5 Overlooked Factors Create Havoc with Practice Location

Making a fully informed decision about where to locate your practice involves several complex issues - some obvious, others less obvious

Planning

5 Overlooked Factors Create Havoc with Practice Location

You've found what you think is the “ideal” location to establish your new chiropractic practice. It's located in a thriving community that's friendly toward alternative healthcare. The site you've selected sits in a well-known historic building with high traffic and convenient parking. And because the landlord wants to fill the offices, he's willing to give you a discounted lease rate for the first couple years.


Before you jump in head first, be sure to consider how these five less obvious issues related to choosing a location might make or break your practice.

1. Space Accessibility

Your potential practice space is located on the third floor, and there aren’t any elevators in the older building. This potential architectural barrier should be a concern because of the inaccessibility. Installing an elevator would probably be cost-prohibitive, and because the building is considered historic, the owner isn’t obligated to pay for the upgrades.

Fortunately, the Americans with Disabilities Act (ADA) is often forgiving, especially when it comes to existing structures, and strives to strike a careful balance between increasing access for people with disabilities and recognizing the financial constraints many small businesses face. ADA’s flexible requirements allow businesses confronted with limited financial resources to improve accessibility without excessive expense.

But architectural barriers are certainly something to consider when choosing a practice location. Suddenly, that perfect spot may not be so perfect.

You’ll also want to find out about the days and hours of service and access to the location. For example, are the heating and cooling systems left on or turned off at night and on weekends?

If you’re considering a location inside an office building, are there periods when exterior doors are locked and, if so, can you have keys?

A beautiful office building at a great price is a lousy deal if you plan to work weekends but the building is closed on weekends—or they allow you and your patients access, but the air conditioning and heat are turned off so you roast in the summer and freeze in the winter.

2. Zoning and Ordinances

Another thing you’ll want to check out is whether any zoning restrictions or ordinances could affect your practice in any way. Many cities have very strict zoning requirements. A certain spot may be good for your practice, but if it’s not zoned for chiropractic or health care services, you’re asking for trouble.

You should never sign a lease without being 100% sure you’ll be permitted to operate your practice in that space. Don’t forget about neighboring properties to make sure they reflect the image you want your practice to portray.

3. Building Infrastructure

While older buildings may look nice and people love them for their historical nature, many simply don’t have the necessary infrastructure to support the high-tech needs of today. So, make sure the building you’re considering has adequate electrical, air conditioning and telecommunications service to meet both your present and future growth needs.

When considering a specific space, ask the real estate agent/leasing agent or the landlord for information about communications wiring, such as whether the space is connected to a fiber optic network or is wired for DSL or a T1 line (high-volume Internet connections). You may want to hire an independent engineer to check this out for you so you’re sure to have an objective—and professional—evaluation.

In short, if a building lacks something major that is essential to your practice operation, you should probably look for another location.

4. Hidden Lease and Location Expenses

When preparing a budget to determine whether you can afford a particular location, look beyond just the rental costs or building costs.

Sure, rent composes the major portion of ongoing facilities expense just like a home mortgage is your major living expense. But just like with a home, there are other costs involved. For example, don’t forget about extras such as monthly utilities — they’re included in some leases but not in others. If they’re not included, ask the utility company for a summary of the previous year’s usage and billing for the potential site.

Find out what kind of security deposits the various utility providers require so you can develop an accurate move-in budget. Remember that you may not need a deposit if you have an established payment record with the company.

Other lease considerations include:

  • Do you intend to clean the office yourself, or will you have to hire a janitorial cleaning service? If so, what will it cost?
  • What are the insurance rates for the area compared to other locations you’re considering?
  • Will you or your patients have to pay extra for parking? This could be a big turnoff.

Bottom line: be sure to factor all lease- and location-related expenses into your decision when choosing a practice location.

5. City, State and Property Taxes

Keep in mind that income taxes and sales tax vary greatly from state to state, as do regulatory requirements. It’s a good idea to find out whether the state where you want to practice is friendly to small businesses and particularly to chiropractic practices.

The Small Business Survival Index ranks the various U.S. states on how friendly they are to small business. Property taxes can also range even within a given geographic location. Consider whether you could pay less in taxes by locating your practice across a nearby state or county line.

While not specifically a tax, your practice location can also determine whether you qualify for government economic business programs, such as state-specific small business loans and other financial incentives. 

More on Planning

As you can see, a fully informed decision about where to locate your practice involves several complex issues – some obvious, others less obvious. Determine your priorities, keep an open mind about your options, do your research, and get ready to make one of the most important decisions about your business.

See the blog post Using Data to Evaluate a Practice Location and visit the “Planning” section of NCMIC's Learning Center for more about choosing a location and establishing a successful practice.


The information in the NCMIC Learning Center is offered solely for general information and educational purposes. It is not offered as, nor does it represent, legal or professional advice. Neither does this information constitute a guideline, practice parameter or standard of care. You should not act or rely upon this information without seeking the advice of an attorney familiar with the specific legal requirements of the state(s) in which you practice. If there is a discrepancy between the site and an insurance policy you have with NCMIC, the policy will prevail.