Office Space Guide¶

Quick Summary: Start with shared/sublease space ($500-$2,500/month) rather than dedicated space. Many solo DPC practices need only 300-800 sq ft. Match your space to your current stage, not your five-year vision. Negotiate shorter lease terms (1-2 years) and free rent periods when possible.

Table of Contents¶

• Starting Lean: Space by Stage
• Finding Space
• Space Requirements
• Lease Considerations
• Setting Up Your Space
• Home Office Considerations
• Shared Space Arrangement Tips
• Budgeting for Space
• Checklist

Overview¶

Office space is often one of the largest expenses for a new Direct Primary Care practice—but it does not have to be. Your space needs will evolve as your practice grows. The key is matching your space to your current stage, not your five-year vision.

This guide covers office space options, requirements, and strategies for each stage of practice growth.

Prerequisites¶

• Understanding of your practice model (solo, potentially adding staff)
• Budget parameters from Startup Costs Overview
• Target patient panel size

Starting Lean: Space by Stage¶

The Fundamental Question¶

Do you need a dedicated office to start?

Answer: Not necessarily.

Stage 0: No Dedicated Space¶

Models that can work without traditional office: - Telemedicine-primary practice - House call practice - Mobile practice

What you need: - Reliable phone/internet - Secure place for documentation (treat HIPAA as the floor even if you are not a covered entity; see HIPAA Compliance Basics) - Place to meet patients when needed (home visits, rented space) - Mailing address for business

Pros: - Zero rent - Maximum flexibility - Test the waters before committing

Cons: - Limited services (no in-office procedures, labs) - May feel less "legitimate" to some patients - Work-life boundary challenges

Stage 1: Shared/Sublease Space (0-100 patients)¶

Best option for most new DPC practices.

What it means: - Rent space within existing medical practice - May be exam room(s) on certain days - May include shared reception, waiting area

Where to find: - Existing primary care practices - Specialist offices with unused space - Urgent care centers - Shared medical office spaces (growing trend) - Executive/professional office suites with medical option

Typical Arrangements: - Fixed hours/days (e.g., MWF, certain rooms) - Per-hour or per-day rental - Monthly flat fee for guaranteed space

Costs: $500-$2,500/month depending on market and arrangement

Pros: - Low commitment - Shared overhead (utilities, some equipment) - Professional environment - Can often use existing equipment - Flexibility to grow or change

Cons: - Less control over environment - Scheduling limitations - May share waiting room with host practice - Limited customization

Stage 2: Dedicated Small Space (75-200 patients)¶

When revenue supports dedicated overhead.

What you need: - 300-800 sq ft typically sufficient for solo practice - Waiting/reception area - 1-2 exam rooms - Small office/workspace - Restroom access

Where to find: - Medical/professional office buildings - Retail strip centers (depending on zoning) - Converted residential (check zoning) - Mixed-use buildings

Costs: $1,500-$4,000/month depending on market and size

Pros: - Your own space - Control over environment - Professional identity - Room to add services

Cons: - Higher overhead - Lease commitment - Responsible for all setup and maintenance

Stage 3: Full Clinic Space (200+ patients or growth plans)¶

Traditional medical office setup.

What you need: - 1,000-2,000+ sq ft - Multiple exam rooms - Waiting room - Reception area - Office space - Staff areas (if hiring) - Storage - Procedure room (optional)

Costs: $3,000-$8,000+/month depending on market

Finding Space¶

Sourcing Options¶

1. Your Network - Ask colleagues about unused space - Contact local physicians - Reach out to retiring physicians - Check with specialists who have part-time space

2. Commercial Real Estate - Online listing services (LoopNet, Crexi and similar; the kit endorses none) - Local commercial brokers, ideally one who handles medical space - Search "medical office space [your city]"

3. Shared Office Operators - Executive-suite and coworking operators (Regus/IWG, WeWork and local equivalents) are usually suitable for administrative work only; confirm in writing that the lease and the building's zoning permit medical use before seeing patients there - Local shared medical office concepts (time-share exam rooms)

4. Creative Options - Gyms/wellness centers wanting medical services - Employer sites (on-site clinic arrangements) - Community health centers with excess capacity - Religious organizations with health ministries

What to Look For¶

Location Considerations: - Accessible to target patients - Parking availability - Public transit access (if relevant) - Visibility vs. privacy - Safety of area - Proximity to labs, pharmacy, referral partners

Building Considerations: - Zoning allows medical use - ADA accessibility (see the note below) - Building condition - HVAC adequate - Plumbing appropriate (sink in exam room) - Signage allowed

Space Requirements¶

Minimum Functional Space¶

Solo DPC, lean model:

Comfortable Solo Space¶

Room-Specific Requirements¶

Exam Room: - Minimum 100 sq ft - Sink with hot/cold water - Exam table - Seating for patient and companion - Counter/workspace - Privacy (solid walls, door with lock) - Appropriate lighting

Restroom: - Accessible to patients with disabilities (ADA Title III; see the note above) - Hand washing - Sharps container if collecting specimens

Lease Considerations¶

Types of Leases¶

Gross Lease: - Flat monthly rate - Landlord pays utilities, maintenance, property taxes - Simpler, more predictable - Often available in shared/sublease arrangements

Net Lease (NNN/Triple Net): - Base rent plus share of operating expenses - You pay proportional utilities, taxes, insurance, maintenance - Common in commercial medical space - Less predictable total cost

Modified Gross: - Some expenses included, some additional - Read carefully what's included

Lease Terms to Negotiate¶

Red Flags¶

Setting Up Your Space¶

Essential Equipment¶

See Equipment and Supplies Checklist for full list.

Space-specific needs: - Exam table ($500-$2,000) - Guest seating - Desk and chair - Waiting room seating - Appropriate lighting - Privacy features (window coverings) - Signage

Creating the Right Environment¶

DPC practices can differentiate through environment: - Warm, welcoming atmosphere (not sterile) - Comfortable seating - Minimal "clinical" feel where possible - Personal touches - Clean but not institutional - Good lighting

Patient-Centered Design: - Easy to find entrance - Clear wayfinding - Comfortable waiting (though DPC means less waiting) - Private exam room conversations - Accessible for all abilities

Home Office Considerations¶

Can You See Patients at Home?¶

Challenges: - Residential zoning often restricts or prohibits seeing patients at home; check with your municipality before you plan on it - Professional appearance concerns - Work-life balance - Privacy and security of records in a home setting (treat HIPAA as the floor) - Malpractice insurance may have limits - Some patients uncomfortable

Where It Can Work: - Home as admin base + house calls - Home office for telemedicine only - Rural areas with different zoning - Properly zoned home-office situations

What You Can Do From Home¶

• Administrative work
• Telemedicine visits (on a platform that will sign a BAA, in a private room; you must be licensed where the patient is located—see Telehealth Legal Considerations)
• Phone consultations
• Documentation
• Business planning

Home Office Deduction¶

If part of your home is used regularly and exclusively for the practice, you may deduct it. The simplified method allows $5 per square foot up to 300 square feet (a maximum of $1,500 a year); the regular method deducts a share of actual home expenses. A room that doubles as a guest room does not qualify. See Tax Planning Basics and confirm with your accountant.

Shared Space Arrangement Tips¶

Making Shared Space Work¶

Get It In Writing: - Days/hours of access - Which rooms/equipment included - Storage allocation - Phone/reception handling - Signage rights - Cost and payment terms - Duration and termination - Liability/insurance requirements

Be a Good Tenant: - Leave space clean - Don't overrun your time - Handle your own patients (don't burden host staff) - Pay on time - Maintain good relationship with host practice

Set Expectations: - Patients should know your schedule - Clear contact methods for non-office days - System for urgent issues when not on-site

Budgeting for Space¶

Total Space Costs¶

Beyond rent, budget for: - Utilities (if not included) - Internet/phone - Cleaning - Equipment - Furniture - Supplies - Signage - Insurance (renters/business property) - Build-out/improvements

Monthly Space Budget by Model¶

Checklist: Office Space¶

Before Searching¶

• Determine minimum space requirements
• Set budget parameters
• Identify target location/area
• Decide on shared vs. dedicated preference

When Evaluating Space¶

• Confirm zoning allows medical use
• Verify ADA accessibility and agree in the lease who pays for any barrier removal
• Check plumbing (sink capability)
• Assess HVAC adequacy
• Evaluate parking situation
• Consider visibility and access
• Review lease terms carefully

Before Signing¶

• Negotiate terms (length, free rent, build-out)
• Understand total costs (rent + expenses)
• Review personal guarantee requirements
• Confirm signage rights
• Get it in writing
• Have attorney review (recommended)

Setting Up¶

• Plan layout
• Order essential equipment
• Set up utilities and services
• Secure records and devices (see HIPAA Compliance Basics)
• Create welcoming environment
• Install signage (where permitted)

Resources¶

• Startup Costs Overview - Budgeting for space
• Equipment and Supplies Checklist - What you need
• Tax Planning Basics - Home office deduction
• ADA Title III - Accessibility obligations of businesses open to the public
• Commercial listing services (LoopNet, Crexi and similar) and local commercial brokers

Read through and figures checked on 2026-09-23.

Next Steps¶

After securing space: - Equipment and Supplies Checklist - Setting up your space - Patient Onboarding Workflow - Preparing to see patients - Daily Workflow Optimization - Operating efficiently