private practice, you need to register as an individual entrepreneur. This can be done independently or you can turn to the services of numerous intermediary firms. As an economic activity code (OKVED), you will need to select "medical practice" (85.1). It will take no more than a week to complete the documents. As a result, the regional Federal Tax Service will issue you a certificate of registration. Choose the tax regime that suits you in advance.

The fact is that if you do not apply for the choice of tax regime, then by default you will work according to the general regime, which is completely unprofitable. You can go broke on taxes and paying for an accountant. For medical practice, a simplified taxation system is suitable, which is a special type of tax regime for small businesses with a simpler system of maintenance. accounting. Article 346.20 of the Tax Code of the Russian Federation establishes the following tax rates for a single tax:
6% if income is taxed;

15% if the object of taxation is income minus expenses. From January 1, 2009, differentiated tax rates ranging from 5 to 15% depending on the categories of taxpayers may be established in individual constituent entities of the Russian Federation.

The second option is less convenient, since in this case it is necessary to keep a complex record of all expenses. Unfortunately, not all expenses can be documented - with the help of checks and receipts. Please note: an application for the simplified tax system must be submitted simultaneously with the registration of an individual entrepreneur. After receiving the certificate, you will also need to register with the Pension Fund as an entrepreneur and register with the Regional Statistics Committee.

What permits are needed to open a medical office

For medical practice, you will need special license. You can deal with its design as soon as you have a lease agreement in your hands. The exact list of required documents for obtaining a license can be found in the licensing department of the regional Ministry of Health.

It may include the following documents:

an application for a prescribed form of license,

copies of certified and bound constituent documents with the seals of the license applicant (for a legal entity),

a copy of the certificate of registration of legal entities ah in Single register state legal entities,

copy of certificate of state registration applicant for a license as an individual entrepreneur,

a copy of the certificate of registration of the license applicant for tax registration with the tax authorities,

a copy of the conclusion of Sanepidnadzor on the compliance of the work performed and the services provided sanitary rules,

copies of all documents that confirm the qualifications of an individual entrepreneur or employees of a legal entity,

receipts for the payment of license fees for consideration by the licensing authorities of an application for a license,

power of attorney for the right to represent the interests of the license applicant (with the participation of intermediaries).

In addition, you will need to submit documents for the premises (document of ownership or lease agreement), documents that confirm the existence of organizational and technical conditions, as well as logistical equipment (equipment, tools, vehicles, etc.), documents confirming the availability and maintenance of fire protection equipment (fire extinguishing and fire alarm) in working order, documents confirming the presence in your staff of employees with at least five years of experience (for legal entities), documents confirming the presence of an average or higher medical education and at least two years of work experience in the licensed activity (for individual entrepreneurs), documents that confirm the fact of advanced training at least once every five years for employees of legal entities and individual entrepreneurs operating in the field of medicine.

Ready-made ideas for your business

The exact list of required documents depends on many factors, including the availability of special equipment, the specifics of your activity, etc.

In practice, the most difficult thing from this list is to get the conclusion of Sanepidnadzor. Getting this conclusion on your own takes a lot of time and effort. Therefore, experts advise to turn to the services of intermediary firms. In this case, the conclusion will cost more, but the difference in price is compensated by the saved time and nerves. The services of intermediary firms will cost from 7 thousand rubles (checking all documents submitted for obtaining a license) and from 35 thousand rubles for issuing the license itself. The license will have to be obtained every five years.

In addition to the license itself, the execution of which takes the most time, you will need to purchase and register with the tax “Income and Expenditure Accounting Book”, “Strict Accounting Forms Accounting Book”, the strict reporting forms themselves, the “Campular Audit Book”, keep various journals, including a fire safety magazine, etc.

When you start working, you will have to regularly make mandatory contributions to Pension Fund RF and to the Medical Insurance Fund (the amount of payments depends on the size of the minimum wage). Keep in mind that if you plan to hire employees, then you will also have to pay contributions to the Pension Fund, Health Insurance Fund, Social Insurance Fund

How to choose a place for a medical office

So, the main issues that you will have to solve when opening your own medical office are choosing its location, obtaining the necessary documents and licenses, and promoting your services. When choosing a place, experts advise to carefully analyze the situation with competitors.

Moreover, since people usually approach the choice of a doctor very responsibly, when analyzing the level of competition, it is not necessary to take into account only the area where you plan to open an office. Of course, you should not open the third dental office on the same street, but good specialist, trustworthy, customers are ready to travel to the other end of the city. On the other hand, experienced entrepreneurs recommend renting office space in a residential area with new buildings and cottages. The more expensive and “luxurious” housing in the area, the better.

You can study competitors not only “live”, but also according to reviews of certain doctors on the Internet in local forums. By the way, you can also offer your services and advertise there. It is highly desirable to monitor reviews about your work on the Internet, because the number of your customers directly depends on this. Don't forget about traditional methods promotion - distribution of leaflets, placement of advertisements in print media, placement of outdoor advertising.

Ready-made ideas for your business

If you are renting space outside of a municipal health facility and are self-employed without hired employees, then consider whether it is worth spending money on making a large sign. Most likely, you will not sit all the time in the office, and your potential customers, attracted by the sign, may not find you in place, which will not best impression. You can limit yourself to a sign on the door with a reception schedule and a phone number for an appointment.

Among other things, you will also have to deal with accounting and management, reception of visitors and promotion. It will not be easy to deal with all this alone. It is desirable that you have at least one assistant from the very beginning, albeit without a medical education, but with good organizational and entrepreneurial skills, who will deal with administrative problems.

The opening of a private medical office will require from 500 thousand rubles. The exact amount depends on your specialty, the need to purchase (and cost) of special equipment, the number of employees and other factors. The payback period of such a business is from two years.

180 people are studying this business today.

For 30 days this business was interested in 83208 times.

Profitability calculator for this business

rent + salaries + public utilities and so on. rub.

To open private dentistry will require from 3 million rubles. Monthly expenses - 370 thousand rubles. A successful dental clinic pays off in 3 years.

The total cost of the equipment is 7 million 570 thousand rubles ≈ 7 million 600 thousand. The main source of income is, of course, treatment and its support, and, of course, IVF itself.

The average amount required to open your own office or class is from 150 thousand rubles, excluding organizational costs. This amount can be an order of magnitude more if you ...

Private medical offices in the domestic market of medical services appeared relatively recently. A few years ago, it was almost impossible to open your own office due to the huge paperwork that accompanied the main activity. To date, all work on the preparation of the necessary documentation can be entrusted to organizations specializing in providing legal assistance. The last barriers to opening your own medical office are large financial investments, as well as a relatively long payback period.

Which direction to choose

Medical office is more conventional concept, which, as a rule, refers to a separate room that is part of the structure of a medical institution. In such offices it can be quite wide range services ranging from diagnosis to, for example, treatment or rehabilitation of injured people. Typically, medical offices by type of assistance are divided into:

• medical offices where direct assistance is provided
• auxiliary rooms where the patient undergoes various examinations.

Among all areas of paid medicine, the most profitable at present are:

• gynecology;
• dentistry;
• plastic surgery;
• medical cosmetology;
• urology;
• ophthalmology.

Medical office space

As a rule, rented space in a medical institution is used as a room for a medical office. In this case, there are no problems with sanitary and epidemiological supervision. Much less common are medical offices organized in residential buildings. In some cases, such a choice is really justified, for example, if the location of the apartment is convenient, and the main target audience of the medical office is the residents of the house.

Staff

To organize the work of a medical office, you need:

• 2 nurses;
• 2 doctors;
• accountant;
• administrator;

As a rule, one doctor should work with one nurse, but at present it is quite difficult to find nurses, so it is often practiced to work with one nurse with two doctors. Of course, in this case, failures in the work of the office are possible.

It is worth noting that the responsibility for accounting and timely reporting can be assigned to companies specializing in such.

A rather subtle point is the salary of a doctor. IN Lately The most widespread practice is that the salary of a doctor consists of two parts:

1. minimal wage in the region;
2. 10-30 percent of the cost of services rendered.

Equipment

The most expensive part of organizing a medical office is the purchase of the necessary equipment. It should be noted that the spread of prices in Russia is extremely large and depends, in fact, only on financial capabilities. To purchase the necessary equipment, it is best to contact a specialist. As a rule, the cost of the services of such a manager is up to 15% of the equipment price, which is offset by a discount provided by the equipment seller. average cost equipment for one type of activity ranges from 15-25 thousand dollars.

Required investment and profitability

The required investment for opening a highly specialized medical office ranges from $25,000 to $60,000. It is worth noting that to open a multidisciplinary office, you will have to spend at least 100 thousand dollars.

The profitability of the office, ultimately, depends on its attendance. It is difficult to give exact numbers, since the number of clients depends heavily on the professionalism of the doctor and the chosen location. According to statistics, a small medical office with an average workload really pays for itself in 1-2 years.

It can take at least one year to collect all the documents and permits, so be prepared for some serious work. After preparing the papers and submitting the application, it is necessary to wait for a decision within a few months. At the same time, please note that a license is also required for the issuance of hospital cards. The total cost of registration is from 50,000 rubles. Medical center equipment. What to buy? One of the main items of expenditure is the purchase of the necessary equipment. This is the case when saving will only be to the detriment. When choosing, focus on product quality, warranty and service availability. Do not take everything in a row - buy only the equipment that you need to work in the direction.

How to open a private medical office from scratch

If you go to the state branch of this department, then, firstly, it will be long, and secondly, everything will be very strict and complicated. Therefore, it is more expedient to contact a commercial firm of this profile. Pay a little more, but they will do everything faster and much easier ... At the last licensing (and this must be done every five years), the services of such a company cost me about 11-12 thousand rubles.
rubles (but this is an acquaintance). In general, licensing is now becoming a chore. The order is this:

• They collected the documents, paid the fee (300-400 rubles), passed it.
• They check and offer to wait for the visit of an expert to your office. We need to bring an expert by car (and then deliver it to the Ministry of Health).
• The expert will make his opinion, most likely, will say what additional documents need to be collected.

How to open a private medical office

Find a place to rent I know two doctors who used their apartment (or part of it) for their office, transferring it to a non-residential fund. But now the rules for transferring an apartment to a non-residential fund have become more complicated: the consent of all (!) Residents of an apartment building is required. It is much easier to rent an office in a medical institution.

Important

Moreover, best option– office according to your specialty profile; there will be less hassle with sanitary and epidemiological supervision. That's exactly what I did. In this case, it is necessary to deal with the conclusion of a lease agreement with the DIZO of the city administration; it will take about a month. When preparing documents, it is important to note in the schedule that you will work a certain time per week.

Own business: how to open a medical office

Costs and Profits Starting investments in documentation, premises and equipment start at $13,000 and can reach $20,000-25,000. Monthly expenses (rent, salary, disinfection and disinfestation) - about $ 5,000. Such a business will not pay off immediately. It may take a year or two to develop a client base and reputation.

But even with an average attendance of 10-15 people a day, you can count on 3-5 thousand dollars net profit per month. And the net income of a successful medical office can reach 10 thousand dollars a month. In order to start such a business from scratch, you will need considerable endurance and patience.
But it is not for nothing that the field of medicine is considered so profitable. After a few years, you can start expanding your business and earn decent amounts by helping people.

Attention

As a rule, the medical center should have the following equipment - analytical instruments, weighing equipment, devices for measuring physical parameters, special furniture for patient treatment, laboratory furniture and cabinets. If your center has a laboratory, then you cannot do without magnetic hangers, a centrifuge, a microscope, a water bath, drying cabinets, thermostats, hot plates, shakers, stirrers, muffle furnaces and other specialized equipment. The total cost of purchasing equipment can result in an amount of 3-4 million limit.

How to open a medical office from scratch, where to start

It is important to choose the code of economic activity (OKVED) - "medical practice" (85.1). 3. The choice of taxation regime (important!) But it is equally important to immediately decide on the taxation regime. It is impossible for an ordinary doctor to work according to the general regime (which is determined by default): you will have to pay a bunch of taxes and keep complex accounting.
For medical activities, a simplified taxation system (STS) is allowed. It is divided into two modes:

• "income minus expenses" - a rate of 15% (now, depending on the region, the rate ranges from 5% to 15%) and
• "income" - a rate of 6%.

The first option involves a complex accounting of all expenses. All checks and receipts must be kept and accounted for. This is almost impossible, since, in practice, not all expenses can be documented.
Usually doctors choose "income".

Opening of a medical office. what documents are needed?

Are you real or not); it is more convenient to pay quarterly installments

• The “single tax in connection with the application of the simplified tax system” must also be paid quarterly, and a declaration on the simplified tax system must be submitted once a year. You calculate the tax and fill in the Declaration yourself, or you hire an accountant; It's not hard to learn on your own.
• You will also pay rent at DIZO. True, now this moment is simplified: you can pay at the clinic and renew the contract (annually) too.
The nuances of the work of the medical office Nuance number 1 If you have hired employees, then from an ordinary individual entrepreneur, you turn into an individual entrepreneur.


And immediately increases both responsibility and the number of cases that you have to deal with.

How to open a private medical office?

Imagine only indicative prices. Surely, you want your services to be in demand among the population, and for this you need to provide people with quality care, which, in turn, requires the use of medical equipment from serious manufacturers working according to Western standards. Modern equipment is very expensive. ultrasonic machine will cost you at least 5 million rubles, diagnostic devices cost between 300 thousand and two million rubles, prices for dental units range from 450 thousand to 2.5 million rubles. Obtaining a sanitary-epidemiological conclusion To obtain such a conclusion, Rospotrebnadzor will need to provide documents confirming the ownership of the premises in which the doctor's office is located, or a lease agreement, as well as tax certificates and medical books.

How to open a private medical office

You can apply for a license yourself or use the services of a company that will help in obtaining it. Before obtaining a license, an expert visits the premises of the office to inspect and issue the requirements for additional documents that need to be collected. Further, the issue is submitted to the commission of the Ministry of Health. In case of a positive decision, a fee of 1000 rubles is paid, a license is obtained and the office can start working. 4. Reporting and registration documents. Equipment

• Expenditure journal registered with the tax office
• Forms of strict reporting and a journal of their accounting
• Book of cameral checks
• Fire Safety Journal
• Depending on the profile of the medical office, the appropriate basic and auxiliary equipment is purchased

Opening a medical center from scratch

These should include the salaries of personnel (if any), the cost of repair and maintenance of equipment, the cost of purchasing Supplies (medical supplies, drugs), payment for security services, communications, advertising costs, utility bills, and so on. We hope that from the article you have learned all necessary information about how to open a private medical office. Good luck in your endeavors!

• 30.03.2014