January is when many practice owners pause and take stock. Not because something is wrong, but because the practice has evolved. Goals shift. Performance improves. Earlier assumptions may no longer fit the reality of where the practice is today.
One area that often goes unexamined during this reflection is the facility itself.
Practices rarely outgrow their clinical model first. More often, they outgrow assumptions about space, rent, flexibility, and how the facility supports performance. That misalignment rarely announces itself as a real estate problem. Instead, it shows up as quiet friction.
Growth feels harder than expected. Lenders raise questions that seem out of left field. Buyers focus on issues the owner did not anticipate. Lease renewals suddenly feel more restrictive than they used to.
Whether a practice owns its building or leases space, the same underlying question applies:
Does the facility support where the practice is going, or does it reflect where it has been?
For owners of real estate, this question often centers on whether self-rent is still defensible and whether the building aligns with the current scale and performance of the practice. A structure that made sense years ago may no longer reflect today’s financial realities or future plans.
For lessees, the conversation tends to focus on flexibility. Layout constraints, lease terms, expansion options, and how the space would be viewed by a future buyer all matter more than they did at signing. What once felt sufficient can quietly become limiting.
January is not about making a move. It is about removing blind spots.
Facilities rarely destroy value on their own. Misalignment does. When real estate decisions are evaluated earlier — alongside broader planning conversations — clarity tends to replace urgency. Options become visible. Advisors have better information. Decisions feel less reactive and more intentional.
Clarity creates options. And when a facility is aligned with where a practice is headed, future decisions tend to unfold more smoothly, more predictably, and with fewer surprises.