What if every rent check you’ve written over the past decade had been building your wealth—instead of your landlord’s?
A chiropractor has been in practice for 12 years. She’s been paying $6,500/month in rent—$78,000 a year. Over 12 years, that’s $936,000 in payments. And she has nothing to show for it except a landlord who’s now asking for a 20% increase at renewal.
This isn’t a unique situation. According to Medical Economics, physician practices often find themselves in exactly this position—facing the question of whether to continue leasing or finally buy.
When you run the numbers on a scenario like this, the difference is hard to ignore.
If that chiropractor continues leasing at the new rate for another 10 years (assuming modest 3% annual increases), she’d pay approximately $936,000 more.
If she bought a comparable property using an SBA 504 loan, she’d pay approximately $540,000 over the same period—and end up owning a building worth over $1 million.
The difference? Nearly $400,000 in her pocket instead of her landlord’s. Plus a seven-figure asset on her balance sheet.
But here’s what most wellness providers don’t understand: buying isn’t always the right answer. Sometimes leasing is the smarter play. The key is knowing which situation you’re in.
When Leasing Makes Sense
I’m not here to sell you on buying—I’m here to help you make the right decision for your situation.
Lease if you’re testing a new market. Opening your first location in a new geography? Proving out an unproven concept? Lease. You need flexibility, not commitment.
Lease if you’re in high-growth mode. When you’re scaling fast—opening multiple locations, chasing market share—your capital may be better deployed in growth than real estate. Private equity-backed wellness platforms typically lease because they want every dollar working on expansion.
Lease if your space needs might change dramatically. Anticipating a major service line addition? Uncertain about square footage requirements? Lease gives you flexibility to right-size at renewal.
Lease if you’re planning an exit within 5–7 years. If you’re building to sell, clean and transferable leases can actually be more attractive to buyers than owned real estate (which complicates transactions).
When Buying Makes Sense
Buy if you’re established in a proven location. You’ve been in the same market for 5+ years. Patient base is stable. You’re not going anywhere. Stop paying rent.
Buy if your business generates strong, consistent cash flow. SBA 504 loans require demonstrated ability to repay. If your practice throws off reliable income, you’re a candidate for ownership.
Buy if tax benefits matter to your situation. Depreciation, mortgage interest deductions, and potential 1031 exchanges can significantly impact your after-tax position. Talk to your CPA.
Buy if wealth-building is a priority. Every mortgage payment builds equity. Every rent payment builds your landlord’s equity. Over 10–20 years, that difference adds up to six or seven figures.
The Math Most Providers Get Wrong
Here’s where most wellness providers mess up the lease vs. buy analysis: they compare monthly mortgage payments to monthly rent and call it a day.
That’s not the full picture.
Let me show you the real comparison for a $1 million property:
Leasing scenario (10 years):
Starting rent: $6,500/month ($78,000/year)
Assuming 3% annual increases
Total payments over 10 years: ~$894,000
Equity built: $0
Asset owned: Nothing
Buying scenario (10 years):
Purchase price: $1,000,000
Down payment (SBA 504): $100,000 (10%)
Monthly payment: ~$5,966 (25-year fixed at 6.5%)
Total payments over 10 years: ~$816,000 (including down payment)
Equity built: ~$300,000 (principal paydown)
Asset owned: Building likely worth $1.2–1.4M (assuming modest appreciation)
The lease costs more AND you end up with nothing.
And if you have excess space to lease out? That rental income can cover 30–50% of your mortgage payment, making ownership cheaper than leasing month-to-month while you build equity.
The SBA 504 Advantage
Most wellness providers don’t know the SBA 504 loan program exists. It’s specifically designed for small businesses—including medical practices, wellness centers, and healthcare facilities—to purchase real estate and equipment.
Here’s why it matters:
10% down payment (vs. 20–30% for conventional commercial loans). That $1 million building requires just $100,000 down, not $200,000–300,000.
25-year fixed rate. In a rising rate environment, locking in your payment for a quarter century removes a major variable from your financial planning. Current effective rates are around 6.5%—below conventional commercial mortgages.
Up to $5.5 million for owner-occupied properties. That’s enough for most wellness facilities.
Owner-occupied requirement. You must occupy at least 51% of the building. But you can lease out the other 49% to tenants—creating the wellness hub model I described last week.
Three Questions to Ask Yourself
Before you decide, answer these honestly:
How long will I be in this location?
If the answer is “at least 7–10 years,” buying starts to make sense. The transaction costs of purchasing take a few years to recoup. But after that break-even point, ownership wins every year.
Can my business comfortably service the debt?
Run the numbers with your actual financials. Can you make the mortgage payment if you have a bad month? Lenders will ask these questions—you should too.
Am I willing to manage real estate?
If you buy a building larger than you need (smart move), you’ll have tenants. That means leases, maintenance requests, and occasional headaches. Are you prepared to manage that—or hire someone who will?
The Hybrid Approach
Here’s a strategy worth considering if you’re not ready to commit fully: lease with an option to buy.
Some landlords will negotiate a lease that gives you the right (but not obligation) to purchase the property at a predetermined price within a certain timeframe. You continue leasing while you evaluate whether ownership makes sense—but you lock in the purchase price.
This works especially well in appreciating markets or when you need time to build up your down payment.
My Perspective
After 26 years in healthcare, I’ve watched countless providers make this decision both ways. The ones who bought strategically—established practices, strong cash flow, long-term commitment—almost universally say the same thing: “I wish I’d done it sooner.”
The ones who leased when they should have bought? They’re still writing checks to landlords, watching their payments climb, wondering where all that money went.
The math doesn’t lie. For the right wellness provider in the right situation, ownership isn’t just possible—it’s cheaper over time. And you end up with an asset worth seven figures.
That’s not a minor detail.
Let's talk about your 2026 strategy
I'm offering complimentary Fractional CRE Officer discovery calls for health and wellness businesses that are expanding, acquiring property, or preparing for exit.
Whether you're opening your first location, negotiating a major lease, or planning long-term strategy, I'll help you:
✅ Identify the biggest risks and opportunities in your current portfolio
✅ Understand whether your next move should be lease or buy
✅ Structure deals that protect your cash flow and support growth
✅ Prepare your real estate for an eventual exit or sale
After 26 years in healthcare and commercial real estate, I know the operational pressures you face, the financial metrics that matter, and the decisions that separate businesses that scale from those that stall.
The Next Gen Dev - Wellness Edition is your weekly briefing on the strategies and frameworks that separate wellness businesses building the future from those stuck in the past.
Know a wellness provider who’s looking for space or stuck in a bad lease? Forward this email.
