The Physician-Owned Medical Real Estate Podcast: Recent Episodes
CPOMP
Join us for discussions and analysis provided by industry experts, physician-owners, and healthcare executives from around the U.S., exploring everything related to physician-owned medical real estate. Hosted by CPOMP, the Congress of Physician-Owned Medical Properties.
In this episode, Dr. Tom Sherman shares his group's experience building and managing a physician-owned real estate portfolio across multiple locations. He explains why the practice has prioritized ownership over leasing and how its equal partnership model keeps clinical and real estate ownership aligned among active physicians.
Tom discusses the challenges that come with this approach, including significant buy-in requirements for new partners, internal valuation considerations, and the importance of maintaining clear ownership transition policies. He also shares the story of a recent 25,000-square-foot property acquisition that became more complicated as development costs, excess space, and site limitations challenged the group's original plans.
Throughout the conversation, Tom emphasizes the importance of evaluating real estate decisions based on economics rather than emotion and understanding potential exit strategies before committing to a project. For physician groups considering medical real estate ownership, the episode offers a practical look at both the long-term benefits of ownership and the risks that need to be planned for along the way.
To participate in conversations like this one, attend the CPOMP 2027 Annual Meeting, January 21-23, 2027 at the Omni Scottsdale Resort and Spa at Montelucia. Register at www.CPOMP.org/cpomp-2027.
In this episode, Joe Magliochetti, Chief Investment Officer at Remedy Medical Properties, discusses how physician groups can successfully navigate medical office development and real estate partnerships in today's healthcare environment. Drawing on Remedy Medical Properties' experience developing and investing in medical office buildings nationwide, he explains how joint ventures can help physician groups balance ownership opportunities with long-term risk management.
The conversation explores the fundamentals of successful development projects, including data-driven site selection, construction costs, lease structures, occupancy planning, and aligning new facilities with growth opportunities such as ambulatory surgery centers. Joe also shares practical advice on selecting the right investment partner, understanding an investor's long-term objectives, and avoiding common pitfalls in development and sale-leaseback transactions.
Throughout the discussion, Joe emphasizes that successful real estate partnerships are built on aligned incentives, thoughtful planning, and a long-term perspective. For physician groups considering new development or expansion, this episode provides a practical framework for evaluating opportunities and structuring partnerships that support sustainable growth.
To participate in conversations like this one, attend the CPOMP 2027 Annual Meeting, January 21-23, 2027 at the Omni Scottsdale Resort and Spa at Montelucia. Register at www.CPOMP.org/cpomp-2027.
In this episode, Rich Collins, CFO of Orthopaedic Associates of Hartford, shares how his group transformed its physician-owned real estate investment structure to better support practice growth and future physician ownership. He explains how the group's original ownership model, created when its surgery center opened in 2017, unintentionally limited opportunities for new physicians while allowing retired owners to retain their interests indefinitely. Rich walks through the complex process of restructuring the investment, including navigating fractional ownership valuations, negotiating buyouts with retired physicians, leveraging existing building equity to finance expansion, and creating a new operating agreement with flexible A and B share classes. He also discusses the importance of establishing clear buyout formulas and governance provisions to eliminate future uncertainty. Throughout the conversation, Rich emphasizes that physician-owned real estate should be designed to evolve alongside the practice. His experience offers practical guidance for groups seeking to align ownership with active physicians while creating a sustainable framework for future growth and expansion.
To participate in conversations like this one, attend the CPOMP 2027 Annual Meeting, January 21-23, 2027 at the Omni Scottsdale Resort and Spa at Montelucia. Register at www.CPOMP.org/cpomp-2027.
In this episode, Dr. Bruce Cohen of OrthoCarolina, shares how one of the nation's largest orthopedic practices developed a physician-owned real estate strategy focused on recruitment, retention, and long-term organizational alignment. He explains how OrthoCarolina transitioned from having little emphasis on real estate ownership to building a portfolio that benefits physicians without requiring significant upfront capital.
Dr. Cohen discusses the challenges of integrating multiple physician groups with different ownership structures, the importance of aligning real estate ownership with active practice participation, and how carefully designed operating agreements can prevent future conflicts. He also shares lessons learned from sale-leaseback transactions, including the implementation of "golden handcuffs" to encourage long-term physician commitment and avoid unintended departures.
Throughout the conversation, Dr. Cohen emphasizes that real estate should support the long-term success of the practice—not simply serve as an investment vehicle. His practical insights offer a valuable roadmap for physician groups looking to build sustainable ownership structures that benefit both current and future partners.
Join the conversation at the CPOMP 2027 Annual Meeting, January 21-23, 2027 at the Omni Scottsdale Resort and Spa at Montelucia. Register at www.CPOMP.org/cpomp-2027.
In this episode, Eric explores the complexities of valuing physician-owned medical real estate and explains why many traditional valuation approaches fail to reflect the realities of medical practice ownership. He discusses how commercial real estate differs from residential real estate, why standard bank appraisals often miss important components of value, and how these shortcomings can create challenges during ownership transitions.
Eric outlines a methodology that separates the value of the core and shell building from the tenant improvements, allowing physician groups to more accurately value each component while maintaining affordability for incoming partners. He explains how capitalization rates, depreciation, and tenant improvement costs factor into the equation and why regular valuation updates are important as market conditions change.
The discussion also covers the role of valuation in succession planning, ownership alignment, and tax strategy. Eric challenges the use of minority interest discounts in physician partnerships and explains why valuation methods should support the long-term sustainability of physician-owned real estate rather than simply maximizing short-term value.
Join the conversation at the CPOMP 2027 Annual Meeting, January 21-23, 2027 at the Omni Scottsdale Resort and Spa at Montelucia. Register at www.CPOMP.org/cpomp-2027.
In this episode, Collin explores the critical role real estate plays in physician practice transactions and why many groups fail to maximize its value. He explains how practice owners often focus heavily on the operating business while overlooking the real estate asset, creating situations where significant value is left on the table during a sale.
The discussion covers sale-leaseback transactions, including how they work, why they frequently accompany practice sales, and the importance of establishing fair market lease terms well before entering a transaction process. Collin also breaks down cap rates, current market conditions, and how buyers evaluate medical real estate investments.
Throughout the conversation, he emphasizes that physician groups should view real estate as a separate business asset with its own strategy, valuation, and planning process. He shares practical guidance on lease structures, recommended lease terms, and proactive planning steps that can help physician owners preserve flexibility and maximize value when the time comes to sell.
Join the next session of Physician-Owned Real Estate 101 at the CPOMP 2027 Annual Meeting, January 21-23, 2027 at the Omni Scottsdale Resort and Spa at Montelucia. Register at www.CPOMP.org/cpomp-2027.
In this episode, Dr. Jeff Douglass discusses how the Oregon Clinic — a 220-physician multi-specialty organization — developed a structured approach to physician-owned medical real estate after recognizing the financial impact of millions in annual lease expenses. Drawing from both successes and past challenges, Dr. Douglass explains how the organization created a commercial real estate investment platform designed to support fairness, sustainability, and long-term physician participation.
The conversation explores the importance of governance, operating agreements, succession planning, and equitable ownership structures when building a physician-owned real estate entity. Dr. Douglass also shares lessons learned from earlier ownership models that created imbalance among physicians and complicated long-term transitions.
Throughout the discussion, he highlights how strategic real estate ownership can strengthen physician retention, provide additional financial opportunities, and help independent practices compete more effectively with hospital systems. He also offers practical advice for physicians entering commercial real estate, emphasizing the importance of expert partnerships and understanding the operational details that drive long-term value.
Join the next session of Physician-Owned Real Estate 101 at the CPOMP 2027 Annual Meeting, January 21-23, 2027 at the Omni Scottsdale Resort and Spa at Montelucia. Register at www.CPOMP.org/cpomp-2027.
*]:pointer-events-auto [content-visibility:auto] supports-[content-visibility:auto]:[contain-intrinsic-size:auto_100lvh] R6Vx5W_threadScrollVars scroll-mb-[calc(var(--scroll-root-safe-area-inset-bottom,0px)+var(--thread-response-height))] scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]" dir="auto" data-turn-id="59bad2f4-1e4c-4bd0-81f6-edabbfbcb415" data-testid="conversation-turn-26" data-scroll-anchor="false" data-turn="assistant"> In this episode, Chris shares insights into how lenders evaluate physician-owned medical real estate deals and what borrowers can do to position themselves for successful financing outcomes. He explains the key differences between owner-occupied and traditional commercial real estate loans, including how those distinctions impact loan terms, leverage, and underwriting standards.
Chris breaks down the financial metrics banks prioritize — including liquidity, leverage, and debt service coverage ratios — and discusses how retained earnings and loan covenants can create both opportunities and challenges for physician groups. He also explores the differences between refinancing an existing property and financing new construction, emphasizing the importance of credible projections, market growth assumptions, and historical practice performance.
Throughout the discussion, Chris highlights the importance of creating a compelling narrative alongside the financial data so lenders can fully understand the strength and long-term viability of the practice.
Join the next session of Physician-Owned Real Estate 101 at the CPOMP 2027 Annual Meeting, January 21-23, 2027 at the Omni Scottsdale Resort and Spa at Montelucia. Register at www.CPOMP.org/cpomp-2027.
In this episode, James, Steve, and Greg explore the structure and implications of developer joint ventures in physician-owned medical real estate. They outline how these partnerships typically originate, including scenarios where developers control land, work alongside health systems, or engage directly with physician groups early in the process.
The conversation focuses on the key tradeoffs involved in partnering with developers, including majority ownership structures, governance control, and differing return expectations. They explain how these dynamics can impact everything from lease rates to long-term exit strategies, and why projects with developer ownership may lose the benefits of owner-occupied financing.
The group also emphasizes the importance of early-stage due diligence, transparency in development costs, and negotiating operating agreements before becoming financially committed. For physician groups considering a development partnership, this episode provides a clear framework for evaluating opportunities, managing risk, and protecting long-term value.
Join the next session of Physician-Owned Real Estate 101 at the CPOMP 2027 Annual Meeting, January 21-23, 2027 at the Omni Scottsdale Resort and Spa at Montelucia. Register at www.CPOMP.org/cpomp-2027.
In this episode, Mike McCaslin shares insights from over four decades of experience advising physician groups on real estate ownership. He explains why practices should prioritize owning their medical facilities, highlighting the financial benefits of capturing rental income internally rather than paying third-party landlords.
Mike outlines how to structure ownership through separate LLCs, create affordable entry points for new physicians, and model long-term value for partners. He also addresses the complexities of ownership transitions, including how to handle retiring physicians, maintain fair valuations, and ensure a balanced ownership structure over time.
Throughout the conversation, Mike identifies common pitfalls — such as mispricing ownership interests and allowing indefinite ownership for retired partners — and offers practical solutions, including defined exit timelines and thoughtful buy-in structures.
For physician owners and practice leaders, this episode provides a comprehensive framework for building, managing, and sustaining successful real estate ownership within a medical practice.
Join the next session of Physician-Owned Real Estate 101 at the CPOMP 2027 Annual Meeting, January 21-23, 2027 at the Omni Scottsdale Resort and Spa at Montelucia. Register at www.CPOMP.org/cpomp-2027.
In this episode, Grant breaks down the key differences between short-term and long-term interest rates and explains how each is influenced by the Federal Reserve and broader market forces. He shares insights into current expectations for rate movements, including the potential for short-term rate cuts and the factors that may keep long-term rates more stable.
Grant also explores how borrowers can use interest rate swaps to create more flexible financing structures, allowing them to fix portions of their debt or adjust strategies over time. He highlights why traditional fixed-rate loans may not always be the best fit, particularly for physician groups that anticipate buy-ins, buy-outs, or future refinancing.
For physician owners and practice leaders, this episode provides a practical framework for aligning interest rate strategy with long-term business goals and navigating an evolving rate environment with greater confidence.
Join the next session of Physician-Owned Real Estate 101 at the CPOMP 2027 Annual Meeting, January 21-23, 2027 at the Omni Scottsdale Resort and Spa at Montelucia. Register at www.CPOMP.org/cpomp-2027.
In this episode, Shannon breaks down the structure behind interest rates and demystifies the often-confusing world of interest rate swaps. She explains how banks separate their cost of funds from their profit (spread), the differences between variable and fixed rate loans, and how swaps allow lenders to transfer interest rate risk while potentially offering borrowers more competitive pricing.
Shannon walks through how swaps are structured, why borrowers typically start out "upside down," and how the value of a swap evolves over time — including what happens if a loan is paid off or refinanced early. She emphasizes that fixed rates are only one piece of the puzzle, and that borrowers must also evaluate fees, penalties, and overall loan structure.
For physician groups financing medical real estate or considering hedging strategies, this episode provides essential insight — and a clear reminder to work with trusted advisors who understand the data behind the deal.
Join the next session of Physician-Owned Real Estate 101 at the CPOMP 2027 Annual Meeting, January 21-23, 2027 at the Omni Scottsdale Resort and Spa at Montelucia. Register at www.CPOMP.org/cpomp-2027.
]:pointer-events-auto scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]" dir="auto" tabindex="-1" data-turn-id= "request-69971ded-9f5c-832a-8d02-27ecadbbf157-0" data-testid= "conversation-turn-12" data-scroll-anchor="true" data-turn= "assistant"> In this episode, The IRS Election That Doctors Miss — and How It Costs Them*, Shane, Tax Partner at Eide Bailly, breaks down the tax strategies that can significantly impact physician-owned medical practices and real estate holdings. Shane explains how depreciation works for medical buildings, when cost segregation studies can accelerate deductions, and why bonus depreciation is often misunderstood.
He also dives into the critical — and often overlooked — 754 election, outlining how it allows new physician partners to step up their basis and capture valuable depreciation benefits during buy-ins. Shane highlights the timing requirements, the tax implications of buy-outs, and why missed elections can't be retroactively fixed — potentially costing physicians thousands over time.
If you're part of a physician-owned practice or navigating partnership transitions, this episode offers practical guidance to help you structure smarter and plan proactively.
Join the next session of Physician-Owned Real Estate 101 at the CPOMP 2027 Annual Meeting, January 21-23, 2027 at the Omni Scottsdale Resort and Spa at Montelucia. Register at www.CPOMP.org/cpomp-2027.
In this first episode of our 2026 series, Craig Kilgore, CEO of Coastal Vascular & Vein Center, unpacks the realities of physician-owned medical real estate. Drawing on decades of experience, Craig shares the benefits, pitfalls, and strategic decisions behind owner-occupied vs. investment ownership, how misaligned partnerships can strain practices, and what young physicians should consider if they're thinking about real estate early in their careers.
Join the next session of Physician-Owned Real Estate 101 at the CPOMP 2027 Annual Meeting, January 21-23, 2027 at the Omni Scottsdale Resort and Spa at Montelucia. Register at www.CPOMP.org/cpomp-2027.
In the first session of the CPOMP 2024 Annual Meeting, Real Estate 101, Grant Blackhurst, Principal at CMAC Partners, provides an explanation of capitalization rates, an important metric for measuring return on investment. Cap rates are often one of the most misunderstood terms among physician-owned groups. Understanding cap rates becomes crucial when selling or purchasing a property, putting rents into place, or evaluating JV partner offers.
In the first session of the CPOMP 2024 Annual Meeting, Dr. Bruce Cohen from OrthoCarolina kicked off the Real Estate 101 session by discussing the importance of owning the medical real estate. He touches on why it’s different than your residential real estate investments, why to pay attention to the leases, and why it’s one of the most stable investments a physician can make.
Join discussions like this at CPOMP 2025 from September 11-13, 2025 at The Broadmoor in Colorado Springs. Register at www.CPOMP.org/2025meeting.
In this episode, Steve Dobias, Managing Director at CBIZ Somerset, discusses an upcoming CPOMP session focused on the analysis of new projects - how and why medical practices are continuing to build new facilities. The CPOMP 2023 Annual Meeting is quickly approaching! Listen to get a sense of the timely real estate-focused discussions that will take place between physicians, executives, and industry experts this fall in Ponte Vedra Beach, FL. Join your peers in these valuable conversations from November 2nd to 4th, 2023 at the Ponte Vedra Inn & Club in Ponte Vedra Beach, FL. Register at www.CPOMP.org/2023meeting.
In this episode, Dr. MJ Pennington, President & CEO of Granger Medical Clinic shares what she will discuss at the upcoming CPOMP conference about joint ventures, recognizing partner misalignment, and the provisions needed to protect physician groups' investments. The CPOMP 2023 Annual Meeting is quickly approaching! Listen to get a sense of the timely real estate-focused discussions that will take place between physicians, executives, and industry experts this fall in Ponte Vedra Beach, FL. Join your peers in these valuable conversations from November 2nd to 4th, 2023 at the Ponte Vedra Inn & Club in Ponte Vedra Beach, FL. Register at www.CPOMP.org/2023meeting.
In this episode, Dr. Bruce Cohen, CEO of OrthoCarolina shares what he will discuss at the upcoming CPOMP meeting about methods groups can use to structure buy-ins and buyouts. The CPOMP 2023 Annual Meeting is quickly approaching! Listen to get a sense of the timely real estate-focused discussions that will take place between physicians, executives, and industry experts this fall in Ponte Vedra Beach, FL. Join your peers in these valuable conversations from November 2nd to 4th, 2023 at the Ponte Vedra Inn & Club in Ponte Vedra Beach, FL. Register at www.CPOMP.org/2023meeting.
In this episode, Mike McCaslin, Principal at CBIZ Somerset shares what he will discuss at the upcoming CPOMP panel "Essentials of a Sustainable & Highly Profitable Real Estate Investment." The CPOMP 2023 Annual Meeting is quickly approaching! Listen to get a sense of the timely real estate-focused discussions that will take place between physicians, executives, and industry experts this fall in Ponte Vedra Beach, FL. Join your peers in these valuable conversations from November 2nd to 4th, 2023 at the Ponte Vedra Inn & Club in Ponte Vedra Beach, FL. Register at www.CPOMP.org/2023meeting.
In this episode, Collin Hart, CEO & Managing Director of ERE Healthcare Real Estate Advisors shares what he will discuss at the upcoming CPOMP conference. The CPOMP 2023 Annual Meeting is quickly approaching! Listen to get a sense of the timely real estate-focused discussions that will take place between physicians, executives, and industry experts this fall in Ponte Vedra Beach, FL. Join your peers in these valuable conversations from November 2nd to 4th, 2023 at the Ponte Vedra Inn & Club in Ponte Vedra Beach, FL. Register at www.CPOMP.org/2023meeting.
In this episode, Eric Nuttall, Partner in Charge of Medical Practices at Eide Bailly shares what he will discuss at the upcoming CPOMP conference.
The CPOMP 2023 Annual Meeting is quickly approaching! Listen to get a sense of the timely real estate-focused discussions that will take place between physicians, executives, and industry experts this fall in Ponte Vedra Beach, FL.
Join your peers in these valuable conversations from November 2nd to 4th, 2023 at the Ponte Vedra Inn & Club in Ponte Vedra Beach, FL. Register at www.CPOMP.org/2023meeting.
The Keys To Developing Physician-Owned Medical Real Estate in a Tightening Economy | A Critically Timed Two-Part Webinar Series
This is a recording of the second session in a two-part webinar series that took place on November 14th, 2022. It featured Greg Warren, Managing Member of CMAC Partners and Andy Johnson, General Fund Manager of the CPOMP Physicians’ Equity Fund. Greg discussed the types of real estate deals that are getting done, and how the practices are structuring them to be affordable for the practice and attractive to the investors. Andy shared how owner-occupied medical groups considering development now have access to supplemental equity through a newly formed private equity fund.
The Keys To Developing Physician-Owned Medical Real Estate in a Tightening Economy | A Critically Timed Two-Part Webinar Series
This is a recording of the first session in a two-part webinar series that took place on November 7th, 2022. It featured JP Conklin, Founder of Pensford and Steve Dobias, Partner at Somerset CPAs & Advisors. JP addressed questions such as when will the Fed stop hiking rates, how long before the Fed starts cutting rates again, and how will fixed rates react in 2023. Steve discussed addressing inflation in your project budgets, whether or not a recession will reduce project costs, the impact of labor shortages and supply chain issues on new projects, and if a rent number can be fixed today.
Marion Jenkins, Partner and co-Founder at HealthSpaces, joins us to discuss the technological side of planning new medical office buildings, links between the operations of the practice and technology, future-proofing of medical real estate, and the cost of these technology considerations.
Marion Jenkins, Partner and co-Founder at HealthSpaces, joins us to discuss the technological side of planning new medical office buildings, links between the operations of the practice and technology, future-proofing of medical real estate, and the cost of these technology considerations.
In this virtual forum, physicians, healthcare executives, and three industry expert guests discussed how groups generally choose new real estate locations, the importance of network optimization, and how to use a data-driven strategy.
Discussion Questions:
- 6:00 - Why should groups who are developing new facilities should care about site selection? How do they use it as a tool?
- 14:00 - What does housing growth mean for medical real estate, future and existing?
- 23:35 - A group with plans to build in a rapidly growing part of the city heard of plans to remove a road in the area. Should they be looking for land based on other existing developments, like roads, or focus on the growing area?
- 30:15 - How would you identify a growing population market in need of additional medical services?
- 32:33 - How has COVID impacted medical real estate growth or the desire to be in a certain location?
- 35:46 - At what stage should physicians and executives consider site selection? Before hiring a project manager? With an architect?
- 41:14 How does analysis and high tech play a role in site selection?
- 49:20 Are younger surgeons indicating more interest in state-of-the-art facilities at the consequence of lower returns of investment, or vice versa?
- 51:24 - What is one do and one don't regarding site selection?
About the Forum:
This virtual networking event is an open and intimate discussion where physicians and executives of independent medical practices come together to discuss their experiences, ask questions, and collaborate with peers and the invited industry expert guests.
We are glad to be joined by three experts in the field to clear up the gray area around post-COVID design requirements and assist groups in their upcoming new development discussions.
- 11:00 - What do we see in regards to the timeframe as to when these changes will start taking place?
- 24:13 - How has the shifted focus on telemedicine affected design, patient volumes, and new growth?
- 32:00 - How do these considerations affect waiting rooms? Will there even be waiting rooms?
- 36:27 - Question from industry expert to provider: What are you finding as great successes in recent months in your practices?
- 37:10 - Providers responses and discussion
- 42:20 - Pandemic business safety act info
About the Forum:
This virtual networking event is an open and intimate discussion where physicians and executives of independent medical practices come together to discuss their experiences, ask questions, and collaborate with peers and the invited industry expert guests.
This week we are sharing an episode from Hall Render's Healthcare Real Estate Advisor podcast, hosted by Andrew Dick, an attorney at the firm. Hall Render is the largest healthcare-focused law firm in the country. Andrew interviews James Winchester, the Lead Financial Analyst for CMAC Partners, a firm that works with physicians to maximize the value of their real estate investments.
Visit podcast.hallrender.com for more info.
Josh Teague, President of Development & Investments at Real Estate Strategies discusses how groups generally choose new real estate locations, the importance of network optimization, and how to use a data-driven strategy.
Michael McCaslin, CPA and Partner at Somerset CPAs & Advisors, joins CPOMP to discuss real estate succession planning, its effect on recruitment, the structuring and framing of the investment, and models that help address these issues.
Chris Stai, CPA and Managing Director at Healthcare Real Estate Advisors discusses how MOB/ASC sales have been affected during COVID, objectives and structures to consider when contemplating a sale/leaseback, how to ensure the right representation, what practices are seeing in terms of valuations, and more.
Steve Dobias, CPA and Partner with Somerset CPAs & Advisors, discusses new construction planning and development for MOBs and ASCs in the current environment.
Eric Nuttall, CPA and Partner at Eide Bailly, discusses how physicians can best utilize a myriad of tax benefits during the life of their real estate ownership. The discussion involves buy-in methods, structure of ownership, realization of depreciation, tax programs, and more.
Guests Joe Ashcraft, Healthcare Project Architect and Jason Brown, Senior Preconstruction Manager of Neenan Archistruction discuss how MOB and ASC design considerations are shifting in the COVID-19 environment.
Guest JP Conklin of Pensford & LoanBoss discusses timely topics that focus on the methods banks are using to maintain their loan profitability and how they affect medical borrowers.
Coming soon! Learn more about the topics and discussions included in this podcast series.