When Private Equity Exits, Your Real Estate Stays Behind

Topics Covered

• The Practice Transaction Market in 2026 — PE has pulled back sharply from its peak, but health systems and strategic buyers are filling the gap. Who is buying now, and how buyer type affects your real estate decision
• Two Transactions, Two Advisors — The practice sale and the building sale have separate buyers, separate timelines, and separate structures. Why treating them as one deal — or letting one lag behind — costs physician-owners money on both sides
• The Math of Below-Market Rent — A single rent negotiation on one 40,000 RSF building produced a $3.69M difference in building value. How lease terms set your building's sale price before any buyer ever makes an offer
• The Window of Maximum Value — The window where you control both sides of the landlord-tenant relationship closes the moment the practice sale does. Why timing the real estate process relative to the practice sale is the most important decision you will make
• Three Timing Scenarios — Optimal (parallel processes, both advisors engaged early), common/suboptimal (real estate handled after practice sale closes), and worst case (real estate deferred indefinitely). What each scenario costs in real dollars
• The Coordination Dividend — How a practice M&A advisor and a real estate advisor working in parallel — with coordinated lease terms, sequencing, and tax strategy — produce a better outcome than either transaction handled alone
• What Institutional Buyers Require in 2026 — Healthcare REIT and institutional buyer underwriting criteria, cap rates by property type (5.75%–7.0%), and what disqualifies a building from consideration before the process begins
• The 7-Step Optimal Process — A practical sequence for physician-owners considering a practice sale: when to engage each advisor, how the two processes run in parallel, and what to have in place 12–24 months before your target closing