Physician demand is durable; physician real estate preferences are specific. The product has to match how practices actually occupy.
Medical office demand tracks the most reliable curves in the economy — population aging and outpatient migration — but the product decision carries the project: consolidated multi-tenant MOB space and decentralized campus formats serve different practice economics. Specialties weighing identity, signage, parking at the door, and the option to own frequently prefer building-scale product over suite-scale space, and tenant-demand evidence — letters of intent, oversubscription, specialty mix — is the study’s strongest exhibit when it exists.
The health-system landscape defines the competitive frame: hospital-adjacent versus retail-convenient locations, system-employed versus independent physicians, and the referral geography that decides where practices can actually move. Reimbursement-driven specialties bring credit-quality tenancy with reimbursement-policy exposure, which the analysis prices rather than ignores.
A recent $38,900,000 engagement covered a 12.18-acre medical village — sixty-eight thousand square feet across nineteen buildings of 3,500 to 4,920 square feet, oversubscribed at study date, with a hybrid lease-and-sale absorption strategy and pad-consolidation flexibility engineered into the utility design. Its value-engineering pass cut total project cost by nearly 8 percent — the kind of finding independent technical review exists to produce.
Engagements are typically initiated by the borrower, with lender or CDC confirmation obtained before work begins — institutions apply differing rules, so sponsors should confirm the required path with their lending contact — and are delivered in 10 to 15 business days from complete project data, and built to the program framework that governs the credit — SBA SOP 50 10 8 coverage minimums of 1.15x operating and 1.00x global, the 37-factor structure of USDA RD Instruction 5001, or the 1.20x convention of conventional credit policy — with a ten-year pro forma, sensitivity at ±5/10/15 percent, rate stress to +3.0 percent, and Monte Carlo analysis as standard equipment.
President, Wert-Berater, Inc. — independent feasibility study consultants since 1998. More than 4,000 feasibility studies completed across all 50 states and internationally, evaluating $40.2 billion in project value for SBA, USDA, EB-5, conventional, and institutional financing decisions. Fiduciary duty runs to the lender and agency in every engagement.
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