Every step, in writing.
This page is the whole structure: the timeline, the option fee, the premium, the purchase price, and the fine print. Read it the way you'd read a lease, slowly and with questions. Then bring us the questions.
Medre is a physician ownership platform founded by a commercial real estate broker and a practicing physician. Medre buys the building a practice needs and leases it to the practice, with an exclusive purchase option the practice can exercise in any year from year 5 through year 10, priced by independent appraisal at fair market value plus a purchase premium that declines over time. This page walks the structure end to end.
The timeline
Five steps, start to deed.
The call.
Thirty minutes with Erika or Steve to introduce ourselves, answer your questions, and determine if we would be a good fit for your situation.
The search.
We use commercial real estate tools and market analysis to help you decide where to start your practice. We work with you to find the right office space for your practice. You approve the location, the space, and the numbers before anything gets signed. If the office space isn't right, we keep looking.
The close.
Medre buys the office space or building with our capital and our mortgage. You sign the lease and your Exclusive Purchase Option the same day, and pay the one-time option fee that makes the future purchase exclusively yours. Every term is fixed here, before the first rent check.
The lease years.
You see patients and run the practice. We own the building, the debt, and the landlord obligations. Your rent is at fair market price plus a small premium, and your capital stays where it grows fastest: in the practice.
Years 5 through 10.
Your option window opens at year 5 and runs through year 10. You choose the year, or you choose not to exercise at all. It is a right, not an obligation. Three outcomes, all of them yours to choose.
Buy
Exercise the option in the year you choose. An independent appraisal sets the fair market value, and your purchase price is that value plus the purchase premium for that year. If you agree and want to proceed, you obtain financing, close, and the office space is yours.
Renew
Not ready yet, or the timing is wrong. Keep leasing: the option stays open through year 10, and the purchase premium keeps declining while you wait.
Walk
Plans changed. Complete your lease and choose not to exercise the purchase option.
The option
Appraisal, not negotiation.
The option price is not negotiated when you exercise. It is set by an independent appraisal at fair market value at the time of sale, plus the purchase premium for the year you exercise, a percentage that declines through the option window and is written into your documents on day one. The appraiser doesn't work for us, the standard is fixed, and neither side gets to move the number.
That means today's price is not locked, and we won't pretend otherwise. If your market rises, you pay more. If it softens, you pay less. What you never face is a landlord naming a price because they know you can't leave. The process is agreed years before anyone has leverage, and that is the entire point.
Behind every deal
Underwritten like an institution. Run by people you know.
Every building Medre buys passes the same discipline before we commit: lender-grade underwriting, an occupancy analysis that tests the space against your practice's economics, and investment committee review against a consistent standard. The same rigor, every deal, whether it is our first building in your market or our tenth.
You will never be handed a spreadsheet and told to trust it. What you get is the result of the work: a structure that survives your attorney, your accountant, and your lender, because it was built to.
Questions
The fine print, in plain English.
Why wouldn't I just buy the building myself?
If you have the down payment, the certainty, and the appetite to be a landlord, you should buy the building yourself. Buying is the cheaper path over 30 years for the capitalized and certain, and we'll tell you so on the call. Medre exists for everyone who isn't there yet: the owner whose capital belongs in the practice during its highest-growth years, or whose five-year picture isn't clear enough to bet a mortgage on.
What is the Exclusive Purchase Option Fee?
A one-time upfront payment that makes the future purchase of your building exclusively yours. It is not a deposit, it is not refundable, and it is not credited toward the purchase price. It compensates Medre for taking the building's future off the market for the length of your option window. The amount is set per transaction, and you see it before you sign anything.
What does the premium actually cost?
The exact numbers depend on the building, the market, and the lease terms. The rent premium is a small percentage above fair market rent, stated separately. The purchase premium is a percentage above appraised value that declines each year of the option window. You see every figure before you sign anything.
When can I exercise the option?
In any year from year 5 through year 10 of your lease. The window is six years wide because practices mature on different schedules. Exercising earlier means owning sooner; waiting means a smaller purchase premium. Either way, the timing is your call, not ours.
What's the catch?
There is no catch. We earn the option fee, the premium on your rent, and the purchase premium if you buy, and we keep good medical buildings when practices choose not to buy. Both outcomes work for us, which is why the option is real and not a teaser.
Is this a sale-leaseback?
If you already own your building, yes: selling it to Medre and leasing it back is a sale-leaseback, with one difference that matters: a written buyback option you can exercise in any year from 5 through 10, priced by independent appraisal plus a declining premium. Most sale-leaseback buyers are institutions that intend to keep the building forever; the lease is the product.
How is the option price set?
The price is appraised fair market value plus the purchase premium for the year you exercise. Here is what that means, plainly. An independent appraiser, not us, sets the fair market value at the time of sale. The purchase premium is a percentage on top that declines each year of the option window, and the schedule is written into your documents on day one. Today's price is not locked. If your market appreciates over five years, the year 5 value will be higher than today's, and if it softens, lower. What the structure removes is negotiation. No landlord naming a number, no discount for us, no markup for you.
Can Medre help pay for my buildout?
Often, yes. Medre can contribute capital toward tenant improvements and incorporate that investment into a customized lease structure. The contribution and the lease terms are priced together, transparently, so you can weigh the package as a whole with your accountant.
What happens if I walk away?
If you walk away, you finish your lease on its terms and leave, the same as any tenant. There is no penalty for letting the option lapse. The option fee and the premium you paid were the price of the choice you decided not to make, and we tell you that on day one, not at the end.
Who handles maintenance and repairs?
Medre owns the building, the debt, and the landlord obligations. The lease spells out the maintenance and repair split the way any commercial lease does, and you'll read every line of it with your attorney before signing.
What if I sell my practice before I exercise the option?
Whether the option survives a practice sale is written into your documents before you sign, not improvised later.
Do I need a lawyer for this?
Yes, you need a lawyer for this. Bring your attorney and your accountant, and have them read everything. The structure survives scrutiny.
Where does Medre operate?
Medre is based in Colorado and works with practices nationwide. The structure doesn't depend on geography; the building, the market rent, and the appraisal are all local to you.
Who am I actually dealing with?
You are dealing with two equal partners, both investing in real estate since 2009. Erika Christiansen, a licensed Colorado commercial real estate broker, and Steve Christiansen, MD, a practicing retina specialist who runs a multi-location practice. You deal with us directly on every deal, start to finish.
Now bring us your numbers.
A 30-minute call with the founders. Bring your lease, your renewal terms, or the town you want to practice in. We'll tell you whether this pencils for your situation, including if the answer is no.
Not ready? Take the one-page guide.
One email with the guide.