Medical leases are different from general office leases. Build-outs cost more, infrastructure requirements are specialized, and some terms carry healthcare compliance implications. Here’s how providers can approach a lease with confidence.
Site selection
- Patient access: visibility, parking, ease of entry, proximity to your patient base.
- Referral geography: proximity to hospitals, referring physicians and complementary specialists.
- Competition nearby.
- Growth: new rooftops and planned healthcare development.
Infrastructure checklist
- Plumbing for exam rooms, sterilization and operatories.
- Electrical capacity for imaging and equipment.
- HVAC zoning and ventilation.
- Medical gas, nitrous or vacuum where needed.
- Floor loading for heavy equipment.
- Generator or backup power for critical uses.
- ADA-compliant entrances, restrooms and parking.
Economic terms
Tenant improvement allowance
Medical build-outs are expensive. Negotiate an allowance that reflects real costs and clarify who manages construction.
Term
Longer terms can justify larger allowances but reduce flexibility.
Rent and escalations
Compare total occupancy cost including operating expenses.
Free rent
Rent abatement during build-out and ramp-up.
Protective provisions
- Exclusive use to keep competing specialties out of the building or center.
- Signage rights.
- Assignment and subletting for practice sales or mergers.
- Renewal options with defined rent.
- Hours and access for after-hours care.
Compliance-sensitive terms
When a landlord is also a referral source (for example, a hospital or physician-owned building), lease terms generally need to reflect fair market value and meet specific regulatory requirements. Have healthcare counsel review.
Lease or buy?
If you plan to stay long-term, buying may be worth analyzing. See should your practice buy its building.
Frequently asked questions
How much TI allowance do medical tenants get?
It depends on term, credit and market. Medical allowances are often higher than general office but rarely cover full build-out.
What is an exclusive use clause?
A lease provision preventing the landlord from leasing to competing tenants in the building or center.
Should I lease or buy my medical office?
If you plan to stay long-term with stable financials, buying deserves analysis.
How we help
We represent healthcare tenants in site selection and lease negotiation across Houston. Learn about our medical office practice.
Have a deal or question in mind?
Talk it through with Apurva. A 20-minute call is usually enough to know your next step.
