Path 06 of 08

Property and Real Estate

Lease structure, owning the building, location analysis, build-out costs, and the real estate decisions that affect practice economics for decades.

Real estate decisions have multi-decade implications for practice economics. The lease you sign at startup affects margins for ten years. The buy vs. rent decision affects retirement planning. This path covers the property and real estate framework for clinic operators.

Sequenced Reading

The path, in order

Step 01

Location Analysis for an Independent Clinic

How to evaluate potential clinic locations financially. Demographics, competition, lease economics, and the tradeoffs between location quality and rent burden.

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Step 02

Zoning Considerations for Healthcare Clinic Locations

Zoning rules that affect healthcare clinic locations, the differences between commercial and medical zoning, and the diligence required before signing on a space.

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Step 03

Clinic Lease Negotiations: What Operators Should Know

The negotiation points that matter most in healthcare clinic leases. Base rent, escalations, renewal options, and the leverage operators have during negotiation.

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Step 04

Commercial Lease Clauses That Matter for Healthcare Clinics

Renewal options, exclusivity clauses, demolition clauses, and provisions that protect the practice from landlord changes. The clauses that affect long-term practice economics.

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Step 05

Tenant Improvement Allowance for Healthcare Clinics

How TI allowances work, what they cover, how they're recovered through lease rates, and how to negotiate them effectively for healthcare clinic build-outs.

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Step 06

Commercial Lease Assignment and Subletting for Healthcare

What happens to your lease if you sell the practice or need to move. Assignment rights, subletting provisions, and the lease flexibility that affects practice exit options.

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Step 07

Rent as a Percentage of Revenue: Healthcare Practice Benchmarks

What healthy rent ratios look like across specialties, what to do when rent runs high, and how to think about rent burden when evaluating locations or lease renewals.

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Step 08

Clinic Lease Renewal: The Buy vs. Lease Decision

When the lease comes up for renewal, the buy vs. lease decision becomes real. The financial framework for evaluating commercial real estate ownership against continued leasing.

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Step 09

Own vs. Rent the Clinic Building: Commercial Mortgage Considerations

How commercial mortgage financing works for healthcare practice buildings. The capital requirements, financing structures, and long-term economics of practice real estate ownership.

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After You've Read the Path

Tools for real estate decisions

The Buy vs. Lease Calculator models the rent-vs-own decision with Canadian semi-annual compounding and TI allowance handling. The Cost Estimator helps you size build-out costs.

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