Healthcare & Medical Real Estate

Why are more doctors choosing health system employment, despite limited earning potential?

No other industry has seen the field of battle change so quickly.

There is no quarter of safety—the regulatory environment is perilous, reimbursements are retreating all while patients expect more. Technology has grown to a point that rolling out new software can cost more than a 100-bed facility and consolidation means that we’re constantly reinventing solutions to previously settled problems.

But with turmoil comes opportunity.

In 2015, Dr. David B. Nash, dean of the Jefferson College of Population Health, said at the American  College of Healthcare Executives’ Congress on Healthcare Leadership.

“The most important number I need to predict your health status and well-being is your ZIP code, bar none.”


But flexibility, affordability, and translating strategy efficiently into a physical place that the market supports is important, too.

Providing your system with reliable, empirical and succinct information is how we empower our Healthcare Clients to make the best Atlanta Healthcare or Medical real estate decision possible.

Lease Satisfaction Scores Tougher than CMS

Lease Satisfaction Scores Tougher than CMS’

How FASB and debt markets will grade healthcare organizations’ leases Because of the prevalence of capital leasing for many companies, FASB and IASB have amended accounting guidance (ASC 842) to provide more reporting on lease transactions. …
More Doctors Signing Fewer Checks

More Doctors Signing Fewer Checks

Georgia gains on shifts in physician employment models Inelasticity in demand, an aging population and changes in healthcare policy have led to steady and continued growth in healthcare employment—outpacing total non-farm job numbers…
The Regulator: The State of Healthcare in Georgia

The Regulator: The State of Healthcare in Georgia

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On March 18, 2016, the Georgia Association of Healthcare Executives sponsored a closed door session for C-Level Executives throughout the state to hear perspectives from two insiders: Harold Kirtz, Senior Litigator for the Federal Trade Commission,…

Dental Real Estate

What is the single biggest opportunity in dentistry today?

After staff costs, your real estate expenses will be the largest line item on your budget—and you get one chance to make the best decision possible.

So what if you knew that someone had been working for over 12 years—preparing and gathering resources—to ensure that you would make the best decision possible?

Since 2001, our President has been doing just that in hundreds of Atlanta dental real estate transactions representing dentists.

Whether you are opening your first Atlanta dental practice or fiftieth, the stable of resources DTSpade brings to bear in your transaction is unparalleled. Our team provides the following:

Built-Out Dental Reports

We track space marked for sale or lease that is plumbed for dental. With 50-100 properties in a typical market, this report alone can save hundreds of thousands on a buildout.

Substantive Demographics

Show revenues from area dental offices and household dental spending for any geographic area. Using expensive proprietary data and analysis, you will have empirical evidence to support what is often a gut decision.

Financial Modeling

Normalizes the costs of leased real estate to give you a full understanding of the costs. These are the numbers you wanted from your accountant, but they were unable to provide. With this model, we empower Clients to make a quick and rational decision.

3 Things All Dental Practices Need to Consider Before Renewing or Renegotiating a Lease. Renegotiating or renewing a commercial lease can be a daunting task, even with a global pandemic lurking in the mix.  Because of these circumstances,…
Dentistry From One to Five Offices

Dentistry From One to Five Offices: Part 1 - Why?

Part 1: Why would anyone want five dental practices? November 2016 – Q & A with Pete Newcomb Is dentistry an art, science or business? At DTSpade, we’d argue that it is all three. But every Client decides how much time they can…
Biggest Opportunity in Dentistry


The healthcare industry exhibits high profitability, and dentistry is no different as a whole. The dental industry has benefited from favorable demographic trends, technological advances and attention given to the importance in oral hygiene…


Is your institution fully accountable to its citizens? What is the true cost of your lease obligations?

How excellent can any of us be at activities that are not core competencies?

Governments can be excellent at governing, but have to rely on others—others who have put in the time and practice to achieve excellence—for non-core functions.

This reality can leave jurisdictions unarmed in combat when it comes to negotiating and selecting real estate. Politics change. Laws are complex. Governmentsare further hindered by well-meaning regulations that result in a higher cost for its citizens. On top of that, Landlords have sixty ways to cut you and you’ll never even know you were bleeding.

As your real estate advocate, our role is to analyze your specialized requirements and property, identify a thorough plan of action, and implement that plan to ensure your objectives are not just met, but EXCEEDED.

DTSpade’s value is in our high level of leadership commitment in maintaining real property data, personal accountability and an ability to streamline the market driven negotiation process.

DTSpade represents you BETTER because our team has spent years developing and practicing:

Understanding – Through work with Grady Health System, the Fulton DeKalb Hospital Authority, the City of Atlanta, Atlanta Public Schools & the Atlanta Housing Authority, our team has honed processes for quantifying, evaluating and executing on governmental real estate assets and needs.  DTSpade has earned a reputation for superior performance in our ability to understand the nuances of governmental real estate, and we offer a thorough knowledge of both current and planned processes and procedures.

Patience – Patience is a virtue, and one we can help facilitate through leadership, persistence and coordination of efforts, all while keeping all parties at the table.   We know how to set and manage expectations between the market and government entities throughout a processes that often takes time. By maintaining stamina throughout the process, we ensure our Clients realize the light at the end of the tunnel.

Research & Analysis

We assist in competitive property research and analysis, and provide real time, up-to-date and accurate information regarding government actions to enable our Clients to make the most advantageous business decisions.


As one of our core business values, we offer no exceptions to our accountability. We have process-driven systems in place to ensure accountability from inception to final close.


Only with the benefit of a tenant representation broker can you be guaranteed exposure to every opportunity and the negotiating power to secure the best terms available on your lease renewal or renegotiation.

Government Building Feature

Public Works Can’t Clean up this Mess

How the leases you sign may affect bond ratings FASB and IASB have amended accounting guidance (ASC 842) to provide more transparency for lease transactions. Breaking with tradition of adopting FASB standards, GASB appears poised to…
Atlanta Commercial Real Estate

Who’s got a better multiple than Waze? Your Own City.

Technology, implementation of that technology and viable financial business models are beginning to align for governments to capitalize on new opportunities. The influx of residents to city centers provides challenges to infrastructure,…
Human Resource Planning for the Unplanned - How North Carolina Has Prepared for the Next Generation of Government

Human Resource Planning for the Unplanned - How North Carolina Has Prepared for the Next Generation of Government

Best of Series - Part 1 Baby Boomers are reaching the age of retirement at record rates and by 2025 Millennials will make up three-quarters of the American workforce. Because employees within Government positions are older on average,…


Do you have an equity transaction in your future? What is the easiest way to reduce OpEx & boost valuations?

In the race to close a transaction, commercial real estate can become just another detail.

But it’s more than a detail. Leasehold interest in real estate can be the center of a company, a strategy for the transaction or one piece of a larger plan.  And in haste, companies seeking equity make poor choices that affect value, or private equity firms relegate the task to the settlement counsel.

DTSpade has created a business unit around preparing for equity infusions. Whether the real property is owned or leased, DTSpade helps:

  • companies seeking equity investment plan for the event by managing the transaction through the lens of a private equity firm, and
  • private equity firms to manage the leasehold assignment process cheaper, better and faster than traditional players.

DTSpade represents you BETTER because we are:

  1. skilled in these transactions. Our job is negotiating lease deal terms with Landlords throughout the United States. We’ve counseled owners whose businesses are not saleable because of forward obligation lease terms and negotiated assignments with Landlords who have no incentive to do so.
  2. focused on managing the schedule. It’s a learning curve to explain to a typical broker that the schedule is paramount. Real estate brokers are accustomed to driving schedule, negotiating terms, and managing the process. For any schedule, we can communicate to stakeholders gettable concessions on a given timetable.
  3. prepared for even the most demanding assignments. In living our commitment to build a business around helping Clients make one decision excellently, we are staffed with licensed real estate brokers to reallocate resources for even the largest assignments.

DTSpade works FASTER because we have practiced these transactions for years. Equity transactions in which our Partners have been involved include:

  • Nanston Dental transaction to Great Expressions (17 locations in Georgia)
  • Tenet Healthcare Atlanta asset transaction to WellStar Health System (4 hospitals + 15 locations in Atlanta)
  • Southern Dental transaction to Tralongo Management (11 locations in Texas)

DTSpade completes this work CHEAPER because we can access brokerage commissions from new leases to offset costs of assignments in other locations. Oftentimes, work that would have been charged to the transaction can be completed at no additional cost by accessing these fees.

Mattress Firm Bankruptcy
Trump's Tariffs

How Will Trump’s Tariffs on China Impact Commercial Real Estate?

Earlier this summer, President Donald Trump approved tariffs on about $50 billion dollars in Chinese imports. Some fear this is certain to escalate a trade war between the world’s two largest economies. While others argue the short-term setbacks…
No More Leases in the Junk Drawer

No More Leases in the Junk Drawer

How FASB has changed lease accounting and performance bonuses at the same time Because of the prevalence of leasing for many companies, FASB and IASB have amended accounting guidance (ASC 842) to provide more reporting on lease transactions. …

Commercial Real Estate Services

Let us help you find your place with the following services:

Broker Opinion of Value
Lease Administration
Data Mapping Platform