Your A-Team for Healthcare Clinic Development

Building healthcare organizations from zero-to-one is incredibly exciting. You have seen or, more often, experienced yourself or with your family a problem in the healthcare system where you know you can effect change.

For me, this was seeing how challenging it was for highly educated people with means to manage care for loved ones, and realizing that it must be 100X harder for those who are less fortunate. I love working with founders who share my mission, and recognize the importance of providing high-quality care to high-need populations, whether that’s older adults, middle-aged, or children.

Mission-aligned founders have a strong vision for their care model and burning passion to bring it to the people who need it most. The challenge comes in when the vision meets the reality of managing countless details and making the hundreds of decisions needed to develop brick-and-mortar clinics.

The sheer scale of getting a physical clinic from concept to opening day can be overwhelming and, without the right team in place, becomes a distraction from building out and executing on the care model. Having the right team in place to support hte brick-and-mortar development is critical to success.

But how do you vet them? What should you truly look for? I've seen countless projects succeed and stumble based on these initial decisions.

1. The Real Estate Broker: Your Site Identification Specialist

When you start looking for sites, a real estate broker is usually your first call. Their primary role should be clear: to find you sites that precisely meet your search criteria, to represent your interests fiercely with the landlord, and to act as a critical conduit, translating your operational needs to the landlord in the LOI and lease negotiation process to ensure you have the flexibility to run your business as you see fit.

 But beware of two common pitfalls:

• The "Whale Hunter” Trap: Don't chase the top-billing broker who sells you the dream then delegates your crucial (often smaller, for a startup) transaction to an inexperienced junior. The brokerage industry's commission structure naturally incentivizes senior brokers to focus on larger deals. If you’re signing a 2,500 sq ft lease, insist on meeting the actual team working on your deal. If the senior partner claims to be the only one, consider another firm.

• The "Friend-of-a-Friend" Vetting Fail: Don’t hire a broker just because they're a contact. While fundamentals are the same, healthcare real estate has unique nuances – patient flow, staff needs, regulatory requirements – that a broker focused only on office or retail space might not fully grasp. Vet their healthcare-specific experience rigorously.

2. The Architect: Your Strategic Thought Partner

An architect is critical for translating your vision into a functional, compliant space. Your choice should align with your market, care type, target population, and desired aesthetic. If you're in a heavily regulated market (like California) or a specialized care type (hospitals, PACE, mental health), deep regulatory knowledge is non-negotiable. For senior care or pediatrics, seek architects with relevant population-specific design experience. If you dream of a spa-like clinic, look for hospitality experience combined with healthcare work.

Beyond experience, look for a clear communicator. They are willing to weigh pros/cons, costs, and push back on unrealistic ideas. You, as a founder, are a big ideas person. You need an architect who's able to connect your idea to value for your patients and staff and ensure your idea is matched with a solution to the problem you are trying to solve. An order-taker architect won't serve you well when critical, budget- or timeline-impacting decisions arise. Test their knowledge in interviews: present a design challenge and ask them to tell you why you should think differently.

3. The General Contractor (GC): Your Execution Linchpin

The GC's team – their project managers, engineers, superintendents, and subcontractors – is who actually builds your architect's plans. Resist the urge to pick a GC based solely on their firm’s overall experience. While their broader portfolio is a factor, the crucial decision lies with the specific GC project team that will be on your job site every day. 

It's certainly beneficial for the firm to understand healthcare builds, but knowing the specific GC team's expertise in navigating the nuances of general healthcare construction in your jurisdiction is paramount. Prioritize their direct experience, skill, and communication style. You're hiring people, not just a logo.

4. The Owner's Project Manager (OPM): Your Construction Navigator

For a founder, managing the broker, architect, GC, your own internal vendors (like IT, furniture), and the landlord through a complex construction project can quickly become a full-time job. This is where an Owner's Project Manager (OPM) becomes a critical component. An OPM's sole job is to organize this chaos. They work alongside you, overseeing the GC, architect, owner's vendors, and landlord, ensuring everything stays on track from a timeline, budget, and invoice payment perspective.

When vetting an OPM, look for someone who prioritizes being onsite regularly, especially given the specific location of your project. They need to be exceptionally organized and meticulous, as they'll be tracking countless moving pieces.

Here are a few ways to test their capabilities during the interview process:

• Present a scenario: Ask them to be a thought partner on a complex problem you've experienced or anticipate facing during your build. See their problem-solving approach.

• Drill into process: Ask them to describe their typical cadence of communication, how they organize projects, and how they handle budget updates. Transparency and consistency are key here.

• Request a specific example: Ask them to describe a challenging issue from a relevant project they've worked on previously, and detail how they navigated it to a successful resolution.

5. The Strategic Real Estate Partner: Your Orchestrator

Beyond assembling the individual experts, there’s an overarching need for a partner who deeply understands your mission and can ensure every step of your real estate journey serves your ultimate goal: delivering exceptional care. This is the role of a strategic real estate partner – someone like me.

Retained CRE is more than an orchestrator; we are your strategic partner dedicated to ensuring your physical footprint amplifies your mission. We understand the profound importance of the care you're bringing to communities in need. We work alongside you through every step of the process, ensuring the significant real estate investment you're making unlocks tangible value for your patients and results in a high-quality facility that truly enables high-quality care. Our aim is for you to feel informed and involved, without ever feeling overwhelmed by the thousands of decisions required during the build and while managing the rest of your growing business.

What's one partner you've found indispensable (or desperately needed) during a healthcare clinic development? Share your insights in the comments below! If you're ready to build your A-Team with the right strategic oversight and ensure your real estate truly supports your mission, reach out to explore how we can partner.