An Update on New Construction Planning & Development
The Physician-Owned Medical Real Estate Podcast
Release Date: 08/05/2020
The Secret to Keeping Real Estate and Physician Ownership Aligned
The Physician-Owned Medical Real Estate Podcast
In this episode, Dr. Bruce Cohen of OrthoCarolina, shares how one of the nation's largest orthopedic practices developed a physician-owned real estate strategy focused on recruitment, retention, and long-term organizational alignment. He explains how OrthoCarolina transitioned from having little emphasis on real estate ownership to building a portfolio that benefits physicians without requiring significant upfront capital. Dr. Cohen discusses the challenges of integrating multiple physician groups with different ownership structures, the importance of aligning real estate ownership with active...
info_outline
Exploring a New Valuation Methodology: How & Why
The Physician-Owned Medical Real Estate Podcast
In this episode, Eric explores the complexities of valuing physician-owned medical real estate and explains why many traditional valuation approaches fail to reflect the realities of medical practice ownership. He discusses how commercial real estate differs from residential real estate, why standard bank appraisals often miss important components of value, and how these shortcomings can create challenges during ownership transitions. Eric outlines a methodology that separates the value of the core and shell building from the tenant improvements, allowing physician groups to more accurately...
info_outline
The Future of Physician Real Estate: Valuation, Private Equity & Planning in Volatile Times
The Physician-Owned Medical Real Estate Podcast
In this episode, Collin explores the critical role real estate plays in physician practice transactions and why many groups fail to maximize its value. He explains how practice owners often focus heavily on the operating business while overlooking the real estate asset, creating situations where significant value is left on the table during a sale. The discussion covers sale-leaseback transactions, including how they work, why they frequently accompany practice sales, and the importance of establishing fair market lease terms well before entering a transaction process. Collin also breaks down...
info_outline
Wins, Losses & Lessons: Unfiltered Stories From Physician Groups
The Physician-Owned Medical Real Estate Podcast
In this episode, Dr. Jeff Douglass discusses how the Oregon Clinic — a 220-physician multi-specialty organization — developed a structured approach to physician-owned medical real estate after recognizing the financial impact of millions in annual lease expenses. Drawing from both successes and past challenges, Dr. Douglass explains how the organization created a commercial real estate investment platform designed to support fairness, sustainability, and long-term physician participation. The conversation explores the importance of governance, operating agreements, succession planning, and...
info_outline
From the Lender’s Perspective: How to Unlock Elite Terms
The Physician-Owned Medical Real Estate Podcast
In this episode, Chris shares insights into how lenders evaluate physician-owned medical real estate deals and what borrowers can do to position themselves for successful financing outcomes. He explains the key differences between owner-occupied and traditional commercial real estate loans, including how those distinctions impact loan terms, leverage, and underwriting standards. Chris breaks down the financial metrics banks prioritize — including liquidity, leverage, and debt service coverage ratios — and discusses how retained earnings and loan covenants can create both...
info_outline
JV Deals Decoded: What Makes a Truly Good Joint Venture
The Physician-Owned Medical Real Estate Podcast
In this episode, James, Steve, and Greg explore the structure and implications of developer joint ventures in physician-owned medical real estate. They outline how these partnerships typically originate, including scenarios where developers control land, work alongside health systems, or engage directly with physician groups early in the process. The conversation focuses on the key tradeoffs involved in partnering with developers, including majority ownership structures, governance control, and differing return expectations. They explain how these dynamics can impact everything from...
info_outline
Real Estate as a Talent Strategy: Attracting & Retaining Key Leaders
The Physician-Owned Medical Real Estate Podcast
In this episode, Mike McCaslin shares insights from over four decades of experience advising physician groups on real estate ownership. He explains why practices should prioritize owning their medical facilities, highlighting the financial benefits of capturing rental income internally rather than paying third-party landlords. Mike outlines how to structure ownership through separate LLCs, create affordable entry points for new physicians, and model long-term value for partners. He also addresses the complexities of ownership transitions, including how to handle retiring physicians,...
info_outline
Short-Term vs. Long-Term Rates: Understanding and Profiting from the Disconnect
The Physician-Owned Medical Real Estate Podcast
In this episode, Grant breaks down the key differences between short-term and long-term interest rates and explains how each is influenced by the Federal Reserve and broader market forces. He shares insights into current expectations for rate movements, including the potential for short-term rate cuts and the factors that may keep long-term rates more stable. Grant also explores how borrowers can use interest rate swaps to create more flexible financing structures, allowing them to fix portions of their debt or adjust strategies over time. He highlights why traditional fixed-rate loans may not...
info_outline
The Hidden Value of Swaps: When & How to Unlock Them
The Physician-Owned Medical Real Estate Podcast
In this episode, Shannon breaks down the structure behind interest rates and demystifies the often-confusing world of interest rate swaps. She explains how banks separate their cost of funds from their profit (spread), the differences between variable and fixed rate loans, and how swaps allow lenders to transfer interest rate risk while potentially offering borrowers more competitive pricing. Shannon walks through how swaps are structured, why borrowers typically start out “upside down,” and how the value of a swap evolves over time — including what happens if a loan is paid off or...
info_outline
The IRS Election That Doctors Miss — and How It Costs Them
The Physician-Owned Medical Real Estate Podcast
.
info_outlineSteve Dobias, CPA and Partner with Somerset CPAs & Advisors, discusses new construction planning and development for MOBs and ASCs in the current environment.