Common Pitfalls in New Practices: #4 Overcommitting on Office Space
By Dr. Ugochi Okoroafor, Board-Certified Orthopedic Surgeon | Owner, Niche Hand Surgery and Orthopedics
A Bigger Office Is Not Always Better
When you open your own practice, a large, fancy office can feel like proof that you made it. More square footage, more exam rooms, a waiting area that impresses every patient who walks in.
But here's what I've seen happen to a lot of new practices: the space you sign for becomes one of your biggest fixed costs before you ever have the patient volume to support it. Rent is due every month, whether your schedule is full or half empty.
That office is nice in theory. But an office that quietly drains your budget every month is a problem you don’t need in your first few years.
How to Choose Office Space Without Overcommitting
The goal is not the most impressive space. It's the space that fits your needs. Here's how I think about it as the owner of Niche Hand Surgery and Orthopedics:
1. Match the Space to the Patients You Actually See
It's tempting to sign a lease for the practice you picture in 10 years. Resist that. Choose a space sized for your current patient volume, with a small, realistic buffer. You can always move or expand once demand is steady and proven. If you're just starting out, you may not know your exact volume yet — but you can build a realistic estimate based on your location and specialty.
2. Start With a Smaller Space or a Sublease
You don’t have to commit to a long-term office space on day one. A smaller suite or a sublease lets you get into the market, see how your patient flow develops, and keep your monthly costs low while you grow.
3. Limit Renovations to What You Truly Need
Focus your buildout on what affects patient care and safety: exam rooms, clean and functional space, the equipment you use every day. The premium finishes and cosmetic upgrades can wait until your revenue is stable.
4. Read Every Lease Term Before You Sign
A lease is a long-term commitment. Look closely at the duration, the annual rent increase or escalation, who pays for maintenance and repairs, and what happens if you need to leave early. Start with a shorter term, like 3 to 5 years, to keep your options open, and have an attorney review everything before you sign.
Pick a Space That Fits the Practice You Have Today
A reasonably sized office almost serves patients better than an oversized one you are struggling to pay for. Choose space you can support today, and your practice stays strong enough to grow into a bigger space when the time is right.
If you are about to sign a lease, keep all of the above in mind before you make the long-term financial commitment.
Stay tuned for Pitfall #5, where we will look at choosing an EMR system and how an expensive one can add cost without adding value.
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