Timing is Key: When to Begin Your Real Estate Transaction

July 16, 2018 quick tips

As the adage goes, “Timing is everything.” This applies to real estate as well, especially when you are searching for that perfect place for your medical practice to call home.

How do you know when to start? You don’t want to be the little piggy that went to the market too early or too late. Too early, and landlords or sellers may not negotiate with you yet, or they’ll expect you to be ready to move forward immediately. Too late, and things get real expensive real fast.

The reality is, most people underestimate how long it takes. Set yourself up for success by understanding how long different transactions take. Here’s a breakdown of timelines for the most common situations and how to navigate them.

Just Renewing? Time to Renegotiate

Time has passed, business is brisk, and it’s coming down to the wire. You know your lease is up for renewal… sometimes. Maybe even sometime soon.

You have a space that you’re happy with, but you’re looking to cut costs or would like some improvements made.

The problem is you’re not entirely sure when to start the renewal process or who to even call. Plus, you want it handled properly. Upon renewing your lease, you’ll want to leverage the context of the market, mitigate risk, and minimize occupancy costs.

A good rule of thumb is to start the process one-year out. The longer you wait the worse your renewal terms may be. By initiating discussions at least twelve months in advance, you allow for more options. Don’t wait!

Growing? You’re Gonna Need a Bigger Boat

Great news – you’re growing! But, you’ll need an office space that will grow with you. You don’t want to be bursting at the seams.

For the relocation process, we recommend giving yourself a lead time of about 12 months. The process may vary depending on your practice’s needs, but here is a brief breakdown of how we handle this process.

  1. First, we conduct a thorough analysis of your office structure, lease, and location.
  2. Then, we evaluate the operating expenses being passed through by your landlord and determine the pros and cons of your existing office space.
  3. After we’ve identified your needs, we prepare a detailed market survey of other opportunities.
  4. We schedule a tour, then review the best options and request proposals from your final selections.
  5. Then begins the process of negotiating the lease terms in order to achieve a mutually agreeable deal.

This process may then be followed by the build-out process if you plan on renovating.

To Build-Out or Not to Build-Out?

Depending on the space, you may want to build-out the space and make tenant improvements. While the length of time estimated for this process varies depending on the complexity, we recommend starting at least a year out from when you wish to move into your new space.

The build-out process includes space planning, designing, obtain permits, create engineering plans, building out, and final approvals. Don’t forget to leave time for installing lighting, equipment, technology, and anything else your practice may require.

Medical build-outs are a unique animal, with their own set of unique challenges. So it’s important to assemble a team that is qualified and well-versed in a doctor’s needs for running a successful practice.

This team is often comprised of an architect, an attorney, a lender, and a construction manager to help you best navigate the sometimes-murky waters of leasing a commercial property, and they will be able to advise you on what you can and can’t do to the property while you are leasing it.

One is the Magic Number

Ultimately, if you remember nothing else about this post, remember that “1” is the magic number. You need to allow at least one year to search out a great location, one year to initiate talks regarding renegotiating a current contract, and one year to either build-out to accommodate growth or look to move your practice elsewhere.

And if you need a friendly reminder of when you are one year away from the expiration of your lease—just click here. We are happy to help.


The Boutique Retail Approach to Healthcare

June 27, 2018 The GZ Take

Healthcare is and always has been an industry that changes rapidly. 2018 has been no different, but this year the trends have focused on value, quality of care, and patient outcomes.

Many medical practices have been scrambling, trying to figure out how they can deliver the best patient care experience yet still turn a profit. This has become more and more difficult due to high overhead, tightening government regulations, and only a finite number of hours in the day with which to devote to patients.


Micro-Hospitals On The Rise

June 15, 2018 The GZ Take

As baby boomers age and patients increasingly seek care in non-hospital settings, micro-hospitals are emerging as a solution for providing essential healthcare at the community level.

Capable of meeting up to 90% of local healthcare needs, Micro-hospitals fill the gap between emergency departments and full-service hospitals. They deliver more  services than typical outpatient or urgent care centers, including diagnostics, labs and surgery provision. Plus they’re efficient and economical to build.

Why Micro-Hospitals?

Micro-hospitals are a response to patients’ preference to choose their healthcare providers based on location and services offered. The commodification of healthcare means that patients are demanding hospitality-style approaches to healthcare delivery.

Flexible, versatile and with a smaller footprint than larger-scale hospitals, micro-hospitals can be strategically positioned for prime accessibility. Building costs are lower than for full-scale hospitals, and services can also be configured based on local demand. Plus, they can bill at rates comparable to acute care hospitals, delivering excellent ROI.

Micro-hospitals are an affordable, efficient and effective way to provide the services of big hospitals in smaller communities that could not otherwise support a major healthcare presence.

What to Expect

Micro-hospitals typically span 15,000 SQF, and typically incorporate 5-15 inpatient beds for observation and short-stay use, as well as lab and diagnostic capabilities. Service provision varies depending on local needs, but can include surgery, radiology, emergency departments and diagnostics.

Micro-hospitals operate on a 24/7 basis, and expect to see between 30-100 patients daily, depending on the market.

The Story So Far

A response to “population health” initiatives, Micro-hospitals bring high-quality, “one-stop shop” healthcare to areas more convenient to the population they serve. They provide a new patient access point, as well as a new way of providing care – filling a gap in hospital-level services for communities outside major urban areas.

The demand is clear. Micro-Hospitals can already be found in at least 19 states – with more than 50 nation-wide as of 2016 – and their popularity will greatly increase with both providers and patients as awareness and access grow.


The Growing Need for Data Security in Healthcare

June 7, 2018 quick tips


Healthcare security threats are ever-changing and ever-growing. And so are their associated costs. The costs of healthcare data breaches are among the highest of any industry. Each breach costs $380 per record — or $6.2B globally.

With 90% of hospitals reporting a breach, the risk of facing these costs is all too real.


Debunking A Myth: You Save Money By Not Using an Agent/Broker

May 14, 2018 For Doctors, quick tips

You wouldn’t perform surgery on yourself, would you? Whether you’re negotiating a lease renewal or looking for new space, believe it or not you won’t save money by eliminating the middle man. In fact, you may cost your practice more.

Another thing to keep in mind is there is a commission pool built into most lease deals comprised of rental funds. If you don’t hire a broker to represent you, the landlord’s broker or leasing agent will take the full commission. If you are represented, the fund is shared with your broker or agent. Either way, the commission comes from the pot, not your pocket.


Give Your Waiting Room a Refresh

April 19, 2018 patient experience
photo courtesy of GZ client, Bluemont Plastic Surgery

When it comes to medical care facilities, they need to be designed in such a way that it is easy to change things around when needed. Adaptability is the name of the game, especially as a medical practice grows and gains more patients.

Needs change, and what worked well before may not work as well now. This can be true not just of the space and facility itself, but also the equipment and technology, and even how the facility is staffed and managed. Quality of care is the most important thing, and a facility that can adapt to provide care that is most effective is a facility that will continue to grow and prosper.


Industry Trend: The Rising Tide of Group Practices

April 6, 2018 The GZ Take

For several years the medical industry has been facing a major shift: from the private practice to the group. Increasingly privately owned practices are giving way to group practices helmed by larger corporations or by new providers aiming to offer services directly to patients — and primary care physicians are leading the trend.

There are several reasons this shift is occurring. These include decreased profitability, operational challenges arising from reform efforts and a drive for efficiency. Declining reimbursements and an increase in time spent on admin — not to mention the expense of integrating and maintaining electronic systems — are making the private practice less viable. But there are also larger market forces at play.


How To Spring Clean Your Medical Practice

March 21, 2018 quick tips

With the cold days on their way out, and warm spring and summer months fast approaching, it’s time to do a little spring cleaning and prepare for a busy season ahead.

Making sure your medical practice is clean, tidy, and organized not only presents a professional and reassuring appearance for your patients, it also helps to keep your staff productive and on task.

When everything has a place and everything is in its place, not only is efficiency improved, but quality of care too. Here are a few things to keep in mind as you prep for the big cleaning day.


Dentist Office “Must-Haves”

March 5, 2018 quick tips

Every dental office is different and provides patient experiences in individual and authentic ways. But there are some things that should always be a consideration, if not mandatory for a successful practice. Here are a few “must-haves” every dentist office should strive to provide.


Top 5 Questions To Ask Before Leasing Medical Office Space

February 19, 2018 quick tips, relocation

After years of hard work, it’s time to expand. You’re a successful medical or dental practice and you’ve decided it’s time to lease new office space. As one of the largest expenses, choosing the right office space is a major decision that can impact your practice in so many ways.  The following five questions is a great place to start.

1. How much space do I need?

Having the wrong-size space – either too big or too small – is the biggest pitfall. So, first ask yourself if you’re downsizing or planning for continued growth. To assist in determining your current and future needs, you may want to enlist the services of an architect to help in your decision making.  They will be able to evaluate your current office, likes and dislikes and to determine the inefficiencies that may occur from your current design.  As important is choosing one that knows medical design, current practice trends and one that will understand your unique office flow.


The GZ Take: Tyson’s Corner Medical Center

January 24, 2018 The GZ Take

Good news for emergency medical practitioners and patients, Reston Hospital Center (HCA) has announced a $1.1m expansion in the Tyson’s area.

The funds have been earmarked towards a two-story, 16,250 sqft emergency center located at 2000 Old Gallows Road in Vienna. The center, will have capacity for 11 patient rooms, all dedicated to emergency care, as well as surface parking and parking for emergency services vehicles.

While the hospital is working to have the site rezoned from its current commercial use, the project has already received regulatory go-ahead from the state.

And no wonder. The development is a timely response to a boom in local population growth — one that’s on a continually upward trajectory. Current projections indicate that the area will be home to 100,000 residents and 200,000 jobs by 2050.

A 24-hour emergency department in the heart of this thriving area will deliver local, accessible care and take some of the pressure off county emergency services. Specifically, it will help address patient transport inefficiencies and emergency room overcrowding. We’ll see better response times and better healthcare outcomes.

But having a new player in the area isn’t just good for patients — it’s also good for healthcare industry workers. The new project will come with a need for ER physicians, nurses, imaging technologists, billing specialists, lab techs and more.

We can also expect to see competition continue to heat up between HCA and the nearby Inova Fairfax, located just 4 miles away as it has in Loudon County.  The battle will continue between the two healthcare giants to gain more of the Northern Virginian patient market share, which should be great for patients and their healthcare needs.

Given the area’s rapid expansion, the new center is likely just the beginning of what’s to come for  for patients in the Tysons/McLean/Falls Church markets. Stay tuned!

Read more about this development



Buy vs. Lease – The Medical Practice’s Guide

January 16, 2018 relocation

Finding the right medical office space is a different process for every practice. Some choose to lease, some choose to buy. There is no right or wrong answer in either direction, it really boils down to your specific needs and comparing the pros and cons accordingly. With that said, it may be helpful to ask yourself a few questions and make a list of your comparisons. Let’s talk leasing first.