Opening a new chapter: Medical and Dental Practice Inception

Starting a Medical or Dental Practice


Many doctors and dental professionals’ endeavor to become their own boss and one day open a small or medium sized practice in their area. These journeys are very different for every medical and dental professional. Those aspirations tend to mold the type of needs necessary for certain medical professionals to achieve those goals. The list of needs ranges from medical office space to dental equipment purchases, to marketing and web design. There is a plethora of decisions that need to be made very quickly to begin developing the plan to open a practice quickly and successfully. This can be extremely stressful and can cost medical professionals tens of thousands, if not hundreds of thousands, dependent upon the local markets.

Some tend to search for a company that handles everything from, finding local medical offices to marketing and web design, banking relations, or contractors to help build out the space. These companies are not all bad, and sometimes doctors and dentists find a good one, but a ton of them over charge or can take advantage of doctors and dentists alike. When searching for the right way to approach how you want to set up your new practice here a few ideas to take into consideration.

  1. List out everything needed to open a practice in a local area and set a time frame of when you wish to accomplish that goal
    • Medical or Dental Office Space (real estate agency)
    • Website
    • Marketing
    • Client lists
    • Equipment purchases
    • Local affiliates
    • Lists of hospitals
    • Recommendation lists (hospitals, specialists, MRI, X-Ray, Labs)
    • And more
  2. Reach out to multiple companies (primarily focused on medical and dental practice set-up) that handle everything if you wish to avoid doing all that research yourself. Get quotes from all of them and make the best-informed decision possible.
  3. Finding strategic partners in the area that focus on one or two primary aspects of your practice/business are crucial
    • Real estate agency (save money on lease/ purchase agreement)
      • They tend to have other good contacts
    • Bankers
      • Having multiple bankers will help with getting loans
        • Construction
        • Equipment purchases
        • Property acquisitions
    • Contractors
      • Helps keep prices competitive when you can get multiple bids
      • Trust, knowing your contractor isn’t going to cut corners
      • Or steal your money and then ask for more.
    • Marketing
      • Finding a solid company to help push your local business will increase the probability of success
      • Web design also is necessary to accomplish this goal
      • SEO
      • Social Media
    • Equipment companies
      • Finding multiple companies that provide equipment will ease the process of having to locate required devices and supplies (some will also be less expensive)

These are just some of the matters that must be tended to when deciding to open a practice. There will be other matters to figure out, but these are just a few to discuss and think about prior to opening a practice. It is imperative to have a ton of your research complete and the right teams in place prior to signing any thing or moving forward to quickly. That can cost thousands or hundreds of thousands. It happens every year.


Go to our website at www.hprgrealty.com to learn more or reach out at cfeitel@hprgrealty.com


5 Reasons to Use a Medical Office or Dental Office Real Estate Broker

HPRG - Endodontics office


Five Reasons to Use a Medical Office or Dental Office Real Estate Broker


  1. The biggest reason to utilize a medical office space or dental office space real estate broker is the knowledge that they will have acquired over the years dedicated to searching for this type of space and your local area will help any medical professional locate the correct sized office you require and the location of the office you may desire. LOCATION, LOCATION, LOCATION!
  2. They will negotiate with the landlords on the duration of the lease, the amount of space you require, when the first payment will be due (to give time for construction of new offices), and how much you are willing to pay each month. Good negotiating skills are key.
  3. Real estate brokers will have built many relationships in their course of doing business. These relationships can be with, bankers, landlords, contractors, equipment sellers, other medical professionals, marketing companies, etc.
  4. One of the biggest plus sides is you will not have to pay for their services. The landlord or leasing company is the one who will be paying their compensation.
  5. They will be way less expensive than a medical broker who will handle everything from top to bottom.


Go to our website at www.hprgrealty.com to learn more or reach out at cfeitel@hprgrealty.com

Saving Dentists and Physicians Money On Their Rent or Office Space Purchase

Any successful negotiation hinges largely on leverage. When it comes to a lease renewal for a healthcare professional the same rings true! Our model has saved our clients millions of dollars since 1996 and I would like to specifically enumerate a couple of “real life” examples below.

How HPRG Saved its Medical and Dental Clients Millions

A few years back a dental client of ours in Washington DC was paying an over market rate with about a year and a half left on his lease. His space was 2500sf and his rent was $52psf. At that time market rent in his building was $45 psf. Since we handle hundreds of transactions a year we knew his landlord would do a deal at $45psf. Moreover, we told his landlord if he was not willing to reduce the rent our client would move. We had enough time to make this happen. In this scenario the landlord agreed to drop the rent $7 psf, pay for new paint and carpet and give our client a couple of months of free rent. Over the next 10 years we saved our client $175,000!  The most important aspect of this deal is that the landlord paid our fee so their was no cost to our client.

Dental Surgeon Office Space

A few months back we effectuated a similar task for an Oral Surgery group in Maryland. Our client was in 7500sf and paying $10 psf over the market. The client had two years left on his lease but the vacancy in the market allowed us to negotiate an early renewal. We dropped the rate $10psf, got the landlord to give our client $25psf to renovate the suite and give us four months of free rent. The combination of rent savings, tenant improvements and free rent added up to a staggering $1.2 million over the next ten years!!!!!!!!   Again, at no cost to our client.

The results are not always this dramatic but we can always effect significant savings at no cost to our clients. Go to our website at www.hprgrealty.com to learn more or reach out at cfeitel@hprgrealty.com.

Create Urgency When Negotiating Medical Leases

Medical and Dental Lease Needs

For most medical and dental professionals, real estate leases are not the most pressing issue the owner has to deal with when transitioning to their own practice or a new location. After all, there are payroll concerns, patient concerns, staffing issues, equipment concerns, etc .etc. etc . In many office spaces the monthly rent could be over 10% of the practice total overhead expense. If you leave negotiations up to the landlord they will determine what the rent will be. That being said, it is important to be proactive and get the best possible deal on rent.

Medical and Dental Lease Negotiations 

Since leases all have escalation clauses, over time the rent typically will outpace the current rate of inflation.  So with a typical ten year lease when the lease ends the rent is over market.  Since doctors and dentists do not always know what the market rent should be they end up paying more than they should.  Also, the market may dictate other concessions such as free rent and tenant improvement dollars that the tenant is unaware of when negotiating. 

One of the biggest ways to insure a solid deal is reached between yourself and a landlord is to create urgency for them. Have your agent reach out to the landlord two years before the lease expires. The agent can move you and create a vacancy quickly which the landlord does not want. This creates urgency and enables the agent to get a better deal for you and your practice. Moreover, the agent knows what the deal should consist of and determine the best price per square foot for your medical space needs.

Finally, the landlord pays the agent a commission to do this so you save money while incurring no charge!  Reach out to Charles Feitel to learn more at 301 365 6940 or cfeitel@hprgrealty.comwww.hprgrealty.com

Covid-19 and the Healthcare Business

Healthcare, Covid-19, and Virtual Medical Consultations

So the COVID- 19 crisis is in no way over but we might be coming out of the worst of it. Time to take a step back and look at its effects on the practice of medicine and dentistry; more specifically, the impact on the medical space needs and requirements. A year and a half ago the rage went to telehealth measures.  People were afraid to leave their homes but still faced medical and dental challenges. Talking over the internet gave the masses access to their physicians and dental professionals. As time elapsed this was not even close to a satisfactory solution. Many postponed cancer screenings which ultimately proved deadly and depression and mental health concerns reached an all time high! There is no substitute for “human contact”. A troubling blemish, a lump, change in eye or skin color all requires human contact.

Normal Healthcare Struggles

So now that healthcare is business as normal what is next? How much space do you need? Is office or retail the best setting?  Are you going to continue to be privately owned or is it time to think about the private equity model? All of these questions should be asked. While many office and retail operations have changed their model forever, healthcare for now is more status quo. It is never to early to assess your space needs. Real estate deals take a long time and careful planning can save thousands or even hundreds of thousands of dollars over a typical career. Selling your practice or considering the private equity model is a big decision that takes time.

Regardless of what you are thinking you need a “trusted advisor”. HPRG has been helping doctors and dentists since 1996 with these critical concerns. Call or reach out today to receive a FREE  evaluation of your current situation.


Charles Feitel, 301.365.6940     cfeitel@hprgrealty.com    www.hprgrealty.com

Are You A Doctor or Dentist? Time to Consider Selling!


As you know, timing is a very important aspect of almost everything you do in life. When deciding when to sell your dental or medical practice, timing is a critical part of the overall decision. Your financial goals, age and health all play a role when deciding how and when to retire and sell your practice. Another influencer in this decision is not within your immediate control. It is called “capital gains” tax. I am not a CPA but I am an attorney and real estate broker who helps clients buy and sell medical practices and dental practices. So please consult your individual CPA as my statements are general and may not apply specifically to your financial situation. Let me summarize more below what I am referring too.

Lets say you bought your dental office for $300,000 years ago. Over your career you have worked hard and have had much success. A few decades later your business is now worth $3,300,000. When you sell a medical practice, in general terms, you have a $3,000,000 profit. Currently, the capital gains tax on income has a range but assuming an income of over $400,000 the rate is now 20% . So on a profit of $3,000,000 the tax you would pay is $600,000. President Biden has proposed an upwards capital gains tax of 40% effective 2022! The highest in our history. That means that same profit of $3,000,000 would incur a tax of 40% or $1,200,000. In summation, you walk away with $600,000 less. Lets assume you invest that $600,000 and get 8% on your money. That’s $48,000 a year. Assuming you are 65 and live 20 more years that’s $960,000!!!!!!!!

So……….selling before the end of 2021 in the grand scheme of things could make you almost a MILLION dollars more in your lifetime. So working an additional 3-5 years could cost you almost a MILLION $$.

Call me to schedule a free consultation and learn more. 301.365.6940 cfeitel@hprgrealty.com

Visit our website to see our listings! www.hprgrealty.com

I want to sell my medical or dental practice, Is now a good time?

Selling Medical and Dental Practices to Corporate Buyers

Dentists and doctors are not always sure when the right time to think about transitioning their medical or dental practice. Years ago, when a professional got close to retirement age, they would market their office for sale or bring in a partner to take over their business. But now more than ever the buyers of a medical or dental practice is going to be a corporation. The margins have changed to the point where it is difficult for an individual doctor or dentist to buy a practice. Expenses keep going up while private insurance and government reimbursements continue to decline making it very difficult to generate a profit from a medical or dental office. Corporate medical and dental is a slightly different scenario.

Often time’s corporate doctors and dentists are private equity groups who do not need to finance their purchase. When a practice does not have debt the yields are calculated differently then when they are financed. Corporate medical and dental companies see the value of the founding doctor or dentist staying with the business.  Years ago corporate buyers wanted the founding doctor or dentist to leave so they could implement their goals and objectives. Now corporate buyers want the doctor or dentist to stay around after the acquisition of the practice. Sometimes they even want them to stay on 10 years or more.

These corporate buyers can offer the dentist or doctor a sum of money up front, and a salary while they work and an equity stake in the DSO or MSO when the doctor wants to retire. Depending on the situation, a sale to a corporation may allow for a win- win for all parties concerned.  Please feel free to reach out to HPRG for a free consultation on your situation. cfeitel@hprgrealty.com, 301 . 571.9333, HPRGrealty.com.

Timing is Everything: When to Sell Your Medical or Dental Practice

HPRG - Medical Office Space


Traditional wisdom says to work your whole life and sell your business when you are ready to retire. Although, many buyers of dental offices and medical offices are corporations or private equity firms. These firms have a different model than an individual buyer. Corporations place a huge emphasis on the current dentist or doctor. Ideally they want that individual to stay on as long as possible. Moreover, the office has the highest value when the practice is peaking in value. In other words, it might make sense to sell your office much earlier than you thought in order to get the most value in return for selling your practice.

Medical and Dental Practice Business Value

In many cases you can get 70-80% of the value of the business, keep working up to 10 more years and draw a hefty salary and not have to worry about the mundane headaches of running the business. Then when you are ready, cash out the remaining 20-30% of value. All of the economic experts are predicting a rise in capital gains taxes which could be significant. So getting 70-80% of the value now while taxes are lower and continuing to work without pressure may be something to consider! Not every office will meet the criteria of a corporate or private equity buyer but the right broker knows how to determine if you are a candidate for this type of sale. Size, location and type of medical practice all factor in to this determination. Even if you are remotely considering selling it makes sense to receive  a “free” consultation to see where you stand. 

Feel free to reach out the Charles Feitel at HPRG at 301 365 6940 or email him at cfeitel@hprgrealty.com.   WWW.hprgrealty.com

HPRG Expands Dental & Medical Transition & Realty Capabilities

HPRG: Health-Pro Realty Group, Logo

BETHESDA, Md. – April 27, 2021 – PRLog — HRPG (Health-Pro Realty Group) has expanded its team of commercial agents and transition experts, offering additional support to clients in the medical and dental fields, as well as commercial property owners and landlords.

With decades of experience in medical and dental practice real estate, HPRG has developed specialized expertise that helps local physicians and dentists find the right spaces for their practices as well as complete the sale or purchase of a practice. With offices in Bethesda, Maryland, and McLean, Virginia, HPRG has rapidly grown in the DMV area over the last year, adding new agents and helping close a number of major deals. Currently, HPRG is the largest healthcare brokerage firm in the DMV.

“We are excited about the future of HRPG,” HPRG President Charles Feitel said, “but we are even more excited to assist local physicians and dentists with achieving their dreams of finding the right space, owning their own practice, or selling their practice as they transition into retirement.”

When it comes to helping physicians and dentists sell their practice or purchase an existing practice, HPRG offers a unique approach that has proven successful for many satisfied clients. HPRG provides specialized expertise from its team members in the three most important aspects of the practice transition process: valuation, operations, and real estate. This approach helps practice owners be certain they are getting accurate, unbiased information as they move forward, and can make informed decisions based on the market.

Of the approximately 200,000 practicing dentists in the U.S., approximately 88% are practice owners, either as solo practitioners or partners, according to the American Dental Association. For these practice owners, the sale of their practice may be one of the most important moments in their entire professional career.  Knowing when to sell their practice is as valuable as how to sell their practice.

“Practice owners can count on unbiased, expert advice from their team in each of these pillars throughout the transition,” Feitel said.

For commercial property owners and landlords, HPRG’s connections to the medical and dental fields can help place the ideal tenant.

“Many commercial property owners are looking to add medical and dental tenants to their mix of tenants, as we’ve seen retail decline over the last year. The overarching vision for HPRG’s team is to serve both practice owners and commercial property owners, and create a win-win,” Feitel said.

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HPRG is the premier medical and dental real estate firm on the east coast. HPRG has assisted thousands of physicians, dentists, and landlords in all facets of medical and dental real estate and practice transition. If you would like more information about this topic, please contact Charles Feitel at 240.372.4867 or cfeitel@hprgrealty.com or visit https://www.hprgrealty.com/.

Charles Feitel, HPRG

Information You Need to Sell Your Dental Office

North Bethesda Dental Office

Dental Office Space Sales Requirements

It’s time to start thinking about transitioning to the next phase of your life. It’s been a good run but now let’s consider other life options to pursue. Buyers have some similar things they like to see but every case is different. When attempting a sale of your dental office and/or practice making sure you keep solid records over the years will greatly help with the speed and trust or the sale.

At a bare minimum, you will need to have the following readily available:

  • Last three years tax returns and current year to date profit and loss statement
  • Number of active patients and new monthly patient growth
  • Payor mix if insurance based practice
  • Current AR
  • Employment contracts ( if you have them)
  • Procedures done in office
  • Patient calendar schedules
  • Building lease

This represents the bare minimum information you need to have. After the buyer signs an NDA this basic information can be shared. After the buyer visits the office, they will determine if they want to see additional materials. Every buyer wants to see different information and depending on the buyer certain information is more or less important. Be flexible as a seller and willing to accommodate their requirements. Keep in mind that you have more experience then them and may not see the need for what they want to see.

“Go with the flow” and cooperate so you can get your office sold at the highest price. Your broker will supervise the process and accommodate the buyer. After the basic information has been shared it is in the buyer’s court. I recommend you require a basic letter of intent before you share information over and above the basics. Have the buyer submit the LOI and spend money with an attorney to get them “vested” in the deal. If the terms are close , agree and have their lawyer submit a PSA ( Purchase and sale agreement). Now you can safely spend money with your attorney.

In sum, the sale of a business is a process. Obviously both parties will need to be flexible, but if you adhere to some basic steps, the process will progress in a smoother fashion. To learn more contact Charles Feitel at HPRG Transitions for a “free consultation”. 301.365 .6940 or cfeitel@hprgrealty.com. www.hprgrealty.com