Designing the premier practice

Issue: May/June 2010

ByRichard C. Haines Jr.

Not everyone needs, or wants to, build a new building. For some, occupying your own free-standing building may be the fulfillment of a lifelong dream or a statement to your community. Sometimes it is the only way to get an efficient practice environment. Maybe you want the real estate investment or want to stop paying some else rent. Whatever the reason, once the decision has been made that practicing in someone else’s building is no longer an attractive option, most doctors start to look for land.

In some towns, vacant land is only available on the periphery of the town. The area around the hospital is all built up, and there are no opportunities near there. Doctors drive around looking for land or talk to their friend, the realtor; however, the way the question is phrased often establishes limits on what is considered: “We’re looking for 2 acres of land. Any idea what’s available?”

You could be driving right past a great opportunity. Many towns, especially in these challenging economic times, have buildings that are either abandoned or underutilized. Oftentimes they are in great locations. “But it’s so ugly! I would never practice there.” Ah, but therein lies the opportunity.

The “before” photo, which also appeared in the March/April issue of Premier Surgeon, showed the exterior of a Pontiac car dealership in Alliance, Ohio. It was on one of the main streets in town. This building was abandoned and neglected. The roof over the front showroom leaked. It hadn’t been touched in years and was a mess. Being a car dealership, however, there was plenty of parking available.

Three physicians in individual practices bought the property. Rumor had it that the purchase price was less than the value of the land, but the place had become such a white elephant that the owner was glad to finally be rid of the property.

The issue then became, “How do we make this into a medical practice facility?” The doctors made a wise choice in selecting a car dealership to convert. The advantage: It had big, open spaces inside. We refer to this as a loft-type building – open spaces with just columns inside. (This is the reason houses make such poor conversion opportunities. They are full of weight-bearing walls.) What types of buildings meet this challenge? Supermarkets, strip malls, warehouses, and office buildings. In our practice, we have converted a car dealership, a Shoney’s restaurant, a tube factory, a Coca-Cola truck garage, a supermarket, a meat packing plant, two State Farm Insurance claims offices, a hosiery mill and others into modern medical practice facilities. The one characteristic each of these buildings shared was having a big, open space inside. This allowed us to customize the interior so the doctors could practice state-of-the-art medicine.

Now, no one wants to go see their ophthalmologist in the old car dealership. When you do this, you have to repurpose the building. You have to give it a new image. The townspeople had to come to view the facility as its new identity, not as doctors practicing in its old one. In every case previously noted, the exterior underwent a major redesign to help create a new identity. A picture of the new outside of the Pontiac car dealership is shown above. The leaky showroom was torn off and a new (non-leaky) front was added. The exterior of the rest of the building was covered with EIFS (exterior insulation and finish systems). This hid the old, yellow brick with a fresh-looking material. Other elements were added for focus and drama.

When the project was completed, the doctors moved in and started practicing medicine. No formal opening. No open house. Just straight to work. After a few months in practice, and after explaining to many patients that they hadn’t planned an open house, they realized the town wanted to tour the converted car dealership. So they had a community-wide open house so the town could see what had been done. Marketing like this you cannot buy.

If you are contemplating moving into a new office space, consider old, ugly buildings, as well. The uglier the better – after all, you’re going to change the appearance, and its dilapidated look may help get the price down.

Give the following information to a commercial (not residential) realtor:

The number of useable square feet you will need.
The number of cars you will need to park. (If you don’t know,
allow five to seven cars per 1,000 useable square feet.)
The amount of land you will need. (For flat land, plan for 6 square
feet of land for every square foot of useable space you want.) The land should be zoned for medical office use to avoid rezoning issues.

Tell the realtor to identify all the parcels of land and buildings that fit the criteria within a certain radius of where you want to be. If one of them is a crummy, old building, give it some serious thought. It may be a spark to your practice and a new asset to your community.