Table of Contents

• Cover Page
• Legal Page
• Table of Contents
• 1.0 Executive Summary
• Highlights
• 1.1 Objectives
• 1.2 Mission
• 1.3 Keys to Success
• 2.0 Company Summary
• 2.1 Company Ownership
• 2.2 Start-up Summary
• Start-up
• Start-up
• 2.3 Company Locations and Facilities
• 3.0 Products and Services
• 3.1 Product and Service Description
• 3.2 Competitive Comparison
• 3.3 Sales Literature
• 3.4 Fulfillment

Physicians & Surgeons,17th Street Surgery Center is designed to be the premier surgery center in the Orange County, California area. Through a unique combination of multispecialty surgical services offered, experienced in satisfying patients and physicians alike, they will quickly gain market share. Physicians & Surgeons will provide patients and physicians with a beautiful, confortable atmosphere that delivers peace of mind, where all of their surgical needs can be met. The business owner/ operator is Harrell Robinson, MD, with 25 years experience in surgical treatment and many years experience in surgery center management.

Location

The surgery center and medical office building is located at 1450 East 17th Street, Santa Ana, Ca, which is on the Tustin/ Santa Ana border, approximately 300 yards from the Newport Beach Freeway, on a major six lane traffic route. Orange County has consistently over the last few years been voted the best place to work and live in California, frequently making the top five and ten lists of Forbes, Money, and Inc. magazines. Orange County has one of the most educated populations with high population density. The surgery center is located in an area of Orange County that adjoins communities with diverse population mixture. The community directly west of the surgery center has a median household income of $35,000- $50,000; the community directly north has an average income of $90,000- $145,000, and to the east and south, a household income of $50,000 - $90,000. Additionally, the area surrounding the surgery center location has undergone a recent renovation that has attracted a lot of new businesses as well as become a hot urban area.

Competitive Edge

Physicians & Surgeons competitive edge is their unique combination of services, location, pysician, and patient-centric focus, with a multi-specialty approach, in a dirverse densely populated area, nearby hospitals and medical offices. Both the extraordinary services and location has been detailed previously. Physians & Surgeons has set out since its inception to provide quality, dependable services with an innovative training program that is extensive in its depth, properly training employees to provide an unprecedented level of customer service. All patients and physicians will leave the surgery center with a feeling that their needs were met well beyond any expectations that they previously had and far better than any competitor. This physician/ patient-centric business model is not just rhetoric, there are financial incentives in place for employees to offer unprecedented levels of service. This will ensure a high rate of return patients and referring physicians.

The objectives for Physician & Surgeons of O.C., Surgery Center are outlined below:

1. Lease 100% office space to surgeons and physicians who will serve the Surgery Center.
2. Perform $2.5 million in surgery procedures in the first 12 months
3. Become an established community surgery center by the end of first year.

Our mission is to shape the health care environment by advancing the highest quality, cost-effective, patient-centered, and physician-directed health care; a premier surgery center that promotes patient comfort and quality of care.

1. Effective marketing to potential patients and qualified surgeons.
2. Establishing trust within the community that each patient's needs will be met with the highest quality of care at every visit.
3. Easily accessible location to a variety of population centers by high street traffic and freeways.
4. Surgeons must enjoy the surgical experience, with elegant surroundings that lend a feeling of trust as soon as they step in the door; surgery center staff trained to provide the highest level of support before, during and after surgery; and state of the art equipment available to enable the surgeon to perform at their highest level.

                      Photograph of Seventeenth Street Surgery Center Lobby

Physicians & Surgeons of O.C., 17th Street Surgical Center, provides the most value for surgeons, patients, and 3rd party payors, all in a beautifully serene setting.

Physicians & Surgeons Surgery Center, stands out above all others by providing reasonable cost, high quality delivery of services that create high patient and physician satisfaction. With 25 years of experience in the North Orange County community, Physicans & Sugeons has a well-earned reputation for quality and success.

Physicians & Surgeons of O.C., at this time, is a privately held corporation, owned by Harrell E. Robinson, MD, FACS. In the course of the ongoing business, we will explore the feasibility of providing limited shares to high producing sugical groups as a lawful incentive for maintaining high volume surgical procedures.

Typical start-up expenses include legal expenses of establishment, expenses for developing logo and stationery, additional equipment to transform a specialty surgery center into a multi-specialty center, medical supplies, and general supplies for setting up an office.

In the following table, the start-up cash has been marked for the estimated amount needed to cover operational expenses for the first three months ($933,000).

The surgery center and medical office building is located at 1450 East 17th Street, Santa Ana, Ca, which is on the Tustin/ Santa Ana border, approximately 300 yards from the Newport Beach Freeway, on a major six lane traffic route. 

Contact has been made with Robert G. Caudill of Grubb & Ellis Real Estate (714-939-6010), for discussion of the 21,802 sq. ft. Surgery Center and Medical Office Building. Conversations occurred with the Building Owner, Harrold Brourman, MD, and his son Steve Brourman, MD, Jerry Herschberg, their accountant, and Dan Freeman an associate realtor.

The surgery center is approximately 7,500 square feet, located on the first floor level, of the two story building. The surgery center consists of two very large main operating rooms measuring 19 feet by 22 feet, and a moderately large operating room, measuring 16 feet by 19 feet. A minor procedure room measures 14 feet by 12 feet. There are sufficiently large clean work room, soild room, Medical Gas room, and Supplies and Linens Room. There is an electrical back up power room, and external power supply station.  There is a three bed pre-op room and an eight bed recovery and nurses station. A Men's changing room, Women's changing room with associated bathrooms and showers, a doctors lounge, two Patient change rooms and additional restroom for Post-op, with a doctors dictation room, business office, reception/check-in, and waiting room, round out the Surgery Center floor plan (see attached exibits for floor plan details).

                                     Photograph of 19 foot by 22 foot Operating Room

Adjacent to the surgery center is a furnished, vacant medical clinic, that measures approximately 3,000 feet, and is subdivided for two physicians. There are two waiting rooms, space for office staff and break room, two bath rooms, x-ray and x-ray developing rooms, space for physical therapy, and  ten patient exam rooms and two patient bath rooms. (see exhibits for floor plan).

The second floor consists of 11,250 sqare feet of medical office space. The layout of the second floor consists of individual offices and a centralized Office/exam/consultation complex, as well as a physical therapy/chiropractic treatment office complex.   The physical therapy/chiropractic complex is complete with therapy equipment, including heat lamps, five whirlpool baths, business office space, two large consultation rooms, and three exam/treatment rooms.

                                Physical Therapy Open Rehabilitation/ Exercise Room

Physicians & Surgoens will provide patients with personal beautifying Cosmetic Surgery services, including laser skin treatments for removal of tattoos and hair, removal of spider veins, and for repair of damaged skin, as well as multispecialty services of OG/Gyn, Orthopedic, Podiatry, G.I., and other minor procedures. With Laser ablation equipment even enlarged prostates can be removed in an out-patient setting. Explanations and/or consultations will be provided on all services and products at no charge for every patient as needed.

There are many Surgery Centers in the greater Orange County area and all are thriving. Even surgical centers closely spaced have an over abundance of surgery procedures. An example of this can be seen at the corner of Euclid and Warner (a location 20 miles away), where the Fountain Valley Hospital Surgery Center exists and does well with three other surgery centers all located in less than the distance of a football field from each other.

Success in the Surgical Center business requires medical offices or hospital accessible for referrals at the very most.  Physicians & Surgeons competitive comparisons are numerous:

1. Harrell Robinson, MD, has a reputation that routinely includes referrals from Arizona, Northern California, San Diego, Riverside, the San Fernando Valley, and of course Orange County, California.

2. There are Nine Licensed Freestanding Ambulatory Surgery Centers, in the area nearby the site of the 17th street Santa Ana Surgery Center, and the distance from the Santa Ana location:

Services brochure, logo/slogan with advertising is to be included, and a website similar to the Physician & Surgeons website http://looknew.2ya.com.  The website shows brochure information related to surgical procedures, map, scheduling information, and patient instruction brochures.

   EXAMPLE LOGO        

                  EXAMPLE INFORMATIVE WEBSITE UNDER CONSTRUCTION

Physicians & Surgeons of Orange County will draw on its extensive network of physician contacts for referrals as well as perform their own surgeries in-house.

Dr. Harrell Robinson, alone, performs $1.4 million dollars in outpatient cosmetic surgeries per year. An associate, Nazih Haddadd also performs over $1 million dollars in outpatient cosmetic surgeries each year. Associate Reza Ahkmadinia performs over $800,000 in Gyn procedures in outpatient clinics each year. There would be additional revenues from Orthopedic, Podiatry, G.I., ENT, and Opthalmologists through network contacts and advertising. A small Othopedic group and a G.I. specialist should add $4 Million or more to the revenue.

Physicians & Surgeons Surgery Center will have the latest equipment and facilities available. The facility which is accredited by the State of California and Medicare as well as the Accrediting Association of Ambulatory Health Care gives patients and physicians a convenient, yet equally sophisticated alternative to surgery at the nearby Western Medical Hospital or other hospital/surgical facilities. Physicians & Surgeons Surgery Center lacks the time-wasting red tape of hospital associated ambulatory centers such as the nearby St. Joseph's Hospital Pavilion Surgery Center and the Tustin Hospital SurgiCenter, and yet does not cater solely to a limited surgical group like the La Veta/ HealthSouth Surgery Center, or the Specialty Surgery Center of Orange.

This  surgery center offers the finest state-of-the-art technology - including three spacious operating rooms with a minor procedure room, and fully equipped preoperative and post-anesthesia care areas - to provide the highest level of care in outpatient surgery.  Specially designed to put the patient needs first, the center offers a full weekday schedule and an abundance of free on-site parking. 

The Technology that caters specifically to surgeons of a variety of specialties include, a state of the art YAG laser for endoscopic sinus surgery, endoscopes for G.I. specialists with power and photographic tower that provides the best in medical recording of G.I. procedures. Specialty procedure lasers are:

1.  EpiLight which is a specialized laser which was developed to specifically treat unwanted hair is one of the most versatile lasers around, and can also eliminate unwanted tattoos, and remove Spider Veins, or telangiectasia, which are those small red, blue and purple blood vessels that appear most frequently on the face and thighs. The SuperFast EpiLight used with pulsed light for exceptional comfort, is currently the fastest machine available for hair removal. The SuperFast EpiLight enables treatment of an entire back full of hair in approximately 30 minutes with gentle, fast, effective, and long-term results.  The typical rate of hair removal for a complete back with other lasers is seven to ten hours.
2. The CO2 laser for skin resurfacing : Laser skin resurfacing is an exciting medical procedure which corrects the effects of the sun, wind and time. Physicians around the world use the pinpoint accuracy of advanced CO2 (carbon dioxide) lasers to repair damaged skin. Laser skin resurfacing reduces wrinkles without scalpels or stitches. The laser emits an intense beam of energy that heats and vaporizes tissue instantaneously. It is so precise that the normal surrounding tissue is not affected. As the doctor guides the laser's beam over the damaged or wrinkled skin, it gently removes the outer layers. Fine lines and wrinkles around the mouth and eyes are smoothed. Deep creases and frown lines will be softened and acne scars are minimized. Once the outer layer of skin has been removed, the new skin beneath is softer, smoother with a more youthful appearance. Laser skin resurfacing may be performed in the minor procedure room with local anesthesia when limited areas are treated, and for full facial resurfacing which is usually performed with the administration of intravenous sedation.

The Operating rooms are spacious with excellent lighting and equipment.  All three operating rooms and minor procedure rooms have Dual brightness, recessed, four bank illuminators for an exceptionally bright room. Each of the operating rooms and minor procedure rooms have a motorized O.R. table and a surgical light that can provide optimal illumination and light positioning. The three major operating rooms each have a modern anesthesia machine with available additional oxygen and nitrous gases from a centrally placed gas room, as well as the gas tanks on each anesthesia machine. The latest monitoring equipment, suction, electro-surgical power supplies and emergency cart are also present

                      ACTUAL PHOTO OF SMALLEST OF THREE MAJOR OPERATING ROOMS

Looking ahead, the Physician & Surgeons Surgery Center may decide to include even wider services, such as dental services and/or Lasik vision services.

Because the medical office space can be utilized for a variety of services, it is possible to provide executive offices and a receptionist service for professionals who desire to have a part-time Orange County address, such as attorneys, mortgage brokers, or other professional services that have offices in other counties and merely need a low cost alternative for having a branch office. The professional makes an occasional appearence in the 10 X 8 feet one-room executive office or cubicle, which consists of a phone, desk and file cabinet and not much more, but is serviced by a full-time receptionist, giving the appearance of a larger, more active business. Executive Suites give the added benefit of short term vs. long term obligations - both from a planning and a financial statement point of view, and provides an image of a complete full-time office. Pricing is from $399 to $1200 for a private one-room office per month, or as low as $65 per month for simple phone and mail service (a mail drop is established and phone messages are taken and forwarded).

Orange Counties 3 million+ population (almost 10% of the California total), makes it the second largest county in California, trailing behind Los Angeles County. Nationwide, Orange County ranks as the fifth most populated county with 3,600 persons per square mile. Orange County has averaged a 2% annual population increase in the ten years since 1990 to year 2000, and 5% growth since 2000 to 2005; rapid growth is expected to continue.

The members of these market segments have luxury money on hand, lead professional lives, and make the effort to find the money available to style their "look", for Cosmetic surgery services, and have insurance for all their surgical medical needs. An active sports life also leads to frequent orthopedic sports injuries.

People love to pamper themselves and readily take care of their health concerns, especially people who have achieved a modicum level of professional success. Orange County has become a bastion for the successful, having consistently been named as one of the best cities in America to live and to do business in since the mid 1990's. This has created a community of wealth, mobility, and growth. 

With the continual growth of Orange County, new home development, continued strong economic growth, and near perfect weather year round, Orange County will only become more popular over time. The trend to reduce costs by 60% from traditional hospital surgery costs, perform surgeries on an outpatient basis with the patient recouperating at home, and the ease of access to the surgery center for physicians, the trend toward ambulatory surgical services will continue to expand.

As of 2005, California's economy is larger than all but five national economies in the world. Although the state historically has a reputation as being more sunny and laid back, it is responsible for 13% of the United States Gross Domestic Product (GDP). The Gross State Product (GSP) is about $1.55 trillion ($1,550,000,000,000, as of 2004), making it greater than that of every other U.S. state and greater than most countries in the world. 

The County of Orange's greatest strength is its astonishing diversity. It's what both delights and befuddles newcomers, for just when you think you have it figured out, that you know what these 782 square miles are all about, you stumble across a vision of Southern California that is nothing like what you imagined, whether it be the bustling community of Little Saigon, home to the largest concentration of Vietnamese Americans in the United States, or rustic Silverado Canyon where stagecoach service ran over a hundred years ago between there and Los Angeles.

There is an undeniable connection between the ocean and the County's lifestyle. Perhaps it's because life is said to have risen up out of a salty sea or because the human body is seventy percent water. Whatever the reason, visitors and residents alike are constantly drawn to the ocean--to play, to create, to meditate, to envision--here in the County of Orange. Our 42 miles of coastline offer up spectacular views and a wide spectrum of entertainment that all translate into a certain lifestyle that you can hear in the music, see in the fashion, and taste in the food.

We are part of the healthcare industry which has four major types:

1. Physicians: Practitioners and groups of practitioners providing office based medical services.
2. Hospitals: Overnight stay medical treatment with complete medical services of laboratory, x-ray, surgery, cardiac, pediatric, intensive care, emergency services, and long-term care.
3. Day Spa, Salon, and Weight loss: Stores combining the services of minor cosmetic services, skin care, and occasional medical services such as Botox (by a part-time physician), and weight loss services.
4. Ambulatory Surgery Services: An ambulatory surgery center (ASC) is a distinct entity that operates exclusively for the purpose of providing surgical services to patients not requiring hospitalization.

The general structure of the industry consists of medical practitioners (MD, DO), Chiropractic (DC), specialist therapists such as physical therapists (RPT), Counselors (PhD, and MS), Nurse Practitioners (NP), and certified medical providers (medical assistants, laser and dermabrasion medical personnel, and Nurses such as RN, and LVN).

Hospital based treatment has always been the gold standard for insurance company payors, but also the greatest cost to insurers. Chiropractic services tend to be limited by insurers as are psychological and drug dependency, or counseling services. Nurse practitioners are being found throughout the industry in greater numbers as the Nurse Practitioner (NP) can own up to 49% of a medical practice. Many medical businesses can provide greater care at lower cost by employing Physician Assistants, Nurse Practitioners, RN's, LVN's, and Medical Assistants, with the Medical Assistant the least trained and lowest compensated of all medical personnel. With a 60% savings over traditional hospital based surgery, ease of access, and convenience for patient and physician, the Ambulatory Surgery Center part of the industry is in a growth stage.

Surgeons will choose a surgery center based on appeal, patient satisfaction, availability of the best and most diverse services, ease of use, and price. Patients choose a surgery center by skill of surgeon and secondarily by location near their home or work.

The main competitors are: MAIN STREET MULTI-SPECIALTY SURGERY CENTER, LP ORANGE (2.5 miles);TUSTIN SURGICENTER, L.P. TUSTIN (3.4 miles);LA VETA SURGICAL CTR., AN AFFILIATE OF HEALTHSOUTH ORANGE (2.1 Miles);PROVIDENCE AMBULATORY SURGICAL CENTER ORANGE (2.4 Miles); ST. JOSEPH SURGERY AND LASER CENTER, INC. ORANGE (2.4 Miles)

Our market advantage is wide open, and will give us the opportunity to service a large population base that is not currently being well served.