When Should You Start Planning a Practice Relocation Before Your Lease Ends?

For most practices, plan to start the relocation process about 18 months before your lease expires if you intend to lease or buy an existing building — and 24 months or more if you intend to build from the ground up. Those windows are not the time it takes to construct the space; they are the time the whole process takes, from the first search through opening day. The construction is only one piece of it. The reason to start that early is that the steps before construction — finding the right space and reaching terms on it — can take many months and sometimes fail, forcing a restart with less runway left than before.

This article explains what those windows include, why ground-up needs more time than leasing or buying, why the search-and-negotiate phase is the part that catches owners off guard, and how geography changes the math.

How far ahead should you start?

The honest answer depends on the path you choose, because the paths take different amounts of time:

• Leasing or buying an existing building: start the process about 18 months before your current lease expires.
• Building from the ground up: start 24 months or more before expiration.

These are full-process windows. They cover finding and securing a space, designing it, getting through permitting, building it out, and being ready to see patients — not just the construction. Industry guidance varies, with some advisors suggesting 12 months as a bare minimum for a straightforward move and others recommending owners begin looking years earlier because finding the right space can itself take a long time. The 18- and 24-month windows are a disciplined middle: enough runway to do it well without a scramble, and enough cushion to absorb the delays that relocations commonly hit.

Why does building from the ground up take longer?

Ground-up construction adds two things a lease or an existing-building purchase does not: the land and the approvals to build on it.

The construction itself is longer — a from-scratch dental building commonly runs in the range of 9 to 18 months to construct, versus roughly 6 to 9 months to build out space inside an existing or leased building. On top of that, ground-up adds an entitlements-and-permitting front end that can be unpredictable. A straightforward, by-right site might clear zoning and permitting in a couple of months; a site that needs rezoning, traffic studies, public hearings, or design review can take well over half a year before construction can even begin. That front-end uncertainty is the main reason a ground-up relocation needs 24 months or more of runway rather than 18.

Why is the search-and-negotiate phase the part that catches people off guard?

The most common way a relocation timeline goes wrong is not the construction. It is the part before it — finding the right space and reaching agreement on it.

Here is the scenario that burns owners: you spend six months searching for the right location, then three months negotiating the lease or purchase, and then the deal falls apart — the terms do not come together, the building does not check out, the seller or landlord changes course. Now you are nine months into your runway with nothing secured, and you start over. If you began 12 months before your lease expired, you are now in trouble: construction alone can take 6 to 9 months, and you no longer have that much time left.

That is why the runway has to be long enough to survive a false start. The search-and-negotiate phase can take longer than expected, and it can fail — and the timeline has to have room for that without forcing you into a rushed decision or a holdover at your old space on unfavorable terms. Starting early is not about moving early; it is about having enough room that a setback in the search does not become a crisis.

How does geography change the timeline?

Where the practice is located can move these numbers meaningfully, and it is worth accounting for honestly.

Permitting and entitlement timelines vary widely by jurisdiction — the same building can clear approvals in a couple of months in one market and take far longer in another, and difficult permitting markets can add months on top of a typical schedule. Construction costs and labor availability differ by region as well. A move in a major metro, a slow-permitting municipality, or a market with limited suitable space can run longer than the same move in a faster, more available market. An advisor who has only relocated practices in one kind of market may quote a timeline that does not transfer to yours.

The practical takeaway is to treat the 18- and 24-month windows as starting points and add cushion if your market is known for slow approvals, limited inventory, or a competitive search.

What goes into the runway?

Roughly, the full window covers these stages, several of which can overlap:

• Search. Finding the right space — the right size, location, visibility, and fit for where the practice is headed. This can take months, and patience here matters; settling on the wrong space to save time tends to cost more later.
• Negotiation. Reaching terms on a lease or purchase, which commonly takes several months and is the phase most likely to stall or fail.
• Design. Laying out the space for the practice, which can run anywhere from about one to eight months depending on complexity.
• Permitting. Securing approvals, which varies widely by jurisdiction.
• Construction. Roughly 6 to 9 months for a buildout in existing or leased space; 9 to 18 months for ground-up.
• Move and opening. Equipment, the physical move, and patient communication ahead of opening day.

Because these stages stack — and because the early ones can repeat if a deal falls through — the total is longer than any single stage suggests. That is the number to plan against.

The short version

Start about 18 months before your lease expires if you plan to lease or buy an existing building, and 24 months or more if you plan to build from the ground up. Those are full-process windows, not construction timelines — and the reason for that much runway is that finding and securing the right space can take many months and sometimes fails, forcing a restart. Ground-up takes longer because of land, entitlements, and a longer build. And in slow-permitting or low-inventory markets, add cushion on top. The goal of starting early is not to move early — it is to have enough room that a setback does not turn into a rushed decision.

NextSite Consulting is an independent, fee-based real estate advisory firm for dental and medical practice owners. We help owners plan the real estate side of a relocation — the timing, the options, and how the facility fits where the practice is headed. We work on a flat-fee basis. This article is general information; timelines vary by project and market.