Building an Internal Medicine Clinic

Construction of an inpatient hospital: Review (building/code check) → Preparation (design, licensing, contractor selection) → Construction (demolition → equipment → finishing → equipment installation) → Completion and opening report in this order.

Pre-construction review stage of an internal medicine hospital

Preliminary review steps = building (use/location) + patient demand + legal permits + financial plan + equipment/facilities availability + institutional consultation
It's important to review it at this stage to avoid additional cost/time loss during the construction phase.

1. Review building and site conditions

• Check the building ledger
  • Purpose Neighborhood living facilities (councils available) or Healthcare facilitiesAwareness checks
  • If it is a "business facility" or "neighborhood living facility (type 1 or 2)", it can be a medical center
  • If it says "sales facility", "warehouse facility", etc. Report repurposing Required
• Location and accessibility
  • Preferably near a main street, bus/subway station for easy access to patient population
  • Parking availability (legal number of spaces + patient comfort)
• Number of floors and layout
  • First or second floor is most advantageous (consider older patients)
  • Check elevator capacity and speed if high rise

2. Analyze commercial districts and patient demand

• Know the status of competing legislators
  • Compare Internal Medicine, Family Medicine, Pediatrics, etc. within a 500m-1km radius
  • Need to differentiate when there are many identical subjects (e.g., specialize in digestive-endocrine)
• Estimating patient inflow size
  • Number of nearby apartment complexes, population, and proximity to work.
  • Hospital utilization patterns (day/night, office workers vs. elderly patients)
• Targeting key patient populations
  • Aging neighborhoods → Chronic disease emphasis (hypertension, diabetes, heart disease)
  • New towns/young people → Digestive system, health check-ups, vaccinations

3. pre-check regulations and permits

• Healthcare law
  • Physician level cannot have inpatient rooms (outpatient focused)
  • Required for exam rooms, waiting areas, patient restrooms, and medication storage
• Building codes
  • Gross floor area of 500㎡ or more → Obligation to install facilities for the disabled (accessible restrooms, ramps, elevators)
• Fire Code
  • Determine fire protection obligations based on square footage and number of stories
  • Sprinklers are required for 600 square feet or more
• Radiation Safety Management
  • If you plan to install X-ray, Radiation shielding design Required
  • Prepare for Nuclear Safety Commission reporting and inspections

4. financial review (costs and profitability)

• Lease terms
  • Contract duration: Recommended minimum of 5 years (to account for payback of clinic interiors)
  • Rent levels vs. projected revenue
• Estimating initial investment costs
  • Interiors ($2-4 million per square foot, $4 million+ with lab)
  • Medical equipment (X-ray 7 thousand100 million, ultrasound 50 million100 million, endoscopic 100 million and above)
  • Start-up capital (6 months of labor and rent)
• Review your profitability
  • Estimated number of patients × average fee → simulate monthly revenue
  • Estimate how long it will take to break even

5. Review medical equipment and space requirements

• Required equipment or not
  • X-rays, Ultrasound: General Internal Medicine Basics
  • Endoscopy: Specialty care, requires prewash and pretreatment rooms
• Free up space
  • X-ray room: Reflects shielding thickness → 12-18 m2 minimum
  • Endoscope cleaning room: Separate dirty/clean areas, ventilation required
• Check electrical and plumbing
  • Building power capacity (typical commercial buildings may require increased power)
  • Water supply and drainage plumbing locations (can you add a toilet-sink?)

6. consult with authorities in advance

• Health centers
  • Contact your local health department to open a clinic Facility Standards/Required Documentation Confirm
  • "Can we set up like an endoscopy room and an X-ray room?"
• City Hall Building Division
  • Determine if a change of use is required and how to report a remodel
• Fire Department
  • Discuss fire protection requirements before design (avoid post-construction changes later)

Design and preparation phase

1. Basic Design (Planning Design)
   • Floor plan: Optimize patient flow (reception→waiting→treatment→examination→storage→return)
   • Medical staff mobility: Ensure minimum travel distance from nurse's station to exam room/examination room
   • Separate dirty/clean areas (endoscopy-clinical pathology, etc.)
2. Conceptualization
   • Architecture: Wall, floor, and ceiling finishes
   • Electrical: Dedicated power for equipment such as X-rays, endoscopes, IV pumps, etc.
   • Facilities: water supply and drainage, medical gases (oxygen/negative pressure), ventilation (especially exam rooms/cleaning rooms)
   • Fire: Deploy detectors, guidance lights, fire extinguishers, and fire doors
3. Prepare for authorization
   • Health centers: Submit at the time of opening (floor plans, building ledger, physician licenses, medical waste contracts, etc.)
   • City Hall Building Division: Change of Use/Remodeling Notification
   • Fire Departments: Fire protection design verification and as-built inspection
4. General contractor-selection
   • Experience with medical facilities required (radiation shielding, endoscopy cleaning rooms, etc. are different from general interiors)
   • Work with equipment vendors to pre-empt footprint, power, and plumbing specifications

③ Construction phase

③ - 1. Pre-con (Pre-con)

• Contract-Budget finalization: Specifying Scope, Bill of Quantities (BOQ), Schedule, and VO rules.
• Permits and licenses: Change of use/remodeling notifications, fire prevention consultations, radiation shielding diagram reviews, waste discharge notifications.
• Kickoff: RFI scheme, weekly process meetings, and organizing sign-off lines (presiding/leading).
• Shop Drawings / Manufacturing Drawings Submit: partition-duct-plumbing-junction-box-furniture-shielding-sign.
• Mock-up Approvals: floor cove 100-150 mm, wall-door frame-silicone, clinic soundproofing samples, etc.
• Safety and ICRA plans: dust/noise barriers, negative pressure equipment (if needed), and maintaining emergency lines.
• Site temporary: access control, fire extinguishers/emergency lights, temporary power/water, material delivery routes, floor protection.

③ - 2. Demolition and Cleanup

• Pre-inspection: Structural - load-bearing walls/slabs, location of existing plumbing/wires, presence of hazards (asbestos, etc.).
• Block-Protect: Elevator/common area protection, noise and dust barriers, pick-up and drop-off time arrangements.
• Blocking MEPs: Power-valve closure → Lock-out/Tag-out.
• Selective demolition: removal of walls, ceilings, finishes, fixtures and fittings → separation of debris for discharge and intermediate inspection.

③ - 3. Baseline-Floor-Ceiling-Structure

• Set up/measure baseline (axis-dimensions) → Show wall position, door width-door swing, machine center.
• Floor preparation: leveling (self-leveling/mortar), burying utility trenches and drains, waterproofing if necessary.
• Structural Reinforcement: Structural Inspection approval for opening and top beam reinforcement, core drilling.

③ - 4. MEP Primary Piping (Rough-in)

Piping and wiring are cross-checked in the order of "Drawings→Site Conditions→Equipment Specifications"

• Plumbing/Sanitation: water supply-drain-return line, drain slope (typical 1-2% recommended), trap-cleanout location.
• Heating, ventilation, and air conditioning (HVAC): Intake-Exhaust Ducts, Silencers/Dampers, Fresh Air-Exhaust Routing, Endoscopy Cleaning Room Negative pressure/cleanroom Positive pressure Plan.
• Electricity: Distribution panel extension/move, dedicated circuits (endoscopes, x-rays, refrigerators, servers), grounding/earth leakage circuit breakers.
• Low voltage: Datarack location, AP/EMR/Nurse Call/CCTV, access control wiring.
• Medical Gas (optional)Oxygen (O₂)/Vacuum (VAC) piping, pipe diameter-outlet position (managing ±100 mm tolerance on bay center).

Hold Point: Pipe and duct pressure testing, photographic documentation of conduit/box locations, supervisory interim inspections.

③ - 5. Firewall-Shield-Partition

• Fire Protection: Fire protection of duct penetrations (fire dampers/refractory fillings), fire doors and door closures.
• Radiology (X-ray): Lead plate/glass/shield door installation, shield continuity (corner to outlet) check, control room/glass height.
• Partitions: Exam Room Double plaster + sound absorbing material (target acoustic STC 45±), Door Bottom Seal/Door Gasket.

③ - 6. Secondary Fixtures - Framing - Ceiling Framing

• Adjust sprinkler head/piping locations, wire detectors-emergency lights-indicator lights.
• Ceiling framing construction (grid/plaster), inspection opening locations (valve-damper-trap accessibility).
• Sanitary instrument recessed box - Medical gas panel box - Armrest/rail recessed.

③ - 7. Waterproofing - Flooring - Wall Finishes

• Wet spaces(Wash/Washroom/Washing): Waterproofing → Water proofing → Leak test.
• bottom: For hospitals Vinyl Sheet + COVE (Round) Mop 100-150 mm, treatment/cleaning is chemical-resistant-non-slip.
• Wall/Ceiling: Stain-resistant paint, cleanable finish (film/HPL) site selection.
• Doors/Hardware: Validate aseptic handles, door closers, automatic doors (standby/exit), and wheelchair door widths.

③ - 8. Furniture and Fixtures (FF&E) and Medical Room Specialty

• Receptionist-Accounting: Counters, cache/printer-serverbox, privacy shield.
• Office casework: upper-lower, Hands-free sinks, Sharp's Box, and backsplash.
• Treatment/Irrigation: Curtain track, bed light, oxygen/vacuum panel, call bell.
• Endoscopy: Procedure room monitor arm, Washroom My autocleaner - drying cabinet, passbox (dirty to clean).
• X-ray: Tables/wallstands, shielded door seals, control room consoles.

③ - 9. MEP 2nd (trim-out) - Commissioning

• Electricity: Megger (insulation) testing, measuring earth resistance, labeling distribution boards, and identifying emergency power (UPS) lines.
• Installations: Water supply pressure test - drain leakage test (coloring / irrigation water), water temperature / recovery check.
• Medical Gases: pressure-confidential-Cross-connection Testing, Oxygen Purity-Contamination Measurement, Labeling/Color-Valve Marking.
• HVAC TAB: Air volume / static pressure - temperature and humidity adjustment, Negative/Positive Pressure Check differential pressure (endoscope cleaning/cleaning chamber), check filter rating.
• Firefighting: sprinkler flow/pressure, detection-alarm interlocking, induction light illumination, fire damper activation.

③ - 10. Forensic & Professional Testing & Certification

• Radiation Shielding Field Measurements: Accredited institutional dosimetry (controlled/uncontrolled area criteria met) → Certificate of Conformity.
• Fire Inspection: matching the drawing, operation - water pressure test passed.
• Health center facility inspections: Clinic/waiting room/restroom/medicine storage/waste storage proper.
• Medical Waste: Locker-Cover-Contract (shorten the journey).

③ - 11. Cleaning-Integrity-Handover

• Cleaning the terminal: Dust/glue odor removal, IAQ (formaldehyde/TVOC) testing (if required).
• O&M acquisitions: Equipment Manual - Warranty, As-built drawings(PDF+CAD), electrical circuit-panel schedules, and filter/consumables lists.
• TrainingEMR-Electricity/Distribution, Medical Gas Valves-Emergency Procedures, Fire Evacuation Drills.
• Punch List: Clean up defects → DLP (Day-to-Date) Start.

Construction of an internal medicine clinic

Recommended process example (average 6-10 weeks, depending on size/specialty)

1. 1 week for demolition/temporary
2. Floor-Structure-Baseline 0.5 weeks
3. MEP Rough-in 2 weeks
4. Shielding-Partition-Ceiling-Framing 1.5 weeks
5. Finishing (waterproofing/flooring/painting/doors) 1.5 weeks
6. FF&E - Special 0.5 weeks
7. Trim-out-TAB-check 1 week
8. Forensic inspection, cleaning, and handover 0.5 to 1 week

Quality/risk management checkpoints (core only)

• Hold Points(a) before rough-in closure, (b) before shield concealment, (c) before watertight concealment, and (d) before TAB.
• Soundproofing: Before the walls of the exam room are finished Field Core Testing Or check the Structure Same Thread Mock-up.
• Endoscope Cleaning Room: drainage slope - water heating capacity - maintaining negative pressure Always-on measurement ports Install.
• X-ray: Note missing lead liner in outlet-penetration (photo documentation required).
• Accessibility: Ensure ceiling inspection opening/valve-damper access distance (≥ 450×450 recommended).
• Change management: Changing the route of a ventilation wire/gas/wiring is done using the Post-approval construction(specify cost-fair impact).

Pre-acquisition functional testing (sample checklist)

• Electrical: Insulation resistance ≥ 1 MΩ (at Megger 500 V, design/regulatory priority), earth leakage test, UPS disconnection.
• HVAC: Each room air volume-differential pressure (endoscopy cleaning negative pressure, clean positive pressure), noise, and condensation checks.
• Fixtures: Water supply/water pressure-temperature, drain traps maintained, no leaks.
• Fire: Comprehensive interlocking test (alarm to induction lights/fire dampers/equipment shutdown).
• Medical Gas: Regulator pressure, outlet leakage 0, labeled-valve mapped.
• Radiation: Receipt of shielding compliance letter, control room intercom-emergency switch activation.

Demolition/Framing

• Existing building interior demolition, structural verification
• Wall additions and partitions (exam rooms, waiting rooms, exam rooms, etc.)

1. Capital construction
   • Installing water supply and drainage piping, ventilation ducts, and heating and cooling systems
   • Medical gas (oxygen, negative pressure) piping
2. Electrical, telecommunications, and fire protection
   • Place a dedicated exam room to exam room circuit
   • Build a server room/electronic medical record (EMR) network
   • Install fire protection equipment and conduct fire inspections
3. Finishing touches
   • Floor: Antimicrobial vinyl/tile (easy to clean)
   • Wall-Ceiling: Durable/Antimicrobial Painting
   • Furniture: reception desk, treatment room desk, treatment room cabinet, refrigerated medicine cabinet
4. Bringing in and installing equipment
   • X-ray room: Install equipment after verifying lead shielding
   • Endoscopy suite: Separate washroom-treatment room, check ventilation
   • Deploy ultrasound, electrocardiogram, infusion pumps, blood testers, etc.

④ Preparing for completion and opening

1. As-built inspection
   • Fire Departments: Pass fire safety inspections
   • Health centers: On-site verification that facilities meet criteria
   • City Hall: Check for construction/change of use
2. Get ready for production
   • Contracting a medical waste handler and installing a dedicated storage unit
   • Staffing (nurses, administrative staff) and EMR training
   • Install a claims program and integrate with your accounting system
3. Declare your practice open and start seeing patients
   • Health center opening notification approval → Application for designation as a nursing institution (Simpyeongwon) → Start of treatment

Β Weed

Designing an internal medicine practice