Loft space is primarily open, with

where the physician will actually

practice does not know whether

just columns on the inside. Exam-

practice medicine; how the phy-

to look for a 5,000 or a 10,000

sician's space relates to patient

ples of such buildings include

square foot space. The successful

preparation space; how the

modern office buildings and med-

space program will integrate the

sician's space relates to

ical office buildings, abandoned

goals of the practice and the pro-

tic space.

ductivity and systems design

car dealerships, and drug stores.

The concept o adjacencies de-

f

which have already been done.

Houses generally do not lend

fines how the practice has to func-

The space program deter-

themselves well to creating an ef-

tion and is independent of the

mines how many square feet the

ficient medical office design.

physical location o the practice.

f

practice needs to function well.

We recommend that appropri-

Therefore, it is important that

This is referred to as usable

ate medical office space contain

these elements be defined before

square feet. Landlords often have

twice the number o square feet

f

the practice makes a commitment

different terms. They may refer

indicated by the space program.

to a specific space. Understand-

to gross square feet or rentable

We also recommend that the

ing the space program and the

square feet. In some cases this

space be more square than rect-

concept of adjacencies before-

issue becomes very important.

angular. Odd-shaped spaces can

hand, the practice can be sure

For instance, let's assume the

be difficult to evaluate effectively.

that the option it selects can not

landlord insists that the space

Sometimes the only way to de-

only provide the number of

available contains 9,000 square

termine whether an odd-shaped

square feet necessary but also

feet. After careful measurement

space will be successful is to do a

meet the practice's interrelated

of the space, you find the actual

preliminary design for the space.

functions.

square footage is 6,700 square

One of the issues you will con-

feet (which is sufficient for the

front as you develop new medical

practice's needs.) After discus-

space is whether to rent or own

sions with the landlord it becomes

the space. This issue is often

apparent that the difference be-

The practice now knows what

clouded by the entrepreneurial

tween these figures resulted from

it needs and can evaluate options

desire to own real estate, and it

add on's that the landlord added

for achieving the desired results.

could also be clouded by desires

to the "usable" square feet to get

These include acquiring land to

to do what your colleagues are

the "rentable" square feet. To

develop its own building or find-

doing in other parts of the coun-

prepare effective comparisons

ing an existing building within

try. Each geographic area, how-

between one landlord's offer and

which to locate the practice. If the

ever, presents its own opportuni-

another's, it is best to reduce ev-

practice is looking for land, a gen-

ties and restrictions. The decision

erybody's requirements to usable

eral rule of thumb is to acquire six

of whether to rent or to own

square feet.

feet of land for every square foot

should be based on the econom-

of one story medical office build-

ics of the particular deal.

ADJACENCIES

OF

ing. This ratio assumes that the

In evaluating opportunities be

land is flat and usable. However,

Prior to actually' designing

sure that you are making an "ap-

it is important to check the zoning

space, you should have a sense of

ples to apples" comparison. This

ordinances in each community

how one space within the practice

means that all the numbers

because these will indicate how

will relate to another space. This

should be generated on a gross

much of the land you acquire is

is referred to as the "concept of

cost basis. If you have to under-

actually developable.

adjacencies. This will identify

stand the cost per square foot,

If you are looking for an exist-

such things as how the entering

make sure you divide it by the

ing building, you should look for

patient will relate to the business

usable square feet. Make sure the

those that lend themselves to of-

office; how the exiting patient will

rental figure includes all the costs

fice conversion better than

relate to the business office; how

associated with occupying the

ers. Loft-type buildings provide

the exiting patient who has diffi-

space. This can include the mort-

the flexibility for the optimal in-

culty checking out will be man-

gage payment to the bank and the

aged by the business office;

ternal operation o a practice.

f