Navigating Commercial Real Estate in Orthodontics

Commercial real estate decisions do not just affect where you practice. They affect how you grow, how flexible you can be, and how profitable your practice can become over time.

In a recent episode of the Hey Docs! Podcast, host Jill Allen sat down with Colin Carr, CEO of CARR, to unpack what orthodontists and healthcare providers need to understand about today’s commercial real estate landscape and where many practices unknowingly leave money and leverage on the table.

This conversation was not about square footage or floor plans. It was about strategy.

Understanding Today’s Commercial Real Estate Market

Not all commercial real estate behaves the same, and that matters more than ever.

Colin breaks the market into key sectors, including healthcare, industrial, multi-family, and office. While traditional office space has softened post-COVID, healthcare real estate has remained strong. That demand has driven lease rates higher, but it has also reinforced one important truth: healthcare providers are still highly desirable tenants.

Why? Stability. Longevity. Predictable revenue.

For orthodontic practices, that positioning creates leverage if you know how to use it.

Leasing vs. Buying: There Is No Universal Right Answer

One of the biggest takeaways from this episode is that leasing versus purchasing is not a philosophical debate. It is a strategic one.

Ownership can be powerful. In many cases, the real estate asset can eventually be worth more than the practice itself. Leasing, however, can offer flexibility, lower upfront costs, and fewer long-term commitments during growth phases or transitions.

The mistake is not choosing one over the other.
The mistake is not fully understanding what options actually exist in your market before deciding.

As Colin emphasizes, the right move depends on availability, timing, capital, and long-term practice goals, not gut instinct.

Where Practices Get Tripped Up in Lease Negotiations

This is where we see the most preventable mistakes.

Too many healthcare providers try to navigate lease negotiations on their own without realizing how much information asymmetry exists between landlords and tenants. Market rates, tenant improvement allowances, and renewal leverage are not things you figure out as you go.

Colin stresses the importance of using a broker who specializes in healthcare real estate and understands demographics, competition, and negotiation dynamics. Creating competition between properties is not aggressive. It is strategic. And thorough due diligence is not optional. It is how you protect your future.

Lease Renewals: The Quiet Profit Leak

Lease renewals are one of the most overlooked opportunities for savings and leverage.

Many practices assume renewal terms are fixed or non-negotiable. They are not.

Approaching a renewal 12 to 18 months in advance gives you options, and options create leverage. With the right strategy, providers can often negotiate improved terms, concessions, or flexibility that directly impact long-term profitability.

Waiting until the last minute removes that leverage entirely.

When Your Landlord Is Also Your Patient

One nuance that resonated with many listeners was what happens when your landlord is also your patient.

Colin addresses this directly. Professional negotiations, handled correctly, do not damage patient relationships. Clear boundaries and third-party representation allow you to protect your financial interests without compromising trust or care.

Being respectful does not mean being passive.

The Bottom Line

Commercial real estate decisions shape the trajectory of your practice far beyond the walls you work within.

As Jill and Colin reinforce throughout the episode, the goal is not just securing space. It is securing terms that support long-term growth, flexibility, and financial health. With the right advisors and a proactive mindset, healthcare providers can turn real estate from a stressor into a strategic advantage.

If you are navigating a lease, renewal, or purchase decision, this episode is a must-listen and a reminder that some of the biggest wins in practice management happen long before a patient ever walks through the door.