United States: Should You Rent Or Purchase Your Practice Facility?

Last Updated: July 17 2017
Article by Jason Flahive

Congratulations — you have decided to open your own practice! Or, maybe you have not, but are ready to move to a different, more suitable facility. Once you have chosen the general geographic location, you will face a bigger decision: Should you rent or purchase? They both have their pros and cons.

It is entirely possible that the decision will be made for you. Many practices simply do not have the funds available to build or buy an office. After all, building means a land purchase along with the considerable costs of a construction project. Buying, meanwhile, usually helps avoid building expenses beyond remodeling. However, the purchase of an existing structure will still involve a substantial cash outlay.


What are the upsides of renting a space for your practice? One advantage is that start-up costs are lower and, generally, it can be less expensive. Typically, you need a first and a last month's rent, but not necessarily a down payment. And lease sites often have high-visibility locations that can be difficult to duplicate for a facility you might build yourself.
Additionally, renting allows you to be more flexible about choosing the space and size you need. For instance, you can start small and, when your practice grows, lease additional space or find a new space. Otherwise, you might get stuck building a 10,000 square-foot structure and using only 4,000 square feet of it for the first five years, while still paying for the full space.
On the negative side, expanding your leased space in your existing location might not be possible. As you rent, you are not building equity in the property — the landlord is. Further, if you do make any improvements to the property during your time as a renter, those improvements will revert to the landlord at the end of the lease.
Some landlords limit what types of services physicians are allowed to offer. Often, common area maintenance fees are part of the lease, and renters have little control over them. Finally, when you eventually decide to sell your practice, the process will be significantly more complicated if you are renting. The lease may need to be renegotiated, or the landlord may require approval of the practice's new owner.


If you build or own the site, your building is both an asset and investment, which can build equity over time. In addition, owning the facility can provide stability and control, making the practice more marketable in the future. And, you can make your own building a component of your retirement plan through a sale or by renting it to new tenants.
When you own your building, you will also likely have more control over expansion. And if you build new, rather than buy an existing structure, you will have more creative control over space use and aesthetic considerations, such as architecture and materials.
As mentioned, owning or building your own facility will likely be more expensive in the short term. You will need a down payment and financing. Zoning for your locality may dictate and limit where you can build and the services you can offer. Plus, you may have to navigate local politics to gain all the necessary permits to build a new medical facility.
In addition, when the time comes, a single-use facility sometimes is harder to sell. Although it is not the worst development in the world, if your facility's location goes through a real estate boom, the resulting increase in property value might make it so expensive that it becomes more difficult to sell along with the practice.

Do What Works for You

Whether you are focused on building your own facility or building your practice, it is a good idea to regularly assess if owning or renting best serves your needs, and those of your colleagues, employees and patients. This will ensure that your practice continues to operate in the most optimal way both now and in the long term.

Sidebar: How Much Space Do You Need?

Determining how much space you will need for a new facility depends on the type of practice you are planning to have, whether you have (or plan to have) partners and whether you need a surgical suite. The basic equation is 1,200 to 1,500 square feet for the first physician and 1,000 to 1,200 square feet for each additional physician up to four or five. Traditionally, a single-physician office has three exam rooms, a consultation room, a reception room and a business office and storage space.

The standard equation for your reception room is linked to the number of exam rooms — the more exam rooms, the smaller the reception area. First, think about your busiest hour and decide on the number of patients you expect to see during that period. Multiply that number by 2.5. This allows space for patients, parents of children or relatives and friends of the patient.

Next, subtract the number of exam rooms to arrive at the number of chairs for your reception room. Multiply the number of chairs by 20 square feet. That is the square footage of your reception room.

As you consider your space needs, consider lunch and break areas for staff, along with storage space. Electronic health records and computers can cut down on storage needs, but you will still need room for supplies.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

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Jason Flahive
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