When Should You Start Talking to a Builder? Earlier Than You Think.

The most common version of this mistake goes like this: an operator finds a site they like, negotiates a lease, gets financing lined up, and then calls a design-build firm to start the project. By the time they make that call, they've already made a dozen decisions that can't be undone — and some of them are wrong. The lease is signed. The square footage is committed. The tenant improvement allowance was negotiated without knowing what the buildout actually costs. The move-in timeline is already embedded in a financial model that assumed construction would take four months.

This is not the operator's fault. Nobody tells you that the design-build conversation should happen before the lease conversation. But it should, and here's why.

Site selection looks like a real estate decision. It's also a construction decision, and those two lenses see different things. A real estate broker evaluates traffic counts, demographics, proximity to your patient base, and lease economics. A design-build firm evaluates what it's actually going to cost to build what you need in that specific space. Those are not the same analysis, and the gap between them is where operators get surprised. A shell space that looks ideal can have utility infrastructure that adds $150,000 to the project — a water service undersized for clinical use, an electrical panel that has to be replaced, a gas line that doesn't reach the building. None of that shows up in the listing. It shows up in the construction budget after you've already signed. Catching it at the site-selection stage, before you commit, changes the math on whether that site actually pencils.

Zoning is another front-end filter that gets skipped more often than it should. Your intended use — dental, veterinary, medical, daycare — may require a conditional use permit, or may simply not be permitted in the zone. Discovering this after signing a lease creates a clock. You're paying rent while you work through an entitlement process that may or may not go your way. A thirty-minute conversation with someone who has built in your vertical across multiple markets can tell you whether the site you're looking at has zoning risk before you're financially committed to it.

The TI allowance negotiation is where early design input pays for itself most directly. Tenant improvement allowances are negotiated as a dollar amount per square foot, and landlords offer what the market supports. But what the market supports and what your buildout actually costs are often not the same number. If you negotiate a TI allowance without knowing your real construction cost, you're accepting a number blind. If you go into that negotiation with schematic drawings and a preliminary budget from your design-build firm, you know what you need and you can structure the deal accordingly — whether that means negotiating a higher allowance, adjusting the base rent in exchange for more TI, or deciding the site doesn't work financially before you sign rather than after.

The early conversation also right-sizes your square footage commitment. Operators frequently sign for more space than they need because they're estimating based on their current location, or for less space than they need because they're trying to keep rent down. The right size is determined by your clinical program: how many operatories or exam rooms or treatment bays you're designing for, what your support space requirements are, how you want staff to flow through the building. A design professional can tell you what your program actually requires in a preliminary conversation before you've committed to anything. That information changes which sites you pursue.

The early conversation costs nothing. A serious design-build firm will engage at the site-selection stage without a signed contract. The risk of having that conversation early is zero. The cost of not having it is often measured in six figures — the lease you signed on a site that doesn't work, the TI allowance you left on the table, the utility surprise that blows your budget in month one of construction.

If you're actively looking at sites or approaching a lease decision, reach out to Primus before you sign — not after. The conversation starts at primus-companies.com.