Twenty Years in One Location
Dr. Anderson ran a vision therapy practice from the same medical center for 20 years. She was the building’s first tenant when it opened and secured favorable lease terms that kept her overhead low. Her specialized practice grew steadily. The space didn’t.
After two decades of growth, her 2,500 square feet felt impossibly small. Staff shared desks. Patients doing balance exercises worked in the same space where new patients checked in for appointments. Vision therapy requires controlled lighting and dedicated areas for physical coordination work – none of which she could provide in the cramped layout. The practice couldn’t function properly anymore.
She needed roughly double her current square footage, but couldn’t move more than a few miles from her location. Her patients paid out of pocket for specialized care and expected to find her in this established area. Moving would mean rebuilding referral relationships she’d spent two decades creating. And despite needing significantly more space, she needed to spend less on rent overall.
Dr. Anderson knew PRG agent Todd for years and trusted his judgment. When she realized she’d outgrown her space, she called him. Todd understood what she was up against. In a market with limited inventory and landlords who had no reason to negotiate, her requirements looked nearly impossible.
A Five-Mile Radius and Lower Rent
Dr. Anderson needed to stay in this area. Her vision therapy practice had become established over 20 years in this part of Austin. Her patients paid out of pocket and expected a practice in this kind of setting. She had a competitor nearby who already served the western part of the market, which created a practical boundary on where she could go. The search area was maybe five miles in any direction. In a city the size of Austin, that’s almost nothing.
The financial constraint was just as tight. She needed 5,000 square feet but had to spend less on rent overall than she currently paid. The math seemed impossible. Medical office space in this area ran $30-40 per square foot, sometimes higher. Her current sweetheart deal kept her well below market rate for years. Finding a landlord willing to lease twice the space at a lower total cost – in a market where landlords had multiple options and no reason to negotiate – meant she’d need either exceptional timing or exceptional leverage.
Dr. Anderson also needed rooms with adjustable lighting – some patients with vision issues can’t tolerate bright light. She needed open space for balance work, walking on inclines, and coordination exercises. She needed separate areas for intake and diagnosis so new patients weren’t walking through active therapy sessions. The space had to function in a very specific way, and most medical offices weren’t set up for it.
Finding any 5,000-square-foot medical space in this market would be difficult. Finding one with the right layout, in the right five-mile radius, at a lower cost than she currently paid looked nearly impossible. Todd knew the search would take time. The inventory was limited. And Dr. Anderson wouldn’t compromise – the space had to work, or she’d stay where she was.
Thirty Properties, Three Years
Todd started touring Dr. Anderson through properties. Over the next three years, they’d look at roughly 30 spaces. When she briefly considered expanding her range, they drove to nearby markets. They toured second-generation medical offices that could be adapted. They looked at retail spaces that could convert. Nothing worked.
Todd’s advice stayed consistent: don’t fall in love with any property. In a market this tight, emotion works against you in negotiations. Stay ready to walk away. The space had to be right.
After three years, a first-floor office became available in a professional building near her current location. The space was 5,000 square feet. Todd noticed the layout immediately – you could enter and move in either direction, with a center wall creating a natural division. One side could handle all the vision therapy work. The other side could manage intake and diagnostics. Everything flowed in a loop. The building had good visibility and sat squarely in her target area.
Dr. Anderson toured the space. It worked. The layout could accommodate everything she needed – the separated functions, the lighting control, the therapy areas. The location was right. And Todd believed they could negotiate terms that made financial sense. After three years of searching, they’d found it.
Protecting the Investment
Dr. Anderson wanted to buy the first floor. She was at a point in her career where building equity made more sense than paying rent, and if she was going to invest in a major buildout for vision therapy, she wanted to own the space she was improving. The landlord was open to selling. Todd moved forward with purchase negotiations.
The landlord suddenly changed position. He’d sell the building, but only as a whole. The first floor wasn’t available separately – Dr. Anderson would need to buy the entire property or shift to a lease.
Dr. Anderson couldn’t finance the entire building. The property would cost close to $3 million, and she’d need another $600,000 to convert the former custom home builder’s office into a vision therapy practice. She had capital, but not enough to cover both.
Todd shifted to lease negotiations. The landlord agreed but wouldn’t provide a tenant improvement allowance. The space came as-is. Dr. Anderson would pay for all modifications herself – roughly $600,000 out of pocket to improve a space she wouldn’t own. If the landlord sold the building in a few years, or if she wanted to buy it later, her improvements would have increased its value, potentially pricing her out of purchasing it.
Todd negotiated a right of first refusal (ROFR) into the lease. If Dr. Anderson could arrange financing within the first year, she could purchase the entire building at a locked price of $300 per square foot. Her $600,000 in improvements wouldn’t increase what she’d pay. After the first year, if the landlord decided to sell, she’d still have the first opportunity to buy at whatever price was offered – she just wouldn’t have the locked rate.
The ROFR protected her investment and gave her options. She could demonstrate strong revenue from the larger space and qualify for financing. She could find an investment partner. Or she could simply lease for the full term and never buy. Either way, her $600,000 buildout was protected.
The Long Negotiation
The negotiations dragged on for months. The landlord’s representation changed three times. Each change meant starting over – re-establishing the relationship, re-negotiating points they thought were settled. Terms one broker agreed to would get revisited by the next.
Dr. Anderson kept conceding on smaller items to keep the deal moving. She wanted this done.
Near the end, Dr. Anderson hit her limit. She’d given ground repeatedly on smaller terms. When another issue surfaced, she was done compromising. Three years of searching, landlord representatives changing, constant back-and-forth – she called Todd, questioning whether to walk away entirely.
Todd brought her back to the fundamentals. The space worked. The rate was exceptional for the market. The ROFR protected her $600,000 investment. She’d spent three years finding the right space – this was it. Deals get hardest right before they close, and the exhaustion was real, but the deal itself was sound.
Where She Needed to Be
Dr. Anderson moved forward with the deal. She signed a 10-year lease at $16 per square foot with minimal rent increases over the term, well below the market rate for the area. Todd negotiated a year-long right of first refusal (ROFR) to purchase the entire building at $300 per square foot, protecting her $600,000 buildout investment from being priced out of ownership later.
The space works the way her practice needs it to. Vision therapy patients have dedicated areas with controlled lighting. Intake and diagnostic work happen separately. Her staff has proper workspace – no more shared desks.
The ROFR Todd negotiated gave Dr. Anderson multiple paths forward. If she arranges financing within the first year – either by demonstrating strong revenue or finding an investment partner – she can purchase the building at the locked rate. After the first year, she retains the right to purchase if the landlord sells. And if she never buys, she has a decade in prime real estate at below-market rent. The negotiation protected her $600,000 investment while preserving her options.
After three years and 30 properties, Todd found Dr. Anderson the space she needed. Dr. Anderson opened her new practice space, and the larger layout has allowed her to operate the way she envisioned. The separated functions, the controlled lighting, the dedicated therapy areas – the practice finally has room to grow.
Note: Details have been anonymized to protect client confidentiality.