Category: Medical Real Estate

How do I start a dental practice in Atlanta?

Dec2
2014
Posted by
Brokerage Department

Easy answer: Ask someone you trust.

Dentists begin the process any number of ways. Some start with equipment vendors. Others look for rental space or contact dental office brokers seeking to purchase a fully functioning dental office. But at some point, the question emerges:

Do I want to start from scratch or purchase an existing practice?

There are no wrong answers to this question. Practices, like real estate, are valued by the market. There are times (if prices and demand are low) when there’s no question that purchasing a practice is the right solution. In the last year, most of our clients sifted through every dental practice on the market and felt the existing inventory was picked over. If that’s the case, then you have two options: wait until the market changes or start your own practice. If you’re to the point that you’re ready to start your own practice from scratch.

Where do I begin?

If you’re early in the process, you may not yet realize that real estate is just the tip of the spear. Dentists need a solid team to aid in the daunting process of starting their own practice. The team should include:

  • An equipment vendor; in the Atlanta Market we have partnered with Henry Schein, Benco, Patterson or Atlanta Dental
  • An office designer; the equipment people can serve this need but we also recommend Peacock
  • A lawyer; we suggest the use of an attorney who specializes in real estate to review all legal documents
  • A dental consultant; McIntyre & Associates and Larry M. Guzzardo are two great local consultants
  • A finance company or bank; Affinity Bank and Bank of America have excellent solutions tailored for dentists
  • Contractors, technology firms, data providers, etc.

But none of these can get very far without the identification of real estate.

If you live in a market that supports dental-focused commercial real estate brokers (like us in Atlanta), an experienced real estate broker will have a network of providers to guide you through the process. Even if that option is not available to you, it still benefits you to find an experienced broker who will advocate on your behalf to ensure the best possible outcome. When seeking such a broker, look for a broker who:

  • Focuses exclusively on commercial real estate
  • Works exclusively with dentists
  • Has represented other dentists you know

Some markets may have only two of the above, but I’ll bet you can find at least one of the above requirements in any market. The experience of a commercial, dental focused and trusted broker combined, offers a professional with whom you can go into battle.

From here, the paths toward practice ownership are legion. But with a good foundational team, in place from the beginning, you’ll have the guaranteed support you need to make the best decision should any trouble arise.

 

To read the entire post and learn how to start a dental practice in Atlanta, click here

 

Dental Market Comparison Report

Sep30
2014
Posted by
Marketing Staff

You’ve been thinking about opening a new practice and have been eyeing a couple really nice areas. You’ve driven the major roadways, you’ve stopped for coffee, you know what schools are nearby, but you’re still not 100% sure how the different markets stack up against each other. All in all, each market seems like a winner. How does one possibly begin to get an accurate picture of the demographic breakdown, dentist saturation, and healthcare spending habits of an area without being there day in and day out?

 

Our clients are, through experience, very familiar with the demographic breakdown of their area. They’re
comfortable with their market share and would clone their office and plop it in East Cobb or maybe Snellville
if that were possible. To bring some perspective to various markets, we’ve developed an easy-to-understand
Dental Market Comparison Report.

To read the entire post and learn more about our Dental Market Comparison Report, click here.

Market Spotlight: Gwinnett County

May26
2014
Posted by
Marketing Staff

In our continuing look into the viability of Metro Atlanta counties, we’re focusing this time on Gwinnett County and its ability to remain one of the strongest counties in the Atlanta region and the country.

Gwinnett County is the second largest county in Atlanta and  the most densely populated county per square mile in the Metro Area. The convergence of many diverse cultures make Gwinnett County a unique microcosm — a competitive advantage that would most likely ensure the success of  a multilingual practice.

Gwinnett also has a healthy diversity of industries supporting its economy. Some of the major industries include:

  • Supply Chain Management
  • Information Technology Solution
  • Advanced Manufacturing
  • Health Sciences and Services
  • Headquarters and Professional Services

To read the entire post and learn why Gwinnett is ideal for business and dental practices, click here

 

Market Spotlight: Forsyth County

Apr17
2014
Posted by
Marketing Staff

The Georgia Health Policy Center’s study of Georgia’s dental workforce defines a “dental professional shortage area” as a geographic area with less than one dentist for every 5,000 residents. While Forsyth County is not named as one of these areas, its population growth makes it a strong contender.

Forsyth County is the seventh fastest growing county in the nation, according to Forbes Magazine. In the past two years, the population grew 7.07%. What’s the allure? It could have something to do with Forsyth County’s award-winning schools, which boast the highest CRCT and ACT scores in the state. Perhaps it’s because Forsyth County was named one of the 100 Best Communities for Young People by America’s Promise Alliance in 2012. Whatever the reason, the demographics confirm that the population is growing. The population is educated (26% have attained at least a Bachelor’s degree), employed and the average household income is nearly $100,000. That’s pretty impressive.

To read the entire post, click here

Factors That Affect Our Economy, Dentistry and Your Business – Part III

Nov11
2013
Posted by
Marketing Staff

We’ve reached the last installment of our three-part series on the Factors That Affect Our Economy, Dentistry and Your Business.

We first looked at the State of the Market and identified the destabilizing factors of 2013. We then looked at four risks to consider in 2014 — growth, interest rate fluctuations, lease costs and demographics. This time, we are going to address the opportunities that exist for dentists in this market in the now familiar risk sections.

 

To read the entire post, click here

Factors That Affect Our Economy, Dentistry and Your Business – Part II

Oct31
2013
Posted by
Brokerage Department

A couple of weeks ago, we went over some of the factors that contributed to the current situation. If you missed that, click here to read what happened. This time, we’re going to explore some of the risks/problems that have developed as a result of these factors. They can be broken down into three aspects:

  1. Growth
  2. Interest rate fluctuations
  3. Lease costs
  4. Retirement for all age groups

To read the entire post, click here

 

Factors That Affect Our Economy, Dentistry and Your Business – Part I

Oct21
2013
Posted by
Marketing Staff

Dentist

If you’re running a dental practice in today’s market, you have most likely seen a lot of changes, from classmates selling their practices to competitors being acquired. Perhaps you’ve experienced some change yourself, worked through tough times or received offers to purchase your own practice.  Whatever the case, we’re all a little shell shocked by these occurrences, wondering what happened and what we should be doing in preparation for what’s to come. 

In our three-part series, we will look at the factors that are affecting our economy, dentistry and your business.  We will provide a snapshot of what happened in part I, then in part II, we will examine the associated risks and finally, when you’re in the middle of planning for next year, we’ll get to the really good stuff in part III —the opportunities.

To read the entire post, click here

Making the Case: A Game-Winning Drive

Sep24
2013
Posted by
Marketing Staff

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In commercial real estate, you don’t often get an opportunity to create, much less lead, a last-minute game-winning drive. This is exactly what makes Tenant Broker Ted Schwartz a true asset to his clients — most recently, Orthopedic Surgeon Dr. Vincent Boswell.

Dr. Boswell, under poor advisement, had selected a new space for his practice and was in the process of reviewing the corresponding lease which was only days away from execution. His attorney, having recognized his lack of enthusiasm and overall dissatisfaction with his current situation, recommended that Dr. Boswell hire another broker to redirect the relocation process.

Given that the client’s current lease was expiring in just a few months, Ted got busy at work. Within two weeks on the assignment, he identified a viable location that met all of Dr. Boswell’s requirements; the main ones: close proximity to the practice’s current patient base and the doctor’s residence. The new deal resulted in a seven-year lease with a healthy tenant improvement and concessions package, and most importantly a reasonable lease guarantee provision.

Deal Highlights:

  • Prime South Buckhead location just steps away from Piedmont Hospital (1776 Peachtree St NW, Atlanta)
  • 2,673 SF lease; 7-year term
  • Converted free rent into extra tenant improvement to lower tenant’s out of pocket costs

 

 

When Should a Medical Practice Hire an Attorney?

Jun17
2013
Posted by
Brokerage

For many businesses, it is a practical decision to involve attorneys in important considerations. Regardless of size or specialty, medical practices require a knowledgeable real estate attorney just as much as they need a good accountant. While it may be tempting (and economically appealing) to attempt to handle real estate matters yourself, each advisor possesses a valuable skill set. A good attorney will ask questions you haven’t considered, tailor documents to reflect the negotiated business terms, and provide guidance and overall risk management. 

What Kind of Attorney Does My Practice Need?

While it is not necessary to use a real estate attorney who specializes in medical real estate, some real estate issues are specific to medical practices. Hiring an attorney who has experience with medical clients help you more than hiring one without this expertise.

For example, a real estate attorney who specializes in medical property will know that leases for medical space need to contemplate the following issues, among others:

  • Leasing provisions should have flexibility to add/replace physicians without landlord’s approval
  • Regulatory requirements such as Stark Law that are unique to medical practices
  • Use provisions need to be broad enough to allow the equipment within leased premises
  • Limitations should be included to effectuate a release of professional guarantors who retire or become disabled
  • Contingency of lease obligations upon licensure required to operate the business
  • Transfer and assignment due to sale of the practice without triggering default provisions

A real estate attorney is particularly important for medical practices wanting to purchase and/or build their own facilities. Your attorney should review zoning and land-use restrictions before you purchase a property in order to confirm that you would be permitted to practice medicine from that location.

Additionally, parking and access considerations are vitally important to the health of the practice.

Finding an Attorney

The selection process is not unlike finding a medical provider. A great first step in identifying a potential legal advisor is through your peer or colleague network for referrals. Most legal professionals would be glad to set up an initial call or meeting for a reasonable charge and sometimes free of charge.

Before making a decision, inquire about the following:

  • How many medical practices they have represented in connection with real estate issues?
  • Their area of experience (medical group, landlords, etc.)
  • Their experience in representing medical groups in non real estate transactions, including general medical group issues

Take the opportunity during this phase to clearly understand the economic expectations: the attorney’s hourly rate, who will do the work, how billing will be handled, and whether you may be required to provide a retainer if the attorney should incur significant out-of-pocket costs.

How to Use Your Real Estate Attorney

In most cases, you’ll be consulting your real estate attorney for issues of real estate law that deal with leasing. But don’t hesitate to contact your attorney for matters relating to buying, selling or financing property, or litigation that arises out of real estate issues, such as a dispute over rights to land.

To read the entire post, click here.

 

Medical Office: Considering a Satellite Location?

Mar18
2013
Posted by
Brokerage,

Although a satellite office is a great and fairly inexpensive way to extend your reach into other markets, it will require you to divide your time and resources, with no guarantees of return or performance. It is therefore imperative that you take adequate precaution to protect your practice, yourself and your finances.

Weigh the risks. The biggest risk practices face when opening a satellite office is that patients do not materialize as anticipated. Some groups have ultimately closed their new office because of a lack of patient volume. When a practice can establish a master schedule that includes a mix of follow-up patients and new patients that would fill the satellite office days, it can maximize the physician’s time.

Think small and short term. Many experts advise medical professionals to “think small” when it comes to satellite offices – no more than 2,000 square feet (depending on expected patient volume). Start your satellite office with a short-term lease, if possible 1-2 years in length with a renewal options. Look for ways to protect yourself with a termination clause if the office no longer makes economic sense.

Subleasing space from another doctor with a different and/or complementary specialty is a smart way to minimize your rental obligation for a satellite office. This arrangement may allow you to take advantage of shared common areas and support staff. With an existing doctor’s office, you can eliminate or at least reduce the tenant improvement exposure. In a sublease from another physician group or even a timeshare, you can limit the amount of space you need to about 500 square feet, which would include a couple of exam rooms and part of the reception area or even just to ½ day increments.

In comparison, the smallest suite you would lease on your own would be double that amount at about 1,000 square feet. In that scenario, you would pay the full cost of two or three exam rooms, an office, a lab space and a work area.

Most practices will know after a year of operations if they are going to gain traction in a market with their satellite office. At that time you can evaluate a longer-term arrangement.

Diagnosis: It may be beneficial to consult a medical leasing specialist. There are often existing subleases available (at a discount) for medical suites that have been vacated by another group. A good broker will know the market and available ready medical suites where advantageous deals can be achieved minimizing the commitment, expense, risk to the physician, and the practice.