Among the numerous medical services, the ultrasound room is one of the leaders in terms of the number of visitors. Although starting such a business is difficult to call simple - expensive equipment, special permits and qualified personnel are required - the prospects for profit are very extensive. Ultrasound diagnostics is necessary for the study of all internal organs therefore, the number of visitors to such an institution is not limited to pregnant women. We tell you what is required to open a private ultrasound room, how to choose a location, how much money you have to spend, what income you can count on.

The most difficult step in opening a private ultrasound diagnostics office will be obtaining the necessary permits. Due to the great responsibility assumed by such institutions, all regulatory authorities check them with increased attention. It is necessary that the manager had a medical education and work experience in the specialty for at least 5 years. There is a variant of opening without such qualifications - subject to admission to the staff of a specialist who meets the above requirements.

List of documents and permits:

• certificate of registration with the Federal Tax Service (as an individual entrepreneur or legal entity);
• a lease agreement for the premises or evidence of ownership of it;
• positive conclusion of the sanitary and epidemiological service and fire inspection;
• positive conclusion of Rospotrebnadzor;
• certificates for the ultrasound diagnostic apparatus;
• license for medical activity;
• agreement on Maintenance with the management company;
• waste collection contract;
• employment contracts with employees, copies of their educational documents.

It will be possible to issue a work permit only after the purchase of equipment and the selection of staff. The fact is that a private ultrasound office cannot obtain a license without documents for an ultrasound diagnostic device(they will be provided by the seller of equipment) and documents on the education of personnel (they will be provided by employees upon employment).

Opening an ultrasound room requires a medical license and several other permits.

Room selection

One of the stages of how to open an ultrasound room is choosing a location. It is important to combine two conditions: compliance with the law and the convenience of customers. The requirements for the premises of a private ultrasound diagnostics office are fixed by SanPiN 2.1.3.2630-10, the norms are common to all medical organizations.

Consider the requirements of SanPiN more plain language than used in the official docs:

1. Each ultrasound machine is placed in a separate room with an area of ​​14 sq.m, but preferably 20 sq.m.
2. The office where the examination is carried out must have natural and artificial lighting, cold and hot water supply.
3. Connection to an uninterruptible power supply.
4. The cabinet is equipped with exhaust ventilation.
5. It is recommended to install an air conditioner.
6. Light colored walls, use ceramic tiles forbidden.
7. Noise - no more than 50 dBA.
8. The office should be provided with a sound-absorbing coating, this will provide additional comfort to visitors.
9. To change the patient's clothes, it is required to equip a special area of ​​at least 7 sq.m., connected by a common passage with the diagnostic room.
10. The norm of the area of ​​the waiting area - from 10 sq.m.
11. You can not open a diagnostic room in the basement, basement, in a residential building. Only non-residential fund.

To better understand what is required from the owner of an ultrasound diagnostic facility, study the Regulations on the ultrasound diagnostic room of July 21, 1988 No. 581. Despite the fact that this document was adopted back in Soviet times, its norms are still relevant today.

Equipment standard

Fulfilling the requirements for the premises is not enough to get permission to open a private ultrasound diagnostic room. There is a standard for equipping an ultrasound room for licensing - a list of devices and furniture that must be purchased and installed in a certain way.

Technique:

• ultrasound diagnostic apparatus;
• tonometer;
• bactericidal irradiators;
• lightphonendoscope;
• computer with internet access.

Furniture and interior:

• Desktop;
• desk lamp;
• chair for the ultrasound room;
• couch with the ability to adjust the height;
• screen;
• chair;
• document rack.

Utility equipment and tools:

• first aid kit;
• tape measure;
• waste container;
• disinfectants;
• a set of disposable diapers, paper towels or napkins.

The order of equipment assumes that the couch is installed so that the doctor can freely bypass it and have access to the subject from any side. The device itself should be placed so as to freely conduct an examination in all planes. Cannot be installed in the office electrical equipment, which threatens the accuracy of the ultrasound diagnostic apparatus and provokes interference in its operation.

There are several requirements for the design in terms of space, equipment and furniture.

Purchase of equipment

An effective business plan for an ultrasound room must necessarily include the calculation of costs. Most investments will be required for the purchase of an ultrasound diagnostic device. Its cost is very high: from 850 thousand to 10 million rubles. In this case, you can not limit yourself to buying a used installation. Over time, during active operation, the power of the equipment decreases, the diagnostics become less and less accurate. If the cabinet misdiagnoses, its reputation will once and for all become bad.

The purchase of the device should be made from trusted companies that have proven themselves in the market. The seller must help with the selection and ensure the safe transport of the unit. Among foreign manufacturers, the most reliable are:

• Aloka Hitachi;
• Alpinion;
• Dixion;
• EDAN;
• Esaote;
• General Electric;
• Philips;
• Samsung Medison;
• Siemens;
• sonoscape;
• Toshiba.

Tax regime and OKVED

When registering at tax service the owner of the ultrasound diagnostic room must indicate certain codes from the code classifier economic activity- 86.10 and 86.21. These are the activities of hospital organizations and general medical practice.

The best option for taxation - simplified mode (USN). It involves a minimum of reporting, several advance payments and the payment of tax once a year. This is convenient, since you do not need to pay VAT and calculate income tax. For an ultrasound room, the “6% of Income” option is more suitable, since this institution incurs few expenses, that is, it will not be possible to significantly reduce the tax base by their amount.

Such institutions are allowed to work under the general taxation regime, but, in comparison with the simplified one, it is extremely unprofitable.

Although medical organizations now it is allowed to use a zero interest rate on income tax, this does not exempt them from VAT and a huge number of reporting documents, for the execution of which they will have to hire a full-time accountant.

Staff

All specialists who will work with the ultrasound machine must have a medical education. Work experience is desirable (with the exception of the head physician / owner of the institution - 5 years of work experience in the specialty is required for him). The fact is that ultrasound diagnostics is based solely on the knowledge of a specialist. The device shows a “picture”, and the doctor must interpret it - compare it with the norm, see pathologies. In one office, from 1 to 3 specialists are employed, depending on the work schedule.

Another indispensable employee - nurse. The vacancy of a nurse in the ultrasound room assumes a secondary medical education and work experience (desirable). The duties of a nurse include assisting the doctor and following his instructions. Usually such employees are engaged in preparing the equipment for work, caring for it, as well as filling out some documents. The full list of duties depends on the specifics of the office. More detailed information will contain job description nurses.

The receptionist will work administrator. This employee meets visitors, advises them on the cost and procedure for diagnostics, makes an appointment, and answers phone calls. No medical background required.

The ultrasound machine costs from 850 thousand rubles

Financial investments

The largest part of the investment will be the purchase of an ultrasound diagnostic device. Its cost will be at least 850 thousand rubles, but rather - 2-3 times more. You should not save on this installation, since the operation of the entire cabinet depends on its power and accuracy. Chinese devices for 300-400 rubles do not bring the proper effect, diagnoses with them will be erroneous, and there is also a possibility of refusal to license. The same applies to used equipment.

In addition to the apparatus, the opening requires the following expenses:

• rent of premises - from 30 thousand rubles per month;
• repair - from 50 thousand rubles;
• furniture and auxiliary equipment - about 100 thousand rubles;
• license, registration of all necessary permits - 50 thousand rubles;
• other expenses - about 20 thousand rubles.

A good solution would be to invest in advertising. This would help in the first months of work to attract more clients and ensure the full load of the cabinet. Advertising and promotion in in social networks increase the initial investment by an average of 100 thousand rubles.

The calculation of the total costs depends on the cost of the ultrasound diagnostic apparatus.

How much can you earn

The cost of services of the ultrasound room is in the range of 300 to 5000 rubles. The price depends on the complexity of the procedure. The most inexpensive are examinations of the abdominal cavity, joints and tissues, neck and reproductive system. The most expensive is the examination of the brain. Ultrasound of pregnant women costs an average of 1000 rubles (in the early stages, usually a little less).

Accepting during the working day 20-30 clients (full load) with an average check of 500 rubles, the office will earn about 15 thousand rubles daily and 450 thousand rubles per month. If the load is at the level of 50-60%, then the income will be about 220-250 thousand rubles. This is a good result, which will cover all related costs, the wage fund. But even such income will not allow you to quickly recoup the investment. The average term is 1.5-2 years.

The office must work at least 10 hours throughout the week, without days off. So the number of clients will be maximum. The bigger the load, the bigger the profit.

Conclusion

Opening a private ultrasound office involves spending at least 3 million rubles. This is a complex line of business. To do it legally, you need to fulfill the requirements of the law for the location, equipment of the office, education and staff. This business cannot be attributed to organizations with a quick payback due to the large initial costs.

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Requirements for an ultrasound room must comply with sanitary rules and regulations (SanPiN) 2.1.3.2630-10 on sanitary and epidemiological requirements for organizations engaged in medical activities. This is indicated in the guide R 2.2.4 / 2.2.9.2266-07, approved by the chief sanitary doctor Russian Federation dated 10.08.2007.

HYGIENIC REQUIREMENTS FOR THE WORKING CONDITIONS OF MEDICAL WORKERS PERFORMING ULTRASONIC EXAMINATIONS - 2-2-4- PHYSICAL ... Relevant in 2018

4. Requirements for ultrasound diagnostic rooms

4.1. The set of rooms intended for equipping ultrasound diagnostic rooms must comply with SanPiN 2.1.3.1375-03 and must include the room:

The law is simple: In connection with the loss of force SanPiN 2.1.3.1375-03 "Hygienic requirements for the placement, arrangement, equipment and operation of hospitals, maternity hospitals and other medical hospitals", one should be guided by the SanPiN 2.1.3.2630-10 adopted instead of "Sanitary and epidemiological requirements organizations engaged in medical activities.

4.2. It is forbidden to place ultrasound diagnostic rooms in the basement, semi-basement and basement rooms.

4.3. The room for ultrasound diagnostics should have:

Natural and artificial lighting;

Sink with cold and hot water supply;

General exchange supply and exhaust ventilation system with an air exchange rate of 1:3. Installation of air conditioners is recommended.

4.4. In rooms for diagnostic studies, it is recommended to maintain the following microclimate parameters: air temperature - 22 - 24 ° C, relative humidity - 40 - 60%, air velocity - not higher than 0.15 m/s.

4.5. The walls in the premises of the ultrasound diagnostic room should be painted in light colors. Wall tiling with ceramic tiles is prohibited.

4.6. Noise levels at the workplaces of medical personnel serving ultrasonic diagnostic units should not exceed 50 dBA.

4.7. In order to reduce noise in ultrasound diagnostic rooms, it is recommended to line ceilings and walls with sound-absorbing materials.

4.9. The couch (height-adjustable) should be placed in the center of the room or at some distance from the walls to facilitate access to the patient from any direction.

4.10. Diagnostic equipment should be installed in such a way that it is easy to conduct research in various planes.

4.11. The height of the couch for patients should be selected so that the ultrasound doctor conducting the diagnostic study creates conditions that meet the requirements of "SSBT. Workplace when doing work while sitting. General ergonomic requirements".

4.12. In the room of the ultrasound diagnostics room, electrical appliances that can cause interference with the operation of ultrasound equipment should not be placed.

Public hospitals are overcrowded, the record is kept for 1-2 weeks before the date of the procedure.

Opening an ultrasound is a great business idea, no matter the city.

Getting started means clear respect for the plan.

The initial step is to determine the profile with which the cabinet will work. The direction dictates the installation of certain work equipment. Below is the registration legal entity.

To perform medical activities, registration of an LLC is required. You can register or allow the registration of a specialized company.

The future owner of the company will perform the following activities: draw up an agreement, issue a permit to the company.

Before opening a company, she will have to visit the municipality, the fire department of Rospotrebnadzor. The company registers with the tax office, and an application for a licensed activity is also required.

An application is required to issue the appropriate license.

The doctor conducting the study must have a degree in health education and pay for a certificate.

The record of his work must be five years. If the duration of the service is not sufficient, they should use another expert during the first months of the operation.

Overview of room selection and location

The search includes the following items:

• The space must be chosen non-residential, private housing will not work due to the lack of permission to practice medical practice (which allows the premises to be transferred to another type of use);
• The space must be connected to utilities: sewerage, ventilation, cold, hot water, heating;
• The owner is obliged to conclude an agreement with the relevant companies on the export and use of waste;
• The room should be regularly renovated, daily cleaning;
• It is recommended to have a separate entrance, exit to visitors (observance of the anonymity of the survey);
• The waiting room is attached to the office.

The area will be about 20 square meters.

How to open an office ultrasound

The city is enough to install the diagnostic device, computer desk, shelves, sofa, hanger, table.

Equipment order

The biggest cost is the purchase of diagnostic equipment.

The new device costs about 500 thousand rubles. The cost of a new device depends on the speed of diagnosis, efficiency and power.

In private rooms, the average sickness of patients.

Buying a device that can carry about 15 daily checks will cost about 800 thousand rubles.

When it is planned that patients will arrive in large numbers, it will be necessary to purchase a professional cool model worth 2.5 million rubles.

Recruitment

The advantage of a private ultrasound room is the independent adjustment of the patient's appointment time.

However, it will be more advantageous to conduct daily checks, which will require the introduction of two physician movements.

In addition, they will need a cleaning lady, a secretary.

The latter participating in the recording keep the patient's diary.

advertising

This type of business includes many competitors who open their office, which you need to take care of advertising.

This can be done in several ways:

• Order advertising on radio, television;
• Create a website, then pay for its promotion, making it more popular and attracting customers;
• Make sure you know your doctor to give you some business cards and guide them to get you an ultrasound.

Particular attention should be paid to the category of pregnant women, because they require ultrasound. Before the consultation, women must be left Business Cards on tables and offer advertisements to doctors.

Investment, profit

Approximate accounting for office expenses is as follows (prices in sections):

• The cost of an ultrasonic machine with one sensor is 500,000;
• Registration of LLC, having received a license - 12,000;
• Property rental, payment utilities– 200,000 euros monthly;
• Salary for staff - 100,000 per month;
• Consumables - 10,000.

  monthly.

Ultrasound examination is not a cost-effective procedure, it requires payment of about 1000 rubles. It is easy to calculate: the weakest equipment can produce 10-15 checks per day, which means about 15,000 rubles of income.

For more tips, watch the video:

The annual income will be at least two million rubles.

The above figures will allow us to recover the cost of equipment in just six months of continuous operation.

The opening of such a company is a profitable company in terms of formalities and professional work.

This job is suitable for a medical professional who wants to work independently and earn a significant income.

An ultrasound room is a profitable business idea that requires a lot of investment. The main investment will go to the purchase of equipment.

Despite the rather large investments, the payback is 5-7 months. The opening of such an office will require an amount of 3-4 million rubles.

Ultrasound room - profitable business

Why is this business relevant?

An accurate diagnosis cannot be made without modern and functional diagnostics. With the help of ultrasound, you can find out about various problems of internal organs. Doctors call this method of identifying problems the most effective. And patients in the process of performing ultrasound do not experience discomfort and pain.

Why do private ultrasound rooms have more advantages compared to municipal polyclinics? Firstly, in state clinics there is a coupon system and long queues.

Secondly, the queue can be so huge that it will be possible to get an ultrasound in a few weeks or even a month. Therefore, more and more people communicate with the services of a private ultrasound room.

Business can be divided into several main stages.

1. Room selection. It is advisable to open an office in large areas or in the central part of the city. Two rooms should be allocated for the ultrasound room. Entrance hall or living room where the secretary will sit to take phone calls and clients.

   The second room is the ultrasound room itself.

2. The arrangement of the office includes repairs, the purchase of comfortable chairs and a special bed.

   You will also need a special apparatus with 4 sensors.

   Business idea for opening an ultrasound room

   Such a device allows you to perform a complete examination of the body. To increase the profits of your business, it makes sense to buy a portable scanner. Such a scanner allows you to go to seriously ill clients at home.

   Over time, it will be possible to acquire such a portable device.

3. The quality of many private clinics suffers also for the reason that not very qualified doctors work in them. This stage should be given Special attention. It is the highly qualified staff that will create a good reputation for your clinic. The doctor must have a special certificate that gives the right to engage in this type of business.

Features and tips for opening an ultrasound room:

1. The room should be chosen on the first floor.
2. It is necessary to create a cozy and bright atmosphere in the diagnostic center.

   Repairs should be modern, clean and tidy.

3. The presence of the necessary communications - a toilet and a sink. You need to understand that this is a diagnostic center, where all hygiene requirements must be strictly observed.
4. It is advisable to open such an office in cities where the population exceeds 200 thousand people.

Investments in business:

An expert-level ultrasound machine, which has 4 sensors, will cost 3-4 million rubles.

The cost of repair and arrangement of the office - 200 thousand rubles.

The cost of renting an office is 30-40 thousand rubles a month.

Thus, we come to the amount of 3,500,000 - 4,000,000 million rubles. First of all, the final investment figure will depend on the cost of the ultrasound machine. Modern market offers many options and various models. The monthly profit of the office will be 400-500 thousand rubles with an average attendance of 10-20 clients per day.

The cost of one ultrasound procedure is 1000-1500 rubles.

How to open a private meeting room

The use of ultrasound in the diagnosis of disease is very popular today. And this is not surprising, because the ultrasound is well informed and lacks discomfort. Apart from the fact that they have a tongue, they do not need any special training to make an accurate diagnosis, doctors actively refer their patients to this exam.

However, entering public hospitals on the street is not easy.

Due to the long waiting time, people cannot receive an ultrasound for several months. That is why a private ultrasound office for many people becomes a real salvation.

For entrepreneurs, the Uzi Cabinet is a great way to do business today. Due to the constant demand, it creates a stable income.

To open the ultrasound cabinet, specify which ultrasound scanning devices you want to use, the range and models can be viewed at http://mindray.in.ua/.

To do this, you must first and foremost define the profile, because the device can be very different: cardiological, gynecological, etc. Of course, it is better to use it industrial grade UZ for complete review body. And although it is the most expensive of all, its use turns out to be more profitable. Due to the presence of several sensors, various organs can be examined.

You can provide ultrasound services with your clients, which is ideal for placental patients.

If you want to do this, you will need to buy a portable ultrasound machine. However, this device still does not allow enough scanning. So, depending on you.

If you have decent capital for beginners, you can buy more and doppler and 3D scanner transducer which is very popular among pregnant women. Since the employees in the office work only as doctors with a higher medical education. Make sure they have a certificate for this event.

It is best to rent a room for a private office on the first floor of a residential building.

It is important to fully comply with the sanitary and hygienic requirements of the sanitary and epidemiological station and fire tests.

How to open a separate room with ultrasound?

Provide space with good ventilation, running water and comfortable temperature regime. The toilet should also be in the toilet and washbasin. Wet cleaning must be done every day, so you can rent a cleaner.

Log in to the tax office as an IP or LLC, and then get permission to continue operating at the Sanitary and Epidemiological Station and the fire station.

You also need to open a bank account. Select a bank where the conditions for individual entrepreneurs are the most optimal. And the last thing you need is to get a license to work in the licensing committee.

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Nikolay Romanov

I am Nikolai Romanov, an endoscope with 35 years of experience. He worked in large regional medical institutions in Rostov-on-Don. I have organizational experience: supervisor. department, chief external specialist of the Ministry of Health, president of the regional department of endoscopy, head of the committee of the Russian endoscopic society (in the past).

Now I am joining the work in the district clinic with a job in my office in the same specialty - 9th year (IP, license).

Dear colleagues. Probably every one of you who works in public medical institutions and received a bad salary, often thought about starting your own business.

Today I will try to tell you how to open medical office. And I will do it in my own case: I have been working in a commercial medical institution for more than eight years.

The origin of the idea of ​​opening a medical cabinet

By profession, he is an endoscope. I have been working since 1977. And all this time, like many, somewhere together, one day at work. During the emergence of medical cooperatives, he worked in many of them. We unsuccessfully proposed to the head physician that we could work within the framework of an individual labor activity (1988).

Until 2003, as the head of the department of the most prestigious medical institution in the region, I suddenly began to think about the degree of freedom of an expert in our healthcare.

I should add that during this period I was also the chief external expert of the regional MOH, the president of the regional endoscope department and the head of the committee in the Russian Endoscopy Society of Russia (ROEPS).

But I'm increasingly dependent on some bureaucratic games and leader trips. And the salary remained budgetary ...

Before speaking with colleagues, I always felt that the private medical practice used for endoscopy was not reliable, unprofitable (expensive equipment and supplies).

However, on the one hand, I am well aware that the need for endoscopic examinations in the city police significantly exceeded the capabilities of budgetary institutions.

On the other hand, I saw the willingness of patients to pay for the correct and prompt medical care. Apparently, for example, paid forms of work were in our diagnostic center.

I started counting. First, I calculated the possible amount of work and perhaps the monthly salary of a commercial government, taking into account costs. It turned out pretty good. But without taking into account the cost of endoscopes. Of course, the money for their acquisition was ...

But when there is a dream, sooner or later, this will be the way to realize it.

I talked about my project with my friend who is the head of a company that sells honey equipment. And then he agreed to pay for the purchase of two endoscopes (on a loan). And the Moscow company Olympus gave me the biggest discount.

Therefore, I became the owner of two endoscopes.

By the way, I gave him five years ($15,000) for five years...

And then it was necessary to implement the developed ...

Procedure for opening a health room

You need to do this in order to open your own medical office.

the first

Find a room for rent

I know two doctors who used their home (or part of it) for their office and transferred it to non-residential premises. But now the rules for the transfer of housing to non-residential stock have become more complex: the consent of all (!) Tenants of a residential building is required.

It is easier to find an office in a medical facility. Besides, the best option is an office based on your specialty profile; problems with sanitary control will be less.

I did it.

In this case, a lease agreement with the DIZO City Administration is required; This takes about a month.

When preparing documents, it is important to note in the schedule that you will work during a certain time per week. Otherwise, the rental rate will be calculated for everyday use (destruction).

2. Become an entrepreneur.

It is easy to do it yourself, within five days you will receive a certificate from the county tax office. It is important to choose the economic activity code (OKVED) - "medical practice" (85.1).

Choosing a tax regime (important!)

However, it is equally important to immediately determine the taxation regime. If you want to work in a general mode (which is determined by default), a regular doctor is not possible: you have to pay a lot of taxes and keep heavy records.

For medical purposes, a simplified system is allowed taxation (STS).

It is divided in two ways:

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

The first option includes complex billing of all costs. All checks and certificates must be retained and charged.

This is almost impossible, since in practice not all documents are documented.

usually, doctors choose "income".

now, CSS application must be submitted at the same time as business registration.

Nobody explains it. Need to know. And I didn't know. And so I had to use my links later to fix the error...

4. Registration

You will then have to register with a pension fund (as an entrepreneur). Sometimes they send a notification, but not always; it's better to come alone. I still have to register with the Regional Statistical Committee.

5. Obtaining a permit for medical activity

You can find a list of documents required for issuing licenses at the Licensing Department of the Regional Ministry of Health.

The list is quite large - look for a powerful act. And you can only start them if you have a lease.

It is more difficult to get a sanitation and epidemic management report.

If you go to the government department of this department, then, firstly, it will be long, and secondly, everything will be very strict and complicated. Therefore, it makes sense to register in trading company this profile. Pay a little more, but that makes it faster and much easier...

At the last licensing (and this should be done every five years), the cost of such company services cost me about 11-12 thousand.

rubles (this is an acquaintance).

All in all, licensing is becoming a boring business. The order looks like this:

• They collected documents, paid a fee (300-400 rubles), boxes.
• Check and suggest waiting for a professional visit to your office. We need to provide the car to the expert (and then deliver it to the Ministry of Health).
• The expert will finish, most likely, he will tell you what additional documents need to be collected.

  In general, the set of documents depends on your case, whether you have any equipment and many other features of your profession. In addition to common documents I had to provide:

  • contract for the sale of equipment
  • contract with a service organization for the maintenance of equipment
  • contract with the pathomorphological department for histological analysis
  • de-station checklist
  • contract with clinics for emergency medical care in case of complications.

  Similarly, if you have a nurse, you must submit and receive training and development documents.

• When visiting an expert, if he allows, the case is referred to the Commission of the Ministry of Health.
• If you are allowed to pay 1000 for one month (often earlier).

  you will receive permission to receive the form. I don't know if anyone refused... Everything should be decided at the stage of collecting documents and when communicating with an expert.

Many companies are willing to help physicians through the licensing process. With us in the quote field like: 5000 r. check the collected documents or 30,000 rubles. for "key" licensing.

To be honest, I would choke the frog if I could only think of a company that could save it.

The MP checked it for free. chief physician our clinic; There was one small but valuable observation. Therefore, it is convenient if a doctor in this institution not only borrows a room, but also works in its composition - "not a stranger."

You can start working immediately after obtaining a license.

Just keep in mind:

• buy and register with the Federal Tax Service "Accounting for income and expenses"
• strict liability forms (this will save you from having to buy and register a cashier);
• Book of Accounting Forms of Strict Liability,
• as well as book reviews;
• create a fire safety journal
• and many other magazines, depending on the nature of your activity

In addition to endoscopes, I had to buy additional and auxiliary equipment, expendable materials.

You will have to pay:

1. mandatory contributions to the Pension Fund of the Russian Federation and the Medical Insurance Fund, depending on the size of the minimum wages; now it is, or about 14,4 thousand.

   Opening an ultrasound room: a business plan

   and 2.8 thousand rubles. year (and regardless of whether you actually work or not); payment in installments is more appropriate quarterly

2. The "single tax on the use of the simplified tax system" is paid quarterly, and the USN application must be submitted once a year. Calculate the tax and fill out the declaration yourself or hire an accountant; it's not hard to learn.
3. You will also be paid the DIZO rental.

   However, this point is simplified: you can pay at the clinic and renew the contract (annually).

Medical institution job offers

If you have employees, then from a regular IP you become an IP employer.

And immediately increase both the responsibility and the number of cases that you will have to face. You will have to pay for your employees:

1. contributions to the Pension Fund of the Russian Federation (and submit reports every year)
2. contributions to the health insurance fund
3. Contributions to the Social Insurance Fund
4. And also pay out-of-pocket sick leave if you don't pay in social security and don't go into the employee's workbook.

Nuanca#2

Your income depends not only on the correctness of the business plan, but also on a number of factors and circumstances.

For example, my first three years of earnings match the calculation, and, in fact, I was satisfied. Then I worked only in my commercial office.

However, after the adoption of the national project, the police received the equipment and began to strictly check its use. Managers had to urgently appoint employees and fill them.

The part-time workers that came into our clinic gradually took away some of the work and money. And when 2 applications were fully completed, my volume decreased by almost 2 times.

I acted urgently. I decided that the more someone takes money from me, it would be better to do it alone. Only the doctor remained, who held the headquarters; I returned to public health.

It turned out that this is not only useful (relatively), but also convenient: I support (to a certain extent) monitoring of patient flows.

And many more shades...

Good luck to you! But always be prepared for the unexpected!

Pyotr Stolypin, 2012-11-13

Questions and answers on this topic

MAIN SANITARY AND EPIDEMIOLOGICAL OFFICE

1. Purpose and scope.

1.1 Recommendations are developed in the development of existing " Sanitary standards and rules for working with equipment that creates ultrasound transmitted by contact to the hands of workers" No. 2282-80 in order to optimize and improve the working conditions of medical workers in ultrasound rooms.

2. Hygienic requirements for the equipment of ultrasound rooms

2.1 A set of rooms intended for equipping ultrasound rooms,
should include:

A room for conducting diagnostic studies at the rate of at least 20 m 2 per unit;

A room for undressing and dressing a patient with an area of ​​at least 7m 2;

Premises for waiting for admission at the rate of 1.2 m 2 per patient, at least 10 m 2.

2.2 It is forbidden to place ultrasound rooms in the basement, semi-basement and basement rooms.

2.3 The room for ultrasound should have:
- natural and artificial lighting;
- sink with cold and hot water supply;

General exchange ventilation system with an exchange rate of 1:3, air conditioners BK-1500 are allowed.

2.4 The walls in the premises of the ultrasound room should be painted with light-colored oil paint. Wall tiling with ceramic tiles is prohibited.

2.5 Noise levels at workplaces are not more than 40 dB.

In order to reduce noise in the premises, it is recommended to line ceilings and walls with sound-absorbing materials /for example "Akmigran"/.

2.7 The couch /with adjustable height/ should be placed in the center of the room or some distance from the wall.

2.8 When conducting research, general lighting should be turned off, only a table lamp should be left, the windows in the classrooms should be darkened with curtains.

2.9 Electrical appliances that cause interference with the operation of ultrasound equipment should not be placed in the ultrasound room and near it.

3. Hygienic requirements for the organization and conduct of ultrasound.

To work with ultrasonic equipment, persons are allowed not younger than 18 years old, who have completed the appropriate training course and safety briefing.

Considering that the duration of a diagnostic study varies widely, the number of patients examined by one health worker should not exceed 10-11 people.

For a complex of gymnastic exercises, physiotherapeutic procedures, etc. it is recommended that medical personnel working on ultrasound machines take two 10-minute breaks during a work shift.

To protect the hands of personnel from exposure to contact ultrasound, two pairs of gloves should be used: bottom cotton, top rubber.

Contact of unprotected hands with the scanning surface of a working ultrasonic sensor is not allowed.

When applying a contact lubricant to the area under study, care should be taken to ensure that it does not fall on the hands of the healthcare worker.

4. Therapeutic and preventive measures to prevent the adverse effects of high-frequency ultrasound and related factors.

4.1 The therapeutic and prophylactic complex of measures includes:
- medical examinations, clinical examination;
- physiotherapeutic procedures;

Special complex of industrial gymnastics;

Eye exercises;

Psychological relief.

4.2 Order of the Ministry of Health N 700 (dated 19.06.84).

DOCUMENTATION OF THE ULTRASONIC ROOM

The working documentation of the ultrasound diagnostics office is:

1. Journal of preliminary registration for the study. The purpose of the journal is to plan the scope of the office's work. In this case, patients are distributed among doctors according to their work schedule and by areas of study (abdominal cavity, kidneys, thyroid gland, mammary glands, etc.). Instead of this journal, separate sheets can be used, which are handed over to the registry in advance.

2. Journal of registration of research results. This journal should include:

Date of the study;

The serial number of the study;

Passport data of the patient (full name, year of birth);

Medical institution, department or surname of the doctor who sent the patient for research;

Preliminary clinical diagnosis (the basis for the diagnostic procedure);

The number of studies carried out (codes, ciphers, etc.);

The conclusion of the ultrasound examination (research results).

The last column briefly records the conclusion of the doctor who conducted the study, and a copy of the protocol with detailed description Ultrasound pictures and images taken should be kept in the archive of the department, so that they can be easily found if necessary.

3. Journal of analysis of identified pathology. It is most advisable to keep a journal according to the organ-nosological principle (organ - disease - the number of detected cases per month, quarter, half year, year). The most interesting cases can be recorded separately (with anamnesis, ultrasound results, surgery, section).

4. Archive (file cabinet). The archive organization system can be different and depends on the profile of the medical institution and the volume of research. In small departments (rooms) of ultrasound diagnostics, the second copies of the protocols can be filed, stored in folders or pasted in a notebook according to the dates of the examination.

It is also possible to create a card file in alphabetical order by year of work.

In large departments where diversified studies are carried out, it is advisable to keep an archive not only in chronological order, but also thematically (ie, by organs and diseases).

A copy of the ultrasound protocol and images of an adult patient should be kept 5 years (with identified pathology) and 1 year (in the absence of pathological changes) counting from the date of the last examination. The results of an ultrasound examination of children are archived for at least 5 years, regardless of the nature of the identified changes.

5. Ultrasound protocol. If a special form is not used for the protocol, the name and address of the medical institution, the date of the study and the name of the doctor who conducted the study must be indicated. The conclusion is a medical document only if there is a seal of a medical institution or a personal seal of a doctor.

Order of the Ministry of Health of the USSR N 581 of 06/21/1988.

STAFF STANDARDS FOR MEDICAL PERSONNEL OF DEPARTMENTS (OFFICES) OF ULTRASOUND DIAGNOSTICS OF MEDICAL INSTITUTIONS (Appendix 7).

1. Medical staff. The positions of ultrasound diagnostic doctors are established depending on the amount of work and the current estimated time standards for ultrasound examinations. These positions are established within the limits of the labor plan and wage allocations. The position of the head of the department is established if there are at least 3 positions of ultrasound diagnostic doctors in the state instead of 0.5 positions of a doctor.

2. Middle medical personnel. The position of a nurse is established in accordance with the positions of ultrasound diagnostic doctors, including the position of the head of the department. The position of a senior nurse is established according to the position of the head of the department instead of 0.5 of the position of a nurse.

3. Junior medical staff. The positions of nurses are established at the rate of 0.5 positions for 1 position of an ultrasound doctor, including the position of the head of the department, but not less than 1 position.

Note: engineering support for the functioning of units of departments (rooms) of ultrasound diagnostics is carried out by personnel whose positions are introduced in accordance with the standard staff of managers, specialists, employees and workers of healthcare institutions.

***

MINISTRY OF HEALTH OF THE RSFSR ORDER No. 132, 02.08.91 ON THE IMPROVEMENT OF THE IMAGING SERVICE (excerpt) I ORDER: ... to resolve the issue of organizing on the basis of medical institutions and clinics medical and
scientifically -research institutes departments (departments) of radiation diagnostics, including X-ray and radiological,
X-ray diagnostic departments (rooms), divisions of radionuclide, ultrasound, computer,
magnetic resonance and other types of diagnostics, taking into account local conditions, to organize their work in accordance
with the “Regulations on the Department (Department) of Radiation Diagnostics”, its divisions and personnel ... Appendix N 1 to the order of the Ministry of Health of the RSFSR of August 2, 1991 N 132 REGULATIONS ON THE DEPARTMENT (DEVICE) OF RADIATION DIAGNOSIS 1. General provisions 1.1. Department (department) of radiation diagnostics is organized on the basis of medical and preventive institutions, clinics of medical and research institutes and is their structural subdivision. REGULATIONS ON THE DEPARTMENT (OFFICE) OF ULTRASONIC DIAGNOSTICS 2. Management of the department (cabinet) of ultrasound diagnostics is carried out by the head. 3. The work of the department (office) of ultrasound diagnostics is organized in accordance with the Regulations on the Department of Radiation Diagnostics, these Regulations and other regulatory documents. 4. The main tasks of the department (office) are: 4.1. Providing patients with clinically sound highly qualified diagnostic and therapeutic care using ultrasound methods using additional special techniques. 4.2. Combining the results of work with other diagnostic and clinical departments in order to clarify the diagnosis and determine the amount of medical care. 5. Issuance of conclusions based on the results of an ultrasound examination no later than the next day after the study. Appendix N 18 to the order of the Ministry of Health of the RSFSR of August 2, 1991 N 132 REGULATIONS ON THE DOCTOR OF THE DEPARTMENT (OFFICE) OF ULTRASOUND EXAMINATIONS OF THE DEPARTMENT (DEPARTMENT) OF RADIATION DIAGNOSTICS having special training for ultrasound diagnostics. 2. The doctor of ultrasound diagnostics is directly subordinate to the head of the department (department) of radiation diagnostics, in his absence - to the head of the institution or his deputy for medical work. 3. The doctor of ultrasound diagnostics in his work is guided by the Regulations on the department (office) of ultrasound diagnostics, the Regulations on the department (department) of radiation diagnostics, this Regulation and other regulatory documents. 4. In accordance with the tasks of the ultrasound diagnostic room, The doctor provides and implements: 4.1. Carrying out diagnostic ultrasound examinations according to clearly formulated indications and accepts final decision for its implementation, determining the required volume and rational research methodology, conducting diagnostic and therapeutic-diagnostic invasive manipulations, including on-site visits. 4.2. Development and implementation of new diagnostic methods and equipment. 4.3. Consultative work on the use of ultrasound in diagnostics and its possibilities in medical practice. Participation in the analysis of complex cases and errors in diagnosis, identification and analysis of the reasons for the discrepancy between ultrasound data and pathological and operational data. 4.4. Maintenance of relevant medical and reporting documentation, analysis of quantitative and qualitative performance indicators. 4.5. Raising the qualifications of middle and junior medical personnel and monitoring their work, compliance with safety and labor protection rules. 4.6. Control over the safety and rational use of equipment and apparatus, their technically competent operation. 5 . The ultrasound doctor must: 5.1. Improve their skills in the prescribed manner, master new equipment and new methods for conducting ultrasound diagnostic studies. 6 . The doctor of ultrasound diagnostics has the right: 6.1. Give orders and instructions to the middle and junior medical staff. 6.2. Represent the administration of the institution of employees subordinate to him to encourage or impose a penalty. 6.3. Make proposals to the administration of the institution on improving the work of the office, organizing working conditions. 6.4. Participate in meetings, conferences, which discuss issues related to the work of the ultrasound diagnostic room. Appendix N 19 to the order of the Ministry of Health of the RSFSR of August 2, 1991 N 132 REGULATIONS ON THE NURSE (DEPARTMENT) OF THE ROOM OF ULTRASOUND RESEARCH OF THE DEPARTMENT (DEPARTMENT) OF RADIATION DIAGNOSTICS diagnostic equipment and safety precautions. For the position of a nurse in the office where invasive manipulations are carried out under ultrasound or x-ray ultrasonic control, a nurse with experience in a surgical or intensive care unit is appointed. 2. In her work, the nurse of the ultrasound diagnostics room is guided by the Regulations on the Department of Radiation Diagnostics, on the department (office) of ultrasound examinations, by this Regulation. 3. The main tasks of the nurse in the ultrasound diagnostic room are the preparation of wiping and lubricants, ultrasound equipment for the study, preparing the patient for an ultrasound diagnostic study and participating in other procedures, photographic recording of images during the study and registration of study data in the relevant accounting documents , regulating the flow of examined persons, maintaining a first-aid kit with drugs for emergency care, ensuring the safety of equipment, equipment, household equipment, observing the sanitary regime, participating in archiving and ensuring the safety of medical information. When performing invasive manipulations, her duties include maintaining a clean dressing room or operating room in the office, preparing sterile instruments, materials, gowns, as well as the necessary set of drugs, the patient for invasive manipulation and assisting the doctor during it. four. Nurse of the ultrasound diagnostics room is obliged to improve their qualifications in the prescribed manner, strictly follow the safety rules, internal labor regulations, monitor technical condition equipment and maintain the necessary accounting and reporting documentation.

Appendix N 22 to the order of the Ministry of Health of the RSFSR

EXAMPLE ESTIMATED TIME RATES FOR ULTRASONIC EXAMINATIONS

Ultrasound examination of the organs of the hepatobiliary system:

Liver + gallbladder 20 min.

Gallbladder with function definition 60 min.

Pancreas 20 min.

Spleen 20 min.

Ultrasound examination of the organs of the genitourinary system:

Kidneys + adrenal glands 20 min.

Bladder with determination of residual urine 15 min.

Prostate gland + testicles 20 min.

Ultrasound examination of the female genital organs:

For gynecological diseases 25 min.

During pregnancy 30 min.

Ultrasound examination of the internal organs of the fetus:

in the II and III trimester of pregnancy 30 min.

Ultrasound examination of the organs of the newborn:

Brain 30 min.

Internal organs 30 min.

Ultrasonic examination of surface structures:

Thyroid gland 15 min.

Mammary gland 20 min.

Salivary glands 20 min.

Lymph nodes 20 min.

Peripheral vessels 20 min.

Dopplerometry of vessels with spectral analysis

in constant wave mode 50 min.

Vascular examination with color Doppler

mapping 60 min.

Soft tissues 20 min.

Ultrasound examination of the chest organs :

Mediastinum 20 min.

Pleural cavity 20 min.

Echocardiography with color mapping 60 min.

Echocardiography with Doppler analysis 60 min.

Doppler ultrasonography of blood vessels in pulsed

mode 40 min.

Therapeutic and diagnostic studies under ultrasound control:

Percutaneous diagnostic puncture 45 min.

Percutaneous diagnostic puncture with

express cytological examination 70 min.

Therapeutic and diagnostic puncture of abdominal cysts

cavity and retroperitoneal space 70 min.

Therapeutic and diagnostic puncture of the abdominal and pleural

cavities 90 min.

Percutaneous drainage of the gallbladder 120 min.

Percutaneous drainage of the bile ducts

ultrasonic and x-ray control 150 min.

Ultrasound hysterosalpingography

(echohydrotubation) 60 min.

Note:

Estimated workload for an ultrasound doctor

with a 6.5 hour working day - 33 conventional units.

A conventional unit is taken to be a work with a duration of 10

In combined studies of several organs, the calculated

the norms for each subsequent organ are reduced by 5 minutes.

In the study of children, the norm of time increases by 10%

Estimated time limit includes:

1. preparatory-final time

2. the time of the actual study

3. Time for documentation and work review.

Working hours of the ultrasound doctor

For medical workers, the law provides for reduced working hours. Article 350 Labor Code The Russian Federation establishes that such duration should be no more than 39 hours per week. Depending on the position and (or) specialty, the duration of the working hours of medical workers is determined by the Government of the Russian Federation. Until recently, the Order of the Ministry of Health of the USSR dated 12/11/1940 was in force, the annexes to which contained lists of medical workers who had a working day of 6.5 and 5.5 hours, but with the proviso that with a six-day working week. AT " Russian newspaper”, the official publication, dated February 20, 2003 No. 33 (3147), a new Decree of the Government of the Russian Federation “On working hours medical workers depending on the position and (or) specialty dated February 14, 2003 No. 101. The reduced working hours of medical workers, depending on their position and (or) specialty, is established: 36 hours a week - according to the list according to Appendix No. 1; 33 hours a week - according to the list according to Appendix No. 2; 30 hours a week - according to the list according to Appendix No. 3; 24 hours a week - for medical workers who directly carry out gamma therapy and experimental gamma irradiation with gamma preparations in radiomanipulation rooms and laboratories. So, in Appendix No. 2 - a working week of 33 hours - I are indicated. Medical and preventive organizations, institutions (polyclinics, outpatient clinics, medical centers, stations, departments, offices), if the doctor conducts exclusively outpatient admission of patients. The main purpose of the estimated norms of time for functional studies is to use them when: Solving issues of improving the organization of the activities of offices (departments) of functional diagnostics; Planning and organizing the work of medical personnel of these units; Analysis of the labor costs of medical staff; Formation staff standards medical staff of the relevant medical and preventive institutions. Working time according to the settlement norms cannot exceed 84.5% of your total working time. The fulfillment of settlement norms or overfulfillment ultimately affects your salary. If you are an outpatient, then your working week is 33 hours, and the working day is usually 6.5 hours, unworked hours can "accumulate" to 1 working Saturday per month. On the day you have a norm - 33 units, they are calculated using a special table. In principle, the usual polyclinic reception fully provides the amount of work to fulfill all this norm and even exceed it. You may also be compensated for work during harmful conditions labor. Order of the Russian Ministry of Health of October 15, 1999 No. 377 approved the Regulation on the remuneration of healthcare workers, which is used when determining the wages of employees of healthcare institutions of the system of the Ministry of Health of the Russian Federation. Healthcare institutions include medical and preventive, sanitary-epidemiological and other institutions included in the "Nomenclature of Healthcare Institutions", approved by the Ministry of Health of Russia. If you work in an institution included in this nomenclature, then you are entitled to a salary (rate) increase of 15% (Appendix No. 2 to the said Regulation, position 1.17 of the List of institutions, divisions and positions, work in which gives employees the right to increase salaries (rates) in connection with hazardous to health and especially difficult working conditions "Departments (offices): ultrasound diagnostics and endoscopic")

In this material:

Modern methods of functional diagnostics provide doctors with complete information about the condition of patients. Correct staging diagnosis directly determines the effectiveness of further treatment of the patient, which is why functional diagnostics is significant for modern medicine. Opening an ultrasound room is a promising business decision, due to the prevalence of this method of diagnosing internal human organs. Providing qualified ultrasound services is guaranteed to bring profit.

Relevance and advantages of the idea to open a private ultrasound room

In addition to the obvious prevalence of this method of functional diagnostics of the body, the business plan of the ultrasound room does not imply the need for a higher medical education. Public medical institutions prefer private diagnostic rooms, which ensures a constant flow of customers. The cost of body ultrasound services in private clinics and offices is higher than in public institutions, so you can easily recoup the cost of purchased equipment and other initial costs in a short period.

Market analysis: target audience, competition and risks

Demand paid services Functional diagnostics through ultrasound examination of internal organs is growing, since the main number of diagnoses can be made or refuted thanks to this method of diagnosing the body. Analyzing the market for paid medical services in a particular region, it is necessary to carefully study the level of competition, in advance to protect yourself from losing the competition.

The risks of opening a private ultrasound diagnostic office are due to the low level of consumer demand in a particular region and, at the same time, a high level of competition.

Organizational events

Registration, package of documents

To provide private medical diagnostic services, it is necessary to register as a legal entity (the form of ownership for registration is a company with limited liability). Collect the package needed for state registration documents can be done independently, or you can use the services of a third-party company on a paid basis.

The head of the ultrasound room has an appropriate medical education and a special license to provide functional diagnostic services. The business owner does not need a license or medical education.

Search for premises and requirements for it

The room for the ultrasound examination of the body must meet the following requirements:

• without fail, such premises belong to the non-residential fund;
• all necessary communications, including heating;
• daily cleaning and sanitization, for which it is necessary to conclude a special contract with a service organization;
• a plus will be the presence of separate entrance and exit, due to the anonymity of surveys;
• the area of ​​the room should provide for the convenient location of the reception and waiting room for clients, as well as the placement of the couch for examination and all necessary equipment in the work area.

Among other things, you need to pass a fire inspection and obtain permission from Rospotrebnadzor.

Purchase of equipment and furniture

The main factor determining the choice of patients between state medical institution and your private office, there will be modern equipment for ultrasound diagnostics of the body. Different diagnostic equipment is used to study various internal organs and body systems. To provide a wide range of services in the field of functional diagnostics, you will need to purchase several ultrasound machines or an expensive multifunctional device.

The regulations of the Ministry of Health establish mandatory requirements and standards for functional diagnostic equipment, because of which it will not be possible to save money on the purchase of Chinese counterparts, and devices from leading European manufacturers will have to be purchased.

Search for qualified employees

Qualified personnel will also have a direct impact on the popularity and demand for the services of your functional diagnostics office. In addition to the fact that your employees need to have a higher medical education, a mandatory requirement will be at least 5 years of experience in their chosen specialty. In addition to doctors, the staff should include cleaners and nurses, as well as a specialist working in the reception area.

Financial part of the business plan

Cost of opening and maintaining

As statistics show, the average start-up costs for organizing and opening a full-functional body ultrasound diagnostic room, as well as purchasing the necessary equipment, range from 2 to 4 million rubles in different regions. In addition, the amount of regular monthly expenses for maintaining the institution includes:

• rent for premises, utility bills;
• tax payments to the budget and off-budget funds;
• employee salaries;
• purchase of consumables.

Calculation of future income

Ultrasound diagnosis of the body is medical service, the cost of which in private institutions is quite high. Despite this, clients regularly turn to the services of ultrasound rooms for complete and reliable information about the state of internal organs. The main income is generated by the list of functional diagnostic services offered, as well as the number of clients. As practice shows, the average monthly income of private offices for ultrasound examination of the body is from 300 to 900 thousand rubles.

Payback period

With an average cost policy of your institution, high consumer demand, and the absence of fierce competition, the payback period for a business project will be from 5 to 12 months. This period is directly affected by the size of the initial investment and indicators of the profitable part of the project in direct proportion to regular expenses.

The business project of a private office for functional ultrasound diagnostics of the body in different regions of the country has different chances of success, however, with the proper approach and careful initial analysis of the market and the level of competition, it can develop into a stable business with high profitability.

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