Straight Talk About selecting Medical/Dental Office Space on Orlando Medical News

Straight Talk About selecting Medical/Dental Office Space

By: FRANK RICCI

Posted: Thursday, June 10, 2010 2:40 pm

Locating your professional office is an important step in determining the success of your practice. Rather than sending you out on the road to LWDA (Look while driving around), let me quickly guide you through some important site selection criteria.

When should I start looking?

While it is possible to locate adequate space at the last possible moment, a thoughtful and well conceived plan will take you some time. If you are looking to lease space that is already built, you will need approximately six months to locate the right space. If you are looking to build-out space within an already constructed building, you will need 9-15 months, depending on the amount of renovation. If you are looking to build a new facility from the ground up, expect a time frame of at least 2 years, especially if there are zoning issues.

How much space do I need?

The first step is to complete a space program analysis to determine your personal requirements. This will include all of the spaces you need within your office, such as treatment rooms and storage rooms. Based upon this information and space for circulation (halls, etc.), you will have your net square footage requirements.

If considering a particular location, you might be surprised to learn that square footage is calculated in several different ways and that the difference between two commonly used methods can easily be 25 percent. For example, an office calculated two different ways may be advertised as 1,600 sf or 2,000 sf. Without knowing the basis used by the owner, you may find that your practice actually does not fit the space in spite of your calculations.

Where should I locate my practice?

The location of a practice is oftentimes specialty specific. Typically, the general specialties such as family practice, pediatrics, dentistry, etc. are located in the neighborhoods they serve. An important aspect of site selection for these practices include demographics, traffic patterns and numbers, a competitive market survey and projections for new development.

Surgical specialists and physicians that spend a great deal of time within the hospital often find it advantageous to be located within walking distance to a hospital. Many practices have incorporated hospitalists to manage rounds and patient management tasks but there are additional benefits for specialists to locate near hospitals. These include: better referral patterns, proximity to high tech services, highly trained personnel and proximity to emergency services for high risk patients.

Generalists and specialists need to consider the source of their patients in either case and cultivate the means and methods needed to reach their audience.

What are some specific site requirements?

Common requirements for all healthcare professionals are the following specific requirements:

Signage or identification - the ability of your patients to find you
Proximity - to your patients home and or office as well as their ability to reach the facility by major traffic thoroughfares
Site access - the ease with which patients can turn into your facility relative to traffic, traffic lights, curb cuts, sharp turns, etc... Your patients are probably ill, anxious, with children or elderly and if they have difficulty finding your office, it will be very difficult to keep your practice running smoothly and on schedule.
Parking - due to the nature of the patient visit, a physician's office requires more parking, more handicapped parking and parking in closer proximity to the building entrance than a typical commercial building
Weather protection - due to the amount of rainfall in Florida, a covered drop off area at the entrance is an asset
Interior access - interior signage, elevator operation, restrooms are all important criteria

What are some other factors to consider?

Here are some additional factors to consider for either a lease or purchase.

The layout of the space is critical to efficient operation of the practice. Ideally, the space will be designed for the optimal interaction of the three work components; staff, records and patient flows.
Flexibility - Typically, an office lease/purchase will result in a substantial commitment in terms of time and money at a particular location. The ability to expand or contract the practice space requirements as required, will maximize the physicians return on investment and will allow the physician greater control over risk management.
Privacy - All too often, this is considered a fringe benefit. Elements of privacy include visual privacy while in the exam rooms and sound control in rooms where personal matters are discussed, dictation is recorded and where patient records are kept. As society has grown more litigious, privacy issues have become much more important.
Patient and staff comfort are also important criteria. An aesthetically inviting facility can calm patients and promote greater productivity from the staff. Colors, textures and scents have all been shown to affect people's emotions and feelings of well-being

What about costs?

Physicians too often focus cost when evaluating medical office space. While this is an important factor in the overall equation, the cost per square foot is a very poor indicator of value. As we have seen, the owner's method of calculating square footage can have a significant impact on the cost/sf additionally; the stated lease/purchase cost rarely includes all of the costs that will be incurred. Some additional and/or hidden costs include: core area factors, common area maintenance charges, escalations, utility expenses, janitorial services, building insurance and real estate taxes.

The terms of the lease/sale also deserve careful consideration. The most important may be the length of the lease and renewal options, if any. Typically, the sale/lease represents a substantial investment and care must be taken to provide flexibility for the future. Other provisions may include exclusivity clauses, first right of refusal on adjacent space, requirements to return space to original condition and options to purchase or sublet.

Who can help me?

Typically, real estate brokers are enlisted to help locate medical space and or property, oftentimes before some of the basic consulting work (space program, etc.) has been completed oftentimes causing delays, add expenses and prolong the search process.

There are three types of brokers similar to three types of medical practitioners. The licensed agent that performs primarily residential work is similar to a store clinic, able to handle the most basic transactions. There is the commercial agent that is similar to the general practitioner and handles all types of commercial properties, whichever segment of the market that is "hot" at the moment. Due to our continued recession and relatively stable healthcare market, you have seen a huge increase in the number of "medical specialists" in the marketplace. The third type of broker is a healthcare broker, the equivalent of a medical specialist. This is an agent that has received formal training in medical specialties, practice patterns and stays current on the latest advances in technology and the direction of medicine in particular.

Depending on your needs, time commitments and level of expertise, you have three options from which to choose when evaluating the right broker for your needs.

Any concluding thoughts?

Yes, there are many issues to consider when evaluating options for your medical office. The cost for space must be reconciled with the efficiencies resulting from its design, location, accessibility, and proximity to patients and other healthcare providers and services.

Additionally, LWDA (Looking While Driving Around) is not nearly the efficient management practice as the now famous MBWA (Management By Walking Around). It may best serve your needs and time to enlist the help of a specialist in your real estate search.