In this episode of Beyond Bitewings, Ash welcomes Jennifer Page from Carr, a commercial real estate firm specializing in healthcare transitions, including practice purchases and sales. Jennifer shares her insights on the unique aspects of representing healthcare professionals in real estate transactions.

She explains why dental practice owners must engage real estate agents who specialize in their industry and avoid conflicts of interest by not representing landlords. This episode highlights the importance of timing in lease renewals and relocations, emphasizing starting the process well in advance.

Jennifer outlines several common mistakes healthcare practitioners often make in commercial real estate, such as not giving themselves enough time to negotiate and treating commercial transactions like residential ones. She also discusses how Carr supports their clients with lease abstractions, vendor partnerships, and even connecting them with experts in lending, accounting, and contractor services.

To learn more about Carr or to connect with Jennifer, visit: Jennifer.Page{at}Carr.us.

Key Topics Discussed:

• Importance of specialized healthcare real estate agents
• Avoiding conflicts of interest in transactions
• Timing for lease renewals and relocations
• Common mistakes in commercial real estate
• Lease abstraction services
• Vendor partnerships and additional support
• Cost benefits of using professional real estate agents
• Support for DSOs and larger healthcare groups

Welcome to Beyond by Wings, the business side of dentistry, brought to you by Edwards and Associates, PC. Join us as we discuss how to build your dental practice, optimize your income, and plan for your future. This podcast is distributed with the understanding that Edwards and Associates PC is not rendering legal, accounting, or professional advice. Listeners should consult with their business advisors before acting on any of the information that is shared. At Edwards and Associates, PC, our business is the business of dentistry. For help or more information, visit our website at enassociates.com. Hello, and welcome to another episode of Beyond Bitewings. In today's episode, we have a very special guest.

Her name is Jennifer Page. She's with Carr and she will be talking to our listeners about the amazing world of transitions, practice purchases, sales. So without further ado, Jennifer, how are you?

I am great. How are you doing? Thanks for having me.

Oh, I'm doing well. Thank you. Absolutely. Pleasure is all mine. So, Jennifer, tell us a little bit about yourself and what KAR does, and how do you think our listeners can benefit from this episode?

Absolutely. Yeah. So KAR is a commercial real estate firm. We're based out of Denver, Colorado. We have about a 135 agents all across the US and in most major markets. And there's really two things that make us unique. The first one is that we are strictly health care agents. So we have all kinds of training and ongoing additional training on how to best represent health care professionals.

And then secondly, and probably more important than the health care niche, is that we are what's called buyer tenant agents. And so, basically, what that means is that we only represent health care professionals in the real estate transaction. So what does that mean? We never represent landlords. We never represent sellers. That's super important if you're looking to relocate a practice, open a de novo office, because you wanna make sure that you see everything in your market that's a good fit for you and make sure there's no conflict of interest with the agent that you're working with.

Bingo. Right there. The conflict of interest. And this is one of those things that's very important to, be on the lookout for, especially when you're looking for someone that's going to help you with the transition. Because otherwise, like I said, you may lose out.

Yeah. So what we see, unfortunately, a lot of health care practitioners do is they just kinda go out on their own and they may drive the market or kinda Google online looking for spaces. And if they see something that's interesting to them, they'll just call the agent whose name is on the sign in the window of the parking lot or maybe on the website. And that's your first biggest mistake. Because when you call that agent, you're calling the person that represents the landlord, and they have a fiduciary responsibility to get that landlord the most money they possibly can in that transaction. I often tell people it's kind of like going into a courtroom as a defendant and hoping that the prosecuting attorney will also represent you. So, like, they have the skill set, right? But is that really in your best interest? Probably not.

Right. Right. I see. Now, you know, it's funny you mentioned that because, you know, if I were in their shoes and if I didn't have this knowledge, I probably would have done the same thing. Google that or, you know, call the person that I see on a billboard. I mean, that's marketing for them working. Right? But you're saying that, you know, to get started, let's say if you've made that decision, how should they, you know, begin the process?

Yeah. So I mean, the first thing they need to do is engage a real estate agent that will work on their behalf. Mhmm. And, you know, there are lots of agents out there that they can partner with, but I think what you really wanna focus on is, 1, somebody that really knows your It's a very different representing, let's say, like a nail salon or a restaurant or something like that versus a health care office. Concessions that landlords will give to health care tenants are very different than other uses. And so having an agent that really understands your value is super important. So 1, somebody that knows your industry and then 2, finding somebody that won't work both sides of the table. So in other words, finding an agent that doesn't take listings, because, you know, inherently there's gonna be that conflict of interest.

It's kind of like, you know, if it's, if you have an agent and they represent a landlord that can give them, you know, hundreds of listings to work on versus 1 dentist or 1 orthodontist, right, that needs a space, there's gonna be there's gonna be pressure there to wanna please the landlord that can give them repeat business over the individual that transacts and then is gone.

Right. That's a good point. Yeah. Absolutely. I see. Now, you know, in in your field, you've been doing this for a while. What are some of the common mistakes that you've seen people make?

Well, outside of what we've already talked about, I think not not giving themselves enough time in a transaction. So let's say, for example, you're in a lease space and your renewal is coming up. We've seen a lot of people wait until, you know, 30, 60 days out from their renewal to start thinking about, oh, well, what should we do here? Right? Well, you don't have time to do anything different if you wait that long. So one of the things that we like to do is to track our clients' renewal dates so that we can engage with them a year, maybe a year and a half prior Mhmm. To, to the expiration and say, okay, doc. What are we wanting to do here? Are you wanting to to stay here, or are you wanting to relocate? Well, if they wanna relocate, it's obvious what we need to do. Right? We've gotta go find options.

Mhmm.

But if you wanna stay in the location, landlord to be competitive unless you have other options in the market. So that involves going to market, finding other options, negotiating out those options, and then going to the landlord and saying, hey, I know that my lease is coming up for expiration. I've been to market and I have some pretty enticing options to move, but I'd like to talk to you about what it might look like for me to sign another 5, 7, 10 years here. Here is what I would like that to look like. So that gives them a lot more leverage. Another big mistake we see is people kind of approaching their commercial real estate transaction like they would a residential transaction. So what do I mean by that? A lot of times when people go and they go house hunting, they look at all these different homes, right, and then they find the one. Right? And so they're like, this is the one I want, and they go hard after that location.

That works great in residential for the most part. In commercial, that's a death sentence. So people need to be negotiating on multiple properties at one time. And there's a couple of reasons for this. The first one is deals die in commercial real estate all the time. They may die at the start line or they may die, you know, at the finish line, right before you sign a lease. So you don't really wanna start over at ground 0 if that happens. The second reason you wanna do that is because you want to be honestly be able to tell the different landlords that they're competing for your business.

If they think that you have fallen in love with their space and you have to have that space, then they're gonna smell that. They're gonna sniff that out. Right? And and you're not gonna get their best deal. And then, really, the last reason is for peace of mind for the tenant. You know, if you've not looked at other options, you don't really know what the market will bear. So at the end of the day, you sign a lease, and you don't really know if you got a great deal or a terrible deal because you have nothing to compare it to. So those are some of the most common things I see.

Mhmm. And I I feel like your point your second point and your third point, they go hand in hand with your first point about giving yourself enough time to make sure you get the best utilization of your leverage. Right? Right. Because oftentimes, I get surprised by the clients coming in and saying, oh, you know, I just renewed my lease and they just did it themselves. And without talking about, you know, any inclusion of TI allowance or, you know, looking at the market about what's competitive to make sure that, you know, the rent increase is in their favor or is competitive and they just move forward. And I like the fact that you and your company, you guys actually keep track of it and get in touch with them about a year or a year and a half before it expires because really in reality, I think you should be doing this at least a year before it expires, not just

a couple of months. Yeah. Because there's so many different things you may run into. Like, what if you find a really great option to do a ground up construction? Right?

Yeah. You

need a lot of time to do that. You can't make that happen in 6 months. You know? So, yeah, giving yourself enough time. If you're not tracking those dates or if you don't have somebody tracking them for you, the landlord is going to sit quietly by until, you know, you don't have time to do anything and then bring you the lease. And, unfortunately, a lot of people have this misconception that signing, you know, a lease on a commercial space is kind of like signing a lease in an apartment. Right? Like, you just go, they give you the paperwork, and you sign it, And that couldn't be farther from the truth. You'd need to be negotiating on lots of different parts of that.

Right. Absolutely. Absolutely. And also, you know, the possibility of what you just mentioned, that what if you have other options? You know, you maybe you've been in business for 10 years, and now your bottom line is healthy enough where you may want to consider a build out.

Right.

Right. And that takes time. Right? You can't have a practice be built out in a month or 2. Nope.

Not even really 5 or 6 months, you know? So so, yeah, timing is so critical. And those are all things that if you're working with an agent, they can really give you some good guidelines on, you know, the different types of transactions, how long you should plan, you know, for each one. So if somebody knows, say they're 3 years out from their lease expiration, they're like, you know, I really would like to consider ground up when it's time. Well, then I need to come see you about 2, two and a half years from your lease being up, you know, for renewal, Cause it could take that long to find the land, to figure out what we want done, to get the financing in place, all of that. So yeah, the timing is very critical.

Right. And also the other thing that I can think of would be the location factor, right? Yeah. Sometimes I see clients like going with a location if they're planning on moving, right? For dentists it's not as common because you know you have all the heavy equipment to consider. Usually I see that whenever they're thinking of a build out right they're always looking at a city where they're currently living and maybe that place is already saturated and might not be the best place to open up another practice. And that's where I feel like you know even professionals like yourself you guys can have your input by saying, you know, there are some great deals in these other parts. It's growing. We know the numbers. We see our other clients.

I think you may want to consider other places.

Yeah. Absolutely. That as well as we have vendor partners that we work with that can run reports and tell them areas that are, you know, really hot for a new practitioner. And another thing to keep in mind is a lot of times, because we do so much dental and so much health care, our agents typically are gonna be the 1st to know if there's a vacant dental spot available, which is kind of like finding a diamond. Right? If you're looking for a dental office and you can find one that's already built out, you know, that's a big win.

That is a big win. Absolutely. Yeah. And that's that's also another thing. It's it's almost like insider trading.

Right? But legal. But the legal version.

But the legal version where you have access to information

like that by working with the professionals. So not only are

you getting the advantage of, you know, negotiation or someone who's exclusively working for you for your benefit but at the same time you also get some input on what would be the best place to, you know, continue your business or start your business.

Yeah. You know, and the one thing that we haven't mentioned yet, which is probably the most important piece for your listeners, is none of this cost them anything. So real estate agents in commercial real estate get paid just like residential agents agents get paid. The landlords landlords and sellers set aside somewhere typically between 6 8% of the commission for their agent to split with the tenant's agent. So if the tenant, the dentist, the orthodontist, whoever it is, comes unrepresented, not only do they get a less fair deal, the landlord's agent just gets that full commission versus if they bring somebody to the table that's an expert in representing them and negotiating for them, they they're not having to pay for that. The landlord still pays for that. It comes out of that fee that they've set aside for their agent. So they stand to save, you know, tens to 100 of 1,000 of dollars over the life of their lease, and it doesn't cost them anything.

Amazing.

Yeah. Yeah. Kind of no downside. Right?

Right. It's like a win win situation. It's like, why wouldn't

I use one? Yeah. Especially That's really our biggest competition is really people not knowing we exist. People just not realizing that the service is there and that they should be using someone.

Oh, absolutely. It's one of those things that when we get clients that have these questions, we always recommend, utilizing a professional to help them with the transition. Yeah. And it just makes sense and it doesn't cost them anything. So why would we have an issue with it?

Yeah.

Now you know you went you mentioned vendor partners but if if I understand correctly you guys let's say if somebody's looking for a build out, right, you guys also have networks within the lending world, right, where you can get

Oh, yeah.

You know.

Yes. We absolutely do. We we have some fantastic relationships, not only with some of the big banks that, you know, you would know if I said their names, you know, they're all over the place, as well as local community banks as well. And our team, is very good at identifying, okay. What does this client need? What are their financials look like? Who should I, make introductions to? And, typically, they'll introduce 2 or 3 different lenders for the client to interview and to talk to. But in addition to lenders, we also have, you know, financial planners. We have CPAs that we work with. We have general contractors.

So if, you know, if you're leasing a space that needs a full build out, you wanna make sure that you use somebody that understands health care build out, just kind of like you wouldn't use a residential home builder to build out a medical office. Right? So just having the right team in place is critical. And that's part of our focus in health care is knowing who all those players are and knowing when to bring them into a deal and introduce them to our clients.

That's amazing. It's almost like a one stop shop.

We try. We try.

That's good. And I know and I can vouch for that because I remember this one time I went to a networking event where I met someone from Carr and I think I had a question about a client who was looking for a signage guy. He immediately connected me with somebody that, you know, he usually works with in the Dallas Fort Worth area. And I was just blown away. And he picked up the phone. He was like, oh, yeah. Sure. Yeah.

I can I can make some time for your

call? And Yeah. And, really, that's what a good agent should do. I mean, they're supposed to be able to help hold your hand and be a resource for you from a to z. Whether this is your first transaction or your 5th or 6th transaction, it's still important to have somebody that does this day in and day out, does it for a living, to help make sure that you don't have any missteps.

Absolutely. I agree. I agree. Yeah. Now back to location, I guess. No. Now I I forgot to actually ask you. So where are you located?

Me personally, I'm in Birmingham, Alabama.

I see.

Our headquarters is in Denver, Colorado though, and then we have agents all over the country.

That is true. Yes. So let's say if a listener or a client of ours is interested in working with Carr, would they contact you or would they go on a website and find a representative in Dallas? How would that work?

Yeah. I think probably the best thing to do is to go to our website, and there's a contact us tab there. Okay. And that goes to a central location, and then they would disperse it to the right agent.

Now they

actually can go online and they can filter through state. And then each state, you can see who all the agents are and what markets they're in. And then if they wanna go and and read their bios and set them to somebody, you can actually contact, the our agents through the website as well. But probably the easiest thing to do is just to send an inquiry through our website and that will get routed to the right person.

Fantastic. That's amazing. Now would it be possible for them to reach out to you guys, let's say, well before the lease is gonna expire. But they just want to make sure somebody's gonna send them a reminder.

Yeah. Absolutely. In fact, one of the services that we provide is lease abstracting. And so what that means is if they'll give us a copy of their lease, we're gonna do 2 things with it. The first thing we're gonna do is we're gonna take out all the pertinent business information and put it into a summary for them that's very simple, easy to read. If you've ever looked at a commercial lease, on a good day, they're 20 to 30 pages, and on a bad day, they're, like, upwards of 70. And so that can be super cumbersome. If you have an issue at at an office and you're like, hey.

The air conditioning is out. What did we negotiate on maintenance? Who are we supposed to call? What are so it will outline all of those details for you, in a very concise format. So most of our clients, you know, they give that to the office manager. They set that aside for you if they need it. The other thing we're gonna do is we're gonna look at your dates. So when does your lease expire? When is your renewal notification period? So that's a period of time before your lease ends where you need to let the landlord know if you plan to to vacate or renew. So we're gonna track those dates. We're gonna put them in our system so that our system will alert us in turn to alert you and say, hey, doctor Jones.

Guess what? I got the alert for you. Your lease is coming up, you know, 18 months, 2 years, whatever we decide on. Let's sit down and have a conversation about, you know, what your plans are. So, yes, we can absolutely do that for them.

Oh, that's amazing. Okay. So that's actually quite a bit of help. And, what kind of commitment would the client have to make?

There really is no commitment there. Just, I guess, to have a conversation with us, when the time comes to evaluate whether or not they wanna use our services moving forward. I've failed to mention another thing. When we do the abstract, we're also kind of doing an evaluation. So our agents will look at that lease and say, okay, here are some things that I see in here that I think we could or should improve the next time around, and these are things that I would like to see changed. So they'll kinda have an idea of, you know, I guess, the red flags that the agent sees that they would like to address in their next term.

Oh, fantastic. Well, that's amazing. Yeah. Okay. That's good. I'm I'm getting ideas here.

One of the things we haven't mentioned that I would like to say really quick is so our agents that work all across the country, you know, they're working with, you know, the single dentist, the single, you know, pediatrician, you know, different health care professionals. We also have a team, and these are the folks that I oversee that work with national accounts. So these are the DSOs, the groups that are either across the state, across the region, or across the country. We also have the ability to help those guys and really streamline their processes. Typically, the way that works is they're they're assigned an account manager from within Carr that really gets to know their organization, what they need and want from a real estate perspective. And then wherever they have a transaction, whether it's a renewal in one city, a de novo in another, and maybe, you know, an acquisition in a in a third, that car account manager will pull in the local agent in each of those markets to help them with that transaction. So they get the local expertise, the local knowledge, but yet they have that primary point of contact at KAR that can simplify communication and process.

Okay. Wow. That's amazing. Okay. So not just the single practice owners, but also the DSO folks.

That's right.

Yep. That's amazing. And again, I can I can vouch for CAR because as I mentioned before at a network networking event, I actually met someone who's with CAR now, who's been with them for over 2 years, and and he used to be a former dentist himself?

Yeah. You'd be surprised. We have former dentists. We have former pediatricians. We have a pharmacist. Yeah. You'd be surprised, how many health care professionals we actually have on the team.

Right. So when they say they really know this, this end industry, like I said, I can vouch for them. They do.

Yeah. They really do.

Okay. That's amazing. Well, thank you so much for being on our episode today, Paige. It was wonderful, and I'm sure our listeners have learned some valuable information. And let's not forget, again, if you're on the buying end, it's not gonna cost you a penny to work with them. You guys don't have to pay them. The seller will. Right? So keep that in mind.

And, if they do need to contact you, would you mind, dropping in your contact information?

Yeah. Absolutely. I can do

that. Awesome. So would it be an email or a phone number?

I guess what what is is it do you want me to just, email out? Or did you wanna

Okay. Pause. Up to you. We can also add them in the show notes if you want.

So if you want to wanna do is fine with me. I I just wasn't sure what you were wanting, what wanting my response to be right there.

Oh, I see. I apologize. I know you have not already mentioned, like, to go on the website and find people. But then at the same

time, I'm just gonna give you my email.

That That's easy. Do you want me to direct them to you personally or, you know, just just Carr, generally? Okay.

You can yeah.

Either one. Either way is fine?

Yep. Yeah. So my my e my personal email, if they wanna reach out to me, is jennifer, jenniferdot page, page, like a page in a book, at carr.us, like United States.

Perfect. Amazing. Alright. Well, thank you so much again for being in our episode. It was a pleasure. Thanks for listening today. Be sure to subscribe to Beyond by Wings on your favorite podcast platform. For more information, you can follow us on Facebook, Twitter, and LinkedIn, or reach out to us on our website.

You can also shoot us an email at info at eandassociates.com.