Partners Real Estate

Lease Renewal

Renewing A Medical Or Dental Lease

The landlord's first renewal proposal is an opening position, not a market rate. Here is how the negotiation actually works and what it is worth.

$0 out of pocket for most practices. The landlord pays our fee.

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$3M+saved for San Antonio practices on 100+ completed renewals, versus the landlord's initial proposal
200+medical office tenant leases and renewals signed by Partners' San Antonio office
$250M+transaction value closed by Partners' San Antonio office, all property types, last 36 months
2M+ SFleased by Partners' San Antonio office, all property types, last 36 months

Savings are Partners' aggregate results on completed healthcare renewals versus the landlord's initial proposal. Transaction value and square footage are the San Antonio office's totals across all property types over the trailing 36 months, not healthcare alone. Past results do not guarantee future outcomes. Case studies and client quotes.

Why the first offer is never the number

A renewal proposal is cheap for a landlord to send and expensive for a practice to accept. It arrives with a rate, a term, and often a deadline, and it is written on the assumption that moving a practice is painful enough that you will sign rather than test it. That assumption is usually right, which is exactly why the number has room in it.

The counterweight is a credible alternative. Not a threat, just real pricing on real space that would work for your practice. Once a landlord knows you have priced the alternative, the conversation changes, and it changes whether or not you ever intend to move.

What is negotiable besides the rate

  • Free rent. Months of abatement, and whether they sit inside or outside the paying term.
  • Annual increases. A percentage point of escalation compounds over a ten-year term into real money.
  • Tenant improvement allowance. Renewals get allowances too. Refresh, reconfigure, or expand on the landlord's money.
  • Operating expenses. Caps on controllable expenses, and how the gross-up clause is written, which is where surprises live.
  • Options. Renewal, expansion, contraction, and termination rights that give you flexibility you do not have today.
  • Guaranty. Whether a personal guaranty is required at all, and if so, how it burns off over time.

When to start

We tell practices to start twelve to eighteen months before expiration, and earlier when the space is large or the build-out is complicated. The reason is arithmetic rather than urgency: touring, test fits, proposals, landlord counters, attorney review, and construction each take time, and your leverage lasts exactly as long as a real alternative is still achievable. Ninety days out, there is no runway left to build one.

What it costs you

For most practices, nothing out of pocket. It is standard for the landlord to pay a leasing fee and for the tenant's broker to be paid out of it. Negotiating alone usually does not recover that money for you; it typically leaves all of it with the broker on the other side. Because it is a market custom and not a rule, we confirm the arrangement in writing on each property before you tour it.

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What This Costs Your Practice

Free To Your Practice. The Landlord Pays Our Fee.

1On most listed buildings the landlord pays a leasing fee.

It is in the listing agreement before you walk in.

2Alone, the landlord's broker usually keeps all of it.

You do not save it. Their broker keeps it.

3With us, our share comes out of that fee.

For most practices, $0 and no invoice from us.

Unrepresented
Landlord's broker keeps the whole fee
Represented by us
Landlord's broker
Your broker, on your side of the table

Same fee, two ways to split it. One of them puts a negotiator in your corner. The other does not.

A few situations differ, such as owner-direct, physician-owned and sublease space. We confirm the fee in writing on every building before you tour it. Brokerage fees are negotiable and not set by law.

Common Questions

Lease renewals

How much can a practice actually save on a renewal?

It varies by building and by how much leverage the timing allows. Across completed renewals, our San Antonio office has saved practices more than $3 million versus the landlord's initial proposal. Savings are Partners' aggregate results on completed renewals versus the landlord's initial proposal; past results do not guarantee future outcomes.

My landlord says the rate is not negotiable. Is that true?

It is a negotiating position, and a common one. What tells you whether it is true is what comparable space in that submarket is actually trading for and how much vacancy the landlord is carrying. That is checkable, and it is the first thing we check.

Will bringing in a broker upset my landlord?

It is routine. Landlords negotiate leases for a living and expect professional representation on the other side. It also takes the awkward part of the conversation off your desk, which matters when you plan to stay in the building.

What if I already signed the renewal?

Then the terms are what they are until the next one. Send it over anyway. Knowing where it sits against the market tells you what to set up for next time, and options buried in the document sometimes give you more room than you think.

Behind The Three Of Us

Partners Healthcare Services, And Partners Real Estate

We are the San Antonio team of Partners Healthcare Services, the healthcare tenant and buyer representation practice of Partners Real Estate. The practice began in 2009 as Crown Tenant Advisors in Atlanta, joined Partners in July 2026, and holds a 5.0 rating across 109 Google reviews. Its brokers are on the ground in Texas, Georgia, North Carolina, South Carolina and Indiana, and the healthcare case studies and client quotes on this site are the practice's.

Partners was founded in 1997, reports more than 300 professionals, and has offices in San Antonio, Austin, Houston, Dallas-Fort Worth and Atlanta. When your practice grows past San Antonio you keep us as the point of contact: Austin, Houston and Dallas-Fort Worth through Partners' own offices, and anywhere else through the best healthcare broker in that market, run by us.

The national practice ›   Where we work ›

Have A Renewal Coming Up?

Send the proposal. We will tell you what we see within 72 hours, at no cost.

Send us your lease Call (210) 384-2342
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