The deal rarely fails on square feet. It fails on parking.

A general office tenant brings one car per employee, and those cars arrive once and stay put. You bring staff, plus a patient in every exam room, plus the next appointment showing up early, plus whoever drove them. A busy clinic can turn a building’s parking over several times in a morning.

Buildings get striped for office use. A lot of the medical space that looks like a bargain is a bargain for exactly that reason — and you find out in month two, when patients start mentioning they circled the lot for ten minutes. Parking is the first thing I count, before the floor plan is worth discussing.

You are not leasing space. You are building rooms.

Medical build-out is walls. Ten exam rooms inside three thousand feet means a lot of partitions, a lot of doors, a sink in each room, and mechanical that has to reach every one of them independently — because a procedure room and a waiting room do not want the same air.

That is why medical costs more per foot to build than general office, and why an improvement allowance quoted at office rates comes up short. I came to brokerage from licensed contracting. I can tell you whether the allowance covers your room count before you sign for it.

Imaging asks things of the building that no allowance can fix

X-ray needs shielding. CT and MRI need considerably more — floor loading, clearance, power, cooling, and in MRI’s case a route to vent to the outside. Some buildings simply cannot take it. That is worth knowing on the tour, not in design development after the lease is signed.

Somebody else’s lease can shut you out

Medical buildings often carry use restrictions from earlier tenants. If a group in the building holds an exclusive covering your specialty, you may not be permitted to open there — regardless of what the landlord would like to do about it.

This never appears in a listing. It appears when someone goes looking for it.

How the work goes

1. Start twelve to eighteen months out. Three months is a renewal you sign because the clock ran out. Alternatives only exist while you can still walk.
2. Put several buildings in play at once. Shells, second-generation medical, off-market space, and a purchase if buying is the better answer. Renewals too — your landlord negotiates differently once he knows you have somewhere to go.
3. Negotiate them against each other. Stay through build-out. The lease gets signed months before you see a patient there. Most of what goes wrong goes wrong in that gap.

Where

Most of the work is Seattle, Bellevue, Kirkland, Redmond, Bothell, Renton, Federal Way, Everett, Tacoma, and Olympia — greater Seattle and the Puget Sound corridor. I’m licensed in Washington and Oregon, so a second location in Spokane or Portland doesn’t mean starting over with a stranger.

You don’t pay for this

The landlord does. That commission is written into the deal whether you bring someone or not. If you don’t have a broker, it goes to theirs.

I’m with CARR. We represent healthcare tenants and buyers only — never landlords, never sellers. There’s exactly one side of the table I’m on.

Book 20 minutes Bring the lease and the date it ends.

Questions physicians ask

The listing says the space is “medical.” What does that actually mean?

Usually it means the zoning permits medical use and the landlord is willing. It does not tell you whether the parking supports your patient volume, whether the HVAC can zone your exam rooms, whether the floor will take imaging, or whether an earlier tenant holds a use restriction that excludes your specialty.

Those four things decide whether a building works for you, and none of them appear in a listing. They come out of walking it and reading what is already recorded against it.

We are a specialty practice. Does location matter as much?

It matters differently. A primary care clinic lives on convenience and parking. A specialty practice that runs on referrals cares more about the referring physicians, hospital access, and whether patients traveling in can find you and park once.

The mistake is assuming that because you are referral-driven, the building does not matter. It still has to hold your equipment, your room count, and your patients’ cars.

If we sell the practice, does the lease come with it?

Only if it was written to. Assignment language decides whether a buyer inherits your lease and on what conditions — landlord consent, personal guarantees, whether you stay on the hook after the sale.

This is the clause that most often reduces what a practice sells for, and it is negotiated years before anyone is thinking about selling. It is worth getting right at signing, not at closing.

More on the mechanics of these deals at The Med Space Report. For a Washington address, a free five-minute drive competitor map.