tractor contract. The more com-

fund any project are contingent

operating costs to run the build-

prehensive and complete the con-

upon the scope of the project as

ing. In the case of rental space, it

tract documents are, the better

well as the location. Eight general

would include rent to the land-

accountability the owner has in

guidelines should be considered

lord, any operating costs the prac-

dealing with the contractor.

to determine financing:

tice will incur in addition to those

1. Land acquisition costs

.

After

the landlord is covering, plus pay-

2. Building renovation and

the contract document phase

ment of the debt service of any

construction costs

completed, the project is

out

tenant  improvements beyond

3. Land development costs

to bid or negotiated with a con-

those the landlord is providing in

Contingency  fund;

tractor. During this phase the

the base rent.

change orders,

If the practice is in flux and

price for the project is deter-

environmental

mined and finally negotiated.

growing rapidly, you may prefer

Professional

Contract Administration. In

to rent a suite rather than build

tects, interior designer, design

this phase the project is actually

new space. This allows the prac-

planner

tice flexibility to move on after a

constructed. The architect will re-

6. Attorney's and accounting

short period (three to five years).

solve field problems with the con-

If the practice intends to do this,

fees

tractor, process change orders,

7. Cost of money through

make sure you negotiate in your

and pay requests and work out

completion

lease for all the items you wish to

discrepancies within the contract

take with you when you do move

documents.

on. If they are attached to the

It should be noted that the five

building, they typically belong to

phases described will get the of-

The architectural design of a

the landlord and must be left be-

fice built. The walls will be con-

building or a tenant-improved

hind.

structed, the doors will swing,

space typically goes through five

In urban areas, like downtown

and the cabinets will be in place.

phases, each building upon the

Chicago and downtown New

However, there will be no furni-

information developed in the pre-

York, the options for space are

ture in the office and the fabric on

vious one:

generally limited. This means the

the chair in the offices will not

Schematic Design. In this phase

practice has to live with more

necessarily be coordinated with

the room layout for the office is

compromises than the same prac-

the wall fabric. That is why most

determined. This establishes the

tice would have in a less urban

medical practices also use an in-

general concepts of patient, phy-

area.

terior designer to integrate the

sician, and staff flow for the suite.

As each potential site is exam-

fixtures and furnishings with the

Design Development. In the

ined, you must test the design

office interiors.

second phase systems are added

concepts to ensure the space

In space design, a number of

to the schematic design. The im-

meets the practice needs. After

specific objectives can be pur-

plications of such things as the

the appropriate space is found,

sued. For physicians this means

structural system to be used for

you have to acquire the right to

that they work in as small and

the building, as well as the loca-

use the space. This usually in-

contained a space as possible,

tion of the mechanical and elec-

volves negotiations between the

making them as efficient as pos-

trical equipment room, are ad-

practice and the landlord and of-

sible. For the staff, this means

dressed.

ten hinges on the definitions of

that they have the space to pre-

Con tract Documents. During

usable and rentable square feet.

pare patients at the same rate as

this phase the drawings, fre-

the physician sees them and that

quently referred to as working

every staff member has a place to

drawings, are produced and the

call "home." For the business

The economics of any medical  specifications manual is devel-

staff, this means that staff mem-

office design and subsequent con-  oped. These documents will not

bers who handle patients have di-

struction should be considered as  only guide the contractor in build-

rect patient access so the patient

early in the process as possible.  ing the space, but also form the

can be handled well.

Certainly the dollars needed to  legal backbone of the owner-con-

39

Administrative Ophthalmology