They go by several names—MOBs, (medical office buildings), POBs (physicians office buildings), Ambulatory Services, or even Retail Medical—but all of our clients are giving consideration to including these facilities in their strategic plans, whether on campus or in the outlying parts of their service areas. There are business implications to consider: Will this space be regulated or not regulated under state laws?

  • Will the entities in this space be part of the parent health system or will they be independent providers?
  • Does this space allow us to take less-critical functions out of the main hospital building and house them in less expensive space?
  • Does this facility allow us to reach patients and serve their needs more conveniently?
  • What real estate, financing, and property management mechanisms will be involved in this facility?

Once all of these issues have been sorted out, we the builders come along to make it happen. In the past, most of us did traditional tenant space construction for physician practices not affiliated with the health system and those spaces were not regulated. There was a traditional landlord-tenant contract in place and, while the building may have had some "standards" in place, we basically built whatever that practice wanted, quickly and economically.

It is important for us to be aware that new business arrangements as described above may have an impact on what we build and how we do it. If the space is regulated, and/or is going to belong to the parent health system, there may be more stringent design guidelines to follow, in particular:

  • The need for medical gasses and critical power may come into play unlike in traditional physical offices of the past.
  • Room sizes, number of toilet rooms, and ADA accessibility will be issues.
  • Labs and pharmacies may have to meet specific requirements to hold desirable certifications.
  • There may be a need for additional communication systems including some type of "code blue" and EMS interface.
  • The health system may impose architectural standards in order to "brand" the facility with a recognizable appearance.
  • In order for the facility to share the EMR of a parent health system, it may require more complex IT and telephone installations than traditional physicians’ offices.

All of these are potential cost factors, schedule factors, and satisfaction factors to be considered in planning and executing the project.