Office Space Guide¶
Quick Summary: Start with shared/sublease space ($500-$2,500/month) rather than dedicated space. Most 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 (HIPAA) - 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 - LoopNet.com - Local commercial brokers - Google "medical office space [your city]"
3. Shared Office Providers - Regus/IWG (some medical-capable locations) - WeWork (limited medical options) - Local shared medical office concepts - Coworking spaces (for admin only, not patient care)
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 - Building condition - HVAC adequate - Plumbing appropriate (sink in exam room) - Signage allowed
Space Requirements¶
Minimum Functional Space¶
Solo DPC, lean model:
| Area | Size | Notes |
|---|---|---|
| Exam room | 100-120 sq ft | Exam table, sink, seating |
| Work area | 50-100 sq ft | Desk, computer, phone |
| Waiting | Shared or 50+ sq ft | 2-4 chairs sufficient for DPC |
| Restroom | Required | Can be shared in building |
| Total | 300-400 sq ft | Minimum viable space |
Comfortable Solo Space¶
| Area | Size | Notes |
|---|---|---|
| Exam room 1 | 100-120 sq ft | Primary exam room |
| Exam room 2 | 100-120 sq ft | Flexibility, procedures |
| Office | 100-150 sq ft | Documentation, calls |
| Waiting | 75-100 sq ft | Small DPC panels don't need large waiting |
| Reception | 50-75 sq ft | Optional for solo |
| Storage | 50 sq ft | Supplies, samples |
| Restroom | 50 sq ft | Patient accessible |
| Total | 600-800 sq ft | Comfortable solo practice |
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: - ADA compliant (or plan for compliance) - 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¶
| Term | Consideration |
|---|---|
| Length | Shorter is better initially (1-2 years); longer may get lower rate |
| Personal guarantee | Try to limit or avoid; landlords often require for new businesses |
| Rent escalation | Know how much rent increases annually |
| Build-out allowance | Landlord may contribute to improvements |
| Free rent period | Ask for 1-3 months free during setup |
| Early termination | Try to negotiate exit clause if practice fails |
| Sublease rights | Ability to sublease if you need to downsize or relocate |
| Signage | Ensure you can have appropriate signage |
| Parking | Confirm adequate patient parking |
| Hours of access | 24/7 or limited? Consider after-hours visits |
| Competitors | Any restrictions on landlord leasing to competing practices? |
Red Flags¶
[!WARNING] Watch out for these lease red flags: - Very long lease required (5+ years) with no exit - Large personal guarantee - Significant build-out required at your expense - Hidden fees (CAM charges not disclosed) - Zoning uncertainty - Difficult parking situation
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: - Zoning often prohibits (residential zones) - Professional appearance concerns - Work-life balance - HIPAA/privacy in home setting - 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 (if HIPAA-compliant setup)
- Phone consultations
- Documentation
- Business planning
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¶
| Model | Monthly Total |
|---|---|
| No dedicated space | $0-$200 (phone, mailing address) |
| Shared space | $500-$2,500 |
| Small dedicated | $2,000-$4,500 |
| Full clinic | $4,000-$10,000+ |
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 (or plan for compliance)
- 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
- Ensure HIPAA compliance
- Create welcoming environment
- Install signage (where permitted)
Resources¶
- Startup Costs Overview - Budgeting for space
- Equipment and Supplies Checklist - What you need
- LoopNet.com - Commercial real estate listings
- Local commercial real estate brokers
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