It is believed that state psychiatric hospitals in this country exist not only for the treatment of mentally ill people, but for their simple isolation from society. Rare government agencies can provide high-quality medical care, while the standard of living of patients almost always leaves much to be desired. Patients are accommodated in large multi-bedded wards, nobody cares about their comfort and normal living, thinking that mentally unhealthy people do not need proper care. Thus, they become one of the most vulnerable groups of the population.
We will leave the issues of ethics, morality and content of such state institutions to human rights organizations and the state itself, but any person can get a mental disorder depending on the circumstances in his life. Often these are wealthy people who are able to pay for expensive treatment, even if it concerns his mental health; or relatives can pay for the treatment. In this regard, it is advisable to create your own private psychiatric hospital, and taking into account the experience of countries of Western culture, we can say that such institutions are critically necessary and rarely stand idle. Any private hospital, regardless of the profile of its work in this country, provides its clients with better services, and in Russia it is quite difficult to find a good psychiatric hospital.
Starting such a business, in large cities you can count on a relatively small number of competitors, but even in relatively large settlements there may not be a psychiatric clinic at all. In this regard, the mentally ill are sent for treatment to the nearest major city, and rich people may even go to another country for treatment.
It should be noted that state-owned clinics are inherently not competitive organizations for private entrepreneurship in this area, because they are focused only on those people who cannot pay for expensive treatment. In state centers, as a rule, unsecured segments of the population and marginalized people are treated; private hospitals accept only people with sufficient income.
Psychiatric treatment in private clinics is often very expensive, but it cannot be said that everything works only with rich people, there are institutions that seek to reach poor people as well. The level of service and treatment in such centers is deservedly somewhat lower, but nevertheless, the savings in the first place are due to not providing additional services and the lack of a certain level of comfort. Some entrepreneurs even work on the basis of agreements with government agencies that help find the location of the clinic, get all the necessary documentation and go through all the registration procedures. A non-profit organization has the opportunity to work at the expense of state grants and support; at the same time, the state itself is interested in opening such institutions in which the population can receive inexpensive or even free psychiatric care.
In this regard, we can say that hospitals of various levels are represented in this market, therefore the entrepreneur has many opportunities for developing his business. It is also worth noting that the related niches in this area are the provision of services of rehabilitation centers, drug dispensaries, alcohol dispensaries, centers for assistance in socialization and the like.
Most often, private clinics open with the expectation of providing a full range of psychiatric or rehabilitation services. In this case, you can reach the largest number of potential customers and work simultaneously in many areas. Competitive entrepreneurs can occupy slightly different spheres of activity, so they rarely compete with each other.
In this case, the novice entrepreneur must clearly determine which contingent will be visited or treated in the clinic, and based on this, form his list of services and their prices. The most widely used clinics, focused not even on the middle class, but on very wealthy people, are completely closed institutions, often outside the city. It is there that you can find a full range of services, and the clinic promises its patients a high probability of cure.
Clinics located directly in the city primarily try to attract a few poorer people, often work more as a psychological care center, rarely put their patients in hospital (or rather, resort to this only as a last resort) and provide support to their client who needs to cope with a problem including on their own or with the help of their family. This distinguishes a private clinic from a state one, where doctors often do not worry about the condition of patients, do not delve into their problems, and without hesitation place them in inpatient treatment, which for many becomes life-long.
Another distinctive feature of private clinics is the complete non-disclosure of information about their clients, so they can be treated without fear of getting the so-called yellow ticket, which forever puts a marker on a person incapable and dangerous for a society that does not have the ability to work in state and security structures and get a driver’s license and the right to bear arms. Private clinics, of course, cooperate with the state of absolutely insane psychos and either do not let them into society or significantly limit their capabilities under the law.
To work, you need to correctly select activity codes, and it falls under the definitions (OKPD 2) 86.10 Services of hospital organizations, (OKPD 2) 86.22 Services in the field of specialized medical practice, (OKPD 2) 86.90 Other medical services, (OKPD 2) 87.10 Residential care services - for inpatient care. In this case, a limited liability company is best suited because it makes it possible to use a simplified tax system. This will transfer only 6 percent of revenues or 15 percent of operating profit to the state. It is almost certain that such an institution will be opened by several partners, but if an entrepreneur intends to work alone, then he can also register as an individual entrepreneur, but in this case some work opportunities and obtaining some medical licenses will not be available to him. In general, obtaining a medical license is a rather complicated stage, which can take up to 45 days. The fee for obtaining a license is 6 thousand rubles, and a huge package of documents is transferred to the licensing authority:
Application for a license, constituent documents, constituent agreement (if applicable), charter, documents on registration as a legal entity or individual entrepreneur
Certificate of entry in the register, extract from the register
Documents on payment of duty (original).
Information letter from the body of the Federal State Statistics Service (Rosstat) on accounting in the USREO.
Sanitary and epidemiological conclusion on compliance with the sanitary rules of the work performed and the services provided that constitute medical activity; conclusion of the Federal Fire Service on compliance with fire safety requirements at the licensee's facilities.
Documents confirming the qualifications of employees of a legal entity that comply with the licensing requirements and conditions:
For persons with secondary and higher professional education:
Diploma of secondary and higher medical (or other, if any) education, respectively.
Document (certificate) of specialization corresponding to the type of activity.
Document on the next professional development (valid for 5 years).
Specialist certificate (valid for 5 years).
For the head of the license applicant or individual entrepreneur, in addition: a document confirming the existence of work experience in licensed activities for at least 5 years - a work book.
Documents confirming that the licensee has the corresponding premises legally owned by him, the technical passport of the object with an explication
Operational Management Agreement (decision, order, resolution)
Certificate of state registration of operational management rights
Documents confirming the availability of appropriate organizational and technical conditions for material and technical equipment, including equipment, tools, vehicles and documentation, ensuring the use of medical technologies approved for use by the Federal Service for Supervision of Health and Social Development:
List of used medical equipment with percentage of wear
Maintenance contract, metrological control contract.
Certificate of conformity
Registration certificate
Disposal Services Agreements
The staffing table (for organizations), job descriptions of specialists, an order from the head to appoint a chief physician, an order to control the quality of medical care and the appointment of a responsible specialist
Contracts with medical institutions and laboratories for analysis, research, autoclaving, etc., with a license (if such contracts and activities are available).
List of documents (in form).
Documents are provided in the form of notarized copies. To simplify his task, an entrepreneur can turn to special organizations that are engaged in obtaining licenses for his clients, but in this case you will have to rely on additional expenses. Obtaining a medical license is one of the most difficult, so the cost of services of third-party companies can reach 100 thousand rubles.
You should also choose the location of the future clinic very competently, and rehabilitation centers and psychiatric hospitals, in which in-patient treatment is predominantly in-patient and their patients' normal accommodation, are usually located outside the city, sometimes in a small settlement, and sometimes even far from them. A psychiatric clinic, which is more involved in monitoring and assisting its clients without their admission to a hospital, should be located within the city. In this regard, the opening of its own psychiatric center can cost not only more due to the construction or rental of a building in the city, where it is usually cheaper than outside.
A private psychiatric hospital, as a rule, is much smaller in size than a state one, because it is designed for a relatively small number of patients in a hospital. However, elite psychiatric clinics and rehabilitation centers often have additional comfort zones, for example, a gym, swimming pools, leisure and relaxation rooms, libraries, as well as a physiotherapy department, which may include halotherapy, massage, water treatment rooms, etc. . Therefore, in some private psychiatric hospitals and rehabilitation centers, several times less people are treated than in an average public institution, but the clinic territory is sometimes striking in its scale, because in addition to buildings it can include a full-fledged park.
Depending on which direction the entrepreneur will choose, several ares of land may be sufficient for him, and several hectares may be required. Hence the cost of buying out or renting the territory and the cost of building or renting buildings can vary greatly.
In any case, opening your own psychiatric clinic or rehabilitation center will require a businessman at least a couple of tens of millions of rubles. This amount includes not only the construction of a small building, but also the summing up of all necessary communications, the improvement of the territory and the provision of its protection. In the case of a lease, it will be possible to save on initial investments, but then the monthly expenses will increase significantly.
It should also be noted that the rehabilitation or psychiatric center is not equipped with a large amount of equipment, much larger amounts may require the arrangement of adjacent territories and zones of additional comfort. Mandatory are a magnetic resonance imager, a device for psychophysiological testing, a cardiac analyzer and related additional equipment. In private clinics, it is planned to allocate a single room for each patient, which is equipped with everything necessary for living.
You also need to think about conducting a full-fledged advertising campaign, as well as creating your own website, which will become an information platform for posting information about the clinic as a whole, the services and methods of work, prices and conditions of cooperation. However, an elite rehabilitation or psychiatric center can operate as a closed institution, accessible only to a limited circle of people. In this case, customer acquisition takes place through the personal contacts of the owner of the institution, and does not need advertising. At a later date, the average private psychiatric center posts on its website success information and possibly even interviews with patients who have been treated.
The cost of rehabilitation or psychiatric clinic services can vary significantly. The cheapest cost is to be treated by the client in clinics, which are non-profit organizations, because the organizer receives sufficient funding from the state, and therefore can afford to lower prices for services. But he does not work for profit, and such an institution differs from the state only in a slightly higher level of comfort and a somewhat more attentive attitude and quality treatment.
Typically, the course of treatment in such institutions for several months is 10-20 thousand rubles, but this amount rarely includes the provision of a hospital. A commercial organization almost always guarantees anonymity to its client, but here the minimum cost of treatment is 30-50 thousand rubles, depending on the city.
Well-known and progressive, equipped with all modern equipment, clinics already charge an additional fee for the comfort provided, as well as for fame. In most cases, such centers even work as an elite sanatorium with a specific content. Treatment in such institutions can cost several hundred thousand rubles per month. There are more advanced centers, treatment in which can be compared with a real spa, and only the most affluent people can afford such procedures.
But it should be noted that a significant part of the income goes to staff salaries, as well as to the maintenance of the entire complex, that is, the profitability of a psychiatric clinic does not change much depending on its level. In any case, such an undertaking is distinguished by a rather long payback period, especially if the construction of their own buildings and the purchase of land were made. Such an undertaking may be of interest to large investors who are focused on the long term; such a business is also suitable for well-known psychiatrists who are able to work independently.
Matthias Laudanum
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08/18/2019