Finding the right real estate for your practice requires some research and resolution, but the results are worth the effort.

By Granville Y. Brady, Jr., AuD

One of the First decisions that an audiologist makes when starting a private practice is where to locate the practice. As real estate experts have said for years, "Location, location, location" is what drives the market. For audiologists, a good location can be a ticket to success, creating an instant image for the practice. A bad location, on the other hand, can be a millstone around the neck of the most skillful practitioner.

Beginnings

Real estate agents can be a valuable resource for the business that seeks thousands of square feet of space. However, audiologists typically seek less than 1,200 square feet, which most realtors consider as low-end space, hardly worth showing. Likewise, landlords do not usually advertise low-end office space with a realtor because of the cost of commissions that will be involved in the lease transaction. Instead, low-end real estate is often advertised in the newspaper. Audiologists who have an idea of where they want to locate should walk around the area and spot "For Rent" signs on buildings. This is the best way to locate space while scrutinizing the neighborhood where you will locate.

Buildings

In some parts of the country, storefront professional offices are very popular. They exist in better strip malls and mixed-use professional parks with retail, professional and commercial tenants. In other areas, storefronts are not the best choice for a professional audiology office. They may reflect the image of hearing aid specialists who historically have used a storefront. Offices in professional or medical buildings might lend credibility to the audiologist who seeks to be located near and associated with other healthcare professionals. In either case, the best way to choose is to follow the standards of the community. If strip malls are "in" then go where the trend is.

Likewise, location must consider competition. Unlike restaurants, which try to congregate in one part of town, having other hearing health professionals located nearby might only neutralize your market. After all, a patient base can only support so many hearing centers. Setting up in a retirement community where there is a saturation of hearing care professionals can be a big mistake.

Agreements

Office space is usually leased by the square foot per year. In some areas that are popular, the cost per foot might be high whereas owners of new construction might offer a good deal initially to get their space occupied. Lease terms are typically for one year; sometimes a shorter term is available, and often an option is offered to renew a lease for multiple years. Leasing differs from renting which is done on a month-to-month basis. An audiologist who invests up to $100,000 in equipment is not going to risk renting on a monthly basis. Likewise, entering into a long-term lease for a start-up company might turn out to be a bad choice if the owner needs to scale down or go out of business. Most leases hold the individual, not their corporation, responsible for paying the lease. In all cases, the tenant should have an attorney review the lease before signing it.

Another issue to consider is renovation. Audiologists usually need little renovation except for installing a sink. The sound booth is of pre-fab construction and is not a permanent part of an office. All new and most existing construction is already handicapped-accessible. Renovation typically means painting, carpeting and some minor wall removal or addition. If possible, the landlord should do this before the tenant moves in. The owner, not the tenant, takes the tax write-off for any construction, which is a capital improvement to the property. Of course, the cost for specialized improvements such as sinks in each room for ENG or cable for computer hookups and cabinetry might be borne by the tenant.

Amenities

Certain amenities are very important for professional offices. In choosing a location, make sure that it is convenient and safe. Does the location have adequate parking? Is the entrance to the office well lit and close to parking? Can the audiologist put up adequate signage to inform the pubic of the location? The best way to determine what amenities may be lacking is to do a walk-through with another person. Take an elderly friend or relative to the location, preferably before signing the lease. Ask the person if it was easy to find the office and how convenient they feel the parking is. If you go after sundown, try to visualize how well a person with poor night vision might be able to see the place. Many a great location has been torpedoed because the parking, lighting and signage are not good.

Audiologists should keep in mind that the consumers in their target market might not have the perceptual and cognitive abilities to find a professional office that is in with 20 other offices having the same parking, lights and signage. Offices attached to a medical center have similar logistics problems. The audiology office might be a long walk from the parking deck. Confusing signs and the need to take an elevator are issues that patients often find annoying. Office buildings adjacent to medical centers are not always designed to be consumer-friendly.

Neighborhoods

The last consideration, although not the least, concerns the area itself. Before committing to a location, find out from the city or town if the neighborhood is in a redevelopment zone. Recently the U.S. Supreme Court ruled that municipalities could take property by eminent domain for purposes of generating better property tax revenue. That means that a town can seize property and sell it to a developer even if the property already generates some tax revenue. Simply put, you could spend a great deal of money to open up an office and then be evicted if the city wants to take the property and put up a shopping mall. An audiologist should consider very carefully the disadvantages of locating in an area that is slated for redevelopment.

Finally, the new practitioner needs to consider the distance of the commute between home and office. For some energetic audiologists, the ride to and from home and office might not be burdensome, but consider doing it for the next 20 to 30 years and then decide if the location is right for you.

Location depends upon so many variables not mentioned here. Costs for taxes, utilities, insurance, permits, a certificate of occupancy and other seemingly trivial items can become a nightmare if the audiologist fails to include them. Private practice is rewarding, enjoyable and a lot of fun. The audiologist who prepares for all contingencies should have time to enjoy the best aspects of business ownership.

Granville Y. Brady, Jr., AuD, owns a private audiology practice with offices in Clifton and East Brunswick, NJ. He is also on the distance-learning faculty at Arizona School of Health Sciences. Dr. Brady has been a member of the Somerville (NJ) borough council and planning board. Contact him at 223 Route 18, Ste. 105, East Brunswick, NJ 08816 or at drgranbrady@optonline.net.

Author's Note

Private Practice Growth

As more audiologists graduate with a clinical doctorate, the number of private practices is going to expand. Salary statistics show that audiologists in private practice fare well financially. Financial enticement, coupled with the lure of being your own boss and the promise that entrepreneurship makes for professional and financial growth, make the prospect of going into private practice very attractive. Is it any wonder that business courses in practice development are becoming very popular?

As an instructor of an AuD business course, I am amazed at how many students shy away from entrepreneurship after taking the course. It seems as if there is a wide gap between the dream of business ownership and the reality of being the boss. Yet the trend to open up a practice will continue as opportunities in the public and private sector fail to reward the education and experience audiologists must have to practice. For some audiologists who have worked as an employee, their new degree may not be compatible with their employer's expectations of how a traditional audiologist should behave. For example, some hospital administrators may be loathe to refer to the audiologist as a "doctor" while physicians employing audiologists might want to reserve the term for their own use.

It is far more than ego that will drive the profession into a private practice model. Almost all professional disciplines that have gained independence offer their services directly to the public. Audiology may be a latecomer on the learning curve, but audiologists are bright, motivated and ambitious. In short, the recipe for success is found in this profession.

–Granville Y. Brady, Jr., AuD