Medical Construction FAQ: Should I Build New or Renovate?

Posted in Medical Construction.

Should you renovate or build a new medical office? This is a common question we get from medical professionals looking to open their own practice. As with any decision, there are pros and cons to each option. Read on to determine if building new or renovating an existing building will be better for your situation.

Building an Entirely New Building

Around 20% of our medical construction projects are building new structures.

Pro: Land may be available even when the right building is not.

Con: You must budget for both building expenses and the time and associated costs involved with construction when planning for land development.

If you’re searching for real estate in a tight market, land may be more readily available. If your area is quickly growing, there may not even be existing real estate available. However, developing land can be time-consuming and costly. Your contractor will have to consider storm water solutions, running utility lines, civil engineering, and more.

Pro: You don’t have to work around existing issues.

Con: It generally costs more to build new.

You could buy a building that needs significant repairs or requires major floorplan changes to get your desired layout. This might mean expenses like moving support beams or designing around those support beams. With a new build, you don’t have work around these types of issues – but it will cost you. It generally is more expensive to build new than to renovate.

Pro: You can customize the build to your exact specifications.

Con: Custom, new builds often take longer to complete than renovations.

If customization is your top priority, you’ll enjoy building new. There will be almost unlimited customization options. However, building new means the entire project will take longer to reach the finish line. If you’re on a deadline for opening your new practice, it may be quicker to just take on a renovation.


Smile Arc Orthodontics

Worcester DC Orthodontic

Worcester DC Orthodontic

Renovating an Existing Building

Around 80% of our medical construction projects renovate existing real estate.

Pro: You do not have to worry about land development.

Con: You are limited on the availability of real estate in your desired market.

Land development requires more permits and civil engineering than a renovation. It can often be much simpler to buy an existing property. However, that requires that there be a property you could buy that fits your basic needs. Depending on the real estate market, it may be difficult to find an existing commercial property.

Pro: The entire process will generally be faster than a new build.

Con: You won’t have unlimited customization capability.

If you want to open your practice as soon as possible, then you should definitely consider a renovation. Keep in mind that even though your timeline will be reduced, you may not be able to make unlimited customizations in a renovation project.

Pro: Renovations average less money per square foot.

Con: You have to work around the existing building’s limitations.

Many doctors looking to start their own practice are on a strict budget. Renovations average less cost per square foot than a new build. But if you’re working with an existing structure, you may have to make floorplan compromises.

Green Valley Dental

Green Valley Dental

Green Valley Dental

Howard Orthodontics

Howard Orthodontics

Howard Orthodontics

Which site option do we prefer?

As a contractor, we enjoy the challenge of getting creative in a renovation. While you may not be able to customize the build from the ground up, you may be surprised what is possible in your chosen site. One of our favorite projects was renovating a mid-1800s barn to become a modern dental practice! We were able to incorporate the historic architecture and the latest technology for a unique, functional and beautiful space.

That being said, the best site option will vary depending on your specific needs. Talk to one of our experts to figure out if building from scratch or renovating an existing building makes sense for your situation. Contact Real Services today!


We understand how overwhelming this entire process can be. That’s why we created a guide that breaks down the major steps involved in a dental practice build-out. Read the guide now!