Often, medical practices do not choose the lowest rate when choosing among loan proposals. They are willing to pay a premium to stay with their incumbent bank when that relationship is strong. These orthopedic surgeons hired CMAC to issue a full RFP to gauge the market. The best proposals offered rates significantly lower than the current loan. The incumbent, however, also responded to CMAC’s RFP with a big improvement, which was accepted. While not the lowest rate, the refinance was at a premium which was acceptable to the physician-owners.