Orthopedic office lease negotiation and tenant representation
Go into a new lease or renewal with a professional who represents the practice, not the building. Orthopedic Surgeon Planning introduces orthopedic surgeons to independent commercial real estate professionals who handle tenant representation.
- Independent professionals
- Free introduction
- You decide who to hire
What is tenant representation for a medical practice?
Tenant representation means a commercial real estate professional works for the practice, not the landlord, when it leases space. For orthopedic practices, that usually includes a market survey of comparable space, tours, a letter of intent, orthopedic office lease negotiation alongside the practice’s attorney, and planning for each lease renewal or expansion. Orthopedic Surgeon Planning introduces owners to independent professionals. It is not a real estate brokerage, and it does not give legal advice.
Why do orthopedic practices use tenant representation?
A landlord’s leasing agent represents the building. A tenant representative represents the practice, compares the space against the rest of the market, and keeps the practice’s priorities in front of every conversation, from the first tour to the signed lease.
Medical leases also carry terms that general office leases may not address well: use clauses that allow clinical services, after-hours HVAC, medical waste, signage, exclusive-use rights, and the right to expand or assign the lease if the practice changes hands. The professional flags these early, and the practice’s attorney reviews the final language.
This page is part of the medical office space guide. If the lease includes construction, see build-out and space planning. Plan IT and networking and VoIP phone systems before move-in.
What does tenant representation usually include?
Services worth discussing with any commercial real estate professional.
Market survey
Comparable medical space, availability, and typical terms in the target area.
Tours and shortlists
Organized tours with side-by-side notes on layout, condition, and fit.
Letter of intent
A non-binding outline of key business terms before the lease is drafted.
Lease negotiation support
Business terms negotiated alongside the practice’s attorney, who reviews the lease.
Lease renewal planning
Renewal options reviewed early, with the market tested before the deadline.
Expansion and contraction rights
Options to add space, give back space, or relocate within the building.
What should orthopedic practices know before negotiating a lease?
Points worth raising with any commercial real estate professional.
Start before the renewal deadline
Many leases require notice of renewal months before expiration. Ask the professional to review key dates now, so the practice can compare the market before it has to decide.
Who pays the tenant representative
Ask how the professional is paid, whether compensation comes from the landlord, the practice, or both, and get the answer in writing before tours begin.
Imaging and PT requirements
MRI and x-ray need shielding, power, and sometimes structural work, and a PT gym needs open floor and ceiling height. The lease should allow these improvements and address restoration at the end of the term.
Several clinics, several leases
Groups with several clinics often line up lease dates so locations can be consolidated or expanded together. Ask the professional to map every lease date across the group.
When do orthopedic practices usually bring in tenant representation?
Most introductions start with one of these situations.
- The lease renews within 18 months
- The landlord sent a renewal offer and nobody has compared the market
- The practice needs more space in the same building
- A new location needs a lease
- Ownership of the practice is changing and the lease needs review
- Several clinic leases expire at different times
Space and systems go together. See IT and networking and VoIP phone systems.
How the introduction works
Take the 2-minute check
Answer a few quick questions about your practice, your space, and what you need.
Get a matched introduction
Orthopedic Surgeon Planning introduces you to an independent commercial real estate professional who works with orthopedic practices.
Meet and decide
You speak with them directly. They explain their scope and fees up front, and you decide whether to hire them.
What to ask a commercial real estate professional about lease negotiation
Use these in a first conversation to judge experience and fit.
- Do you represent tenants only, or landlords too, and how are conflicts handled?
- Which medical leases have you negotiated recently?
- How will you compare this space with the rest of the market?
- Which lease terms matter most for clinical use?
- Would you map every lease date across the group?
- How are you paid, and what is in scope?
Lease Negotiation FAQs for orthopedic practices
What is a letter of intent for a medical office lease?
A letter of intent, or LOI, is a usually non-binding document that outlines the main business terms, such as space, term, rent structure, improvement allowance, and renewal options, before attorneys draft the lease. It lets both sides agree on the shape of the deal first. The practice’s attorney should still review the full lease before signing.
When should a practice start planning a lease renewal?
Many practices start 12 to 18 months before the lease expires, and earlier if the renewal notice deadline falls well ahead of expiration. That leaves time to test the market, compare relocation options, and negotiate without pressure. A tenant representative can build the timeline from the dates in the current lease.
What medical-specific terms belong in an office lease?
Common topics include a use clause that permits clinical services, after-hours HVAC and access, medical waste handling, signage rights, exclusive-use rights for the specialty, parking, and rights to expand, assign, or sublease. A commercial real estate professional can flag what to raise, and the practice’s attorney reviews the final language.
What lease terms matter for an orthopedic practice?
Common topics include approval for imaging with shielding and power, structural work for MRI, open space for a physical therapy gym, after-hours HVAC for walk-in or therapy hours, parking for patient volume, and restoration at the end of the term. A commercial real estate professional flags these, and the attorney reviews the final lease.
Is Orthopedic Surgeon Planning a real estate brokerage?
No. Orthopedic Surgeon Planning is an introduction service. It does not list, lease, sell, or manage property, and it does not represent either side of a transaction. It connects practice owners with independent commercial real estate professionals who work with orthopedic practices. The professional you choose works for you directly, explains their own scope and fees up front, and is responsible for the work they deliver.
What does the introduction cost?
Nothing. Orthopedic Surgeon Planning does not charge physicians for the introduction. If you hire the professional, you pay them directly, and they explain their scope and fees up front. Orthopedic Surgeon Planning may receive compensation from partner businesses, as described in the site disclaimer. You are never obligated to hire anyone you meet.
More medical office space topics for orthopedic practices
Medical Office Space
The full guide to medical office space for orthopedic practices.
Back to Medical Office Space →Site Selection
Demographics, referral access, visibility, parking, zoning, and buildings that can support clinical use.
Explore site selection →Lease vs. Buy
The questions practices weigh when choosing between leasing and owning their space, and who reviews the numbers.
Explore lease vs. buy →Buying a Building
Owner-occupied buildings and condos: search, due diligence, inspections, zoning, and the team that closes the purchase.
Explore buying a building →Build-Out & Space Planning
Space planning, floor plans, improvement allowances, and coordination with architects and contractors for clinical space.
Explore build-out & space planning →Relocation & New Locations
Moving the practice or adding a satellite office: timelines, overlap, patient communication, and keeping clinics running.
Explore relocation & new locations →IT & networking
Secure networks, devices, backups, and support for the new space.
Explore IT & networking →VoIP phone systems
Cloud phones, call routing, and number porting for a move or new office.
Explore VoIP services →Negotiate the lease with someone on your side
Take a 2-minute check and request an introduction to an independent commercial real estate professional who works with orthopedic practices.
Take the 2-minute Practice Planning Checkor call (972) 616-4581
Orthopedic Surgeon Planning is an introduction service connecting physicians with independent professionals. It is not a real estate brokerage and does not lease, sell, or manage property. General education, not legal advice.
Please seek professional advice for your specific situation from an independent, qualified professional. View Disclaimer.
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