Getting a custom suit made takes time – and the right expert who knows how to measure precisely and make adjustments that matter. Commercial real estate financing isn’t much different, especially when the borrower is owned by a group of physicians.

Sure, you can walk into a bank and get something “off the rack”: standard rates, predictable terms, and a generic structure built for the average borrower.

But here’s the thing – your group isn't average. And neither are its goals.

We’ve seen too many physician-owned practices boxed into financing that “technically” works, but functionally falls short. It restricts cash flow, adds unnecessary costs, and most importantly, limits your ability to grow strategically.

That’s where customization makes all the difference. At CMAC, we’ve structured physician real estate deals across the country where just a few key adjustments made all the difference. Here are just a few examples:

1. Loose in the Collar: Covenants That Don’t Restrict

If you’ve ever had a commercial real estate loan, you know banks want to test business strength with covenants and ratios. But sometimes, those covenants can feel like a starched collar three sizes too small.

That’s exactly what happened to a client in Arizona. The initial terms proposed by the bank were way too tight – think high-pitched, short-on-oxygen tight. CMAC stepped in and negotiated more forgiving terms on their behalf, including a 1.00x post-distribution debt service coverage ratio (DSCR).

The result? Breathing room. The physicians could now distribute the majority of their excess cash – just as they should.

2. Smart Structuring: Going Beyond Mediocre Terms

For a cardiology group in California, the interest rate and equity weren’t the problem. Their real headache? The time, cost, and hassle of audited financials.

After hitting roadblocks elsewhere, they turned to CMAC. We got to work and structured a deal that reduced their reporting requirement from a full audit to a CPA review and eliminated personal guarantees.

Simpler reporting. Lower cost. Less risk. Oh, and while interest savings weren’t their top concern, it was ours. They still walked away with more than $635,000 saved in interest expense.

3. Refitting the Suit: Working with the Incumbent Lender

Sometimes the problem isn’t the lender – it’s the fit. Maybe it's post-holiday weight, maybe it's a New Year’s resolution. Either way, the old suit doesn’t wear like it used to.

That was the case for a Midwest client. Their existing structure wasn’t bad, but it no longer aligned with their needs. With CMAC’s guidance, we extended their interest-only period, increased loan proceeds across both real estate and equipment draw-down facilities, and improved their spread by over 100 basis points.

The bank kept a valuable relationship. The borrower got a smarter, more strategic structure. Win-win.

There’s no one-size-fits-all solution for physician real estate financing – nor should there be. With the right structure and the right advocate, your loan can do more than just fit. It can flex with your goals. It supports strategic growth. It moves your group forward – on your terms.

Connect with CMAC to explore strategies designed specifically for your group.