Medical Office Feasibility Study in Virginia

Northern Virginia leads a modest physician book

Fairfax County alone accounts for 40 of Virginia's 113 SBA physician office approvals from FY2017 to FY2026, far more than any other county or city in the state, so this record leans heavily on Fairfax. In total the approvals come to $47.3 million. The Virginia median is $245,000, at 0.72x the physician-office median nationally, and the state's interquartile range runs from $100,000 to $533,000. Virginia ranks 19 of 53 for these loans, physicians rank 10 of 39 among its classes, and the location quotient of 0.84x leaves the class slightly underweight. None of the three gauges differs enough from both the Virginia all-class book and the national physician figures to be singled out.

Practice lending here is spread across many holders. In Virginia, Wells Fargo Bank National Association carries 12 practice loans for $4.7 million, and Readycap Lending, LLC holds 10 worth $6.0 million, the larger tickets. BayFirst National Bank and Manufacturers and Traders Trust Company have 7 each, the latter for only $703,000, and TD Bank, National Association has 5. SBA 504 financed 16 approvals, with Business Finance Group, Inc. holding 8 worth $5.8 million and Rappahannock Economic Development Corporation 5; SBA 7(a) financed 97. Franchise loans are 2.7% of the count.

A wide gap between floor and ceiling

Of Virginia physician approvals dated FY2017 through FY2024, 14.9% were cancelled, a floor, but the ceiling, which also counts loans still waiting to disburse, is 18.4%. That gap means a meaningful number of Virginia practice loans sat approved and undrawn when the data closed. Repayment has been sound: among 44 Virginia practice loans paid out in FY2017 to FY2021, 2.3% went to charge-off and the same 2.3% within five years, so the losses came early; both are floors. Approvals reached 18 in FY2024 and 16 in FY2025 before 10 in FY2026.

What a Virginia practice study must test

Beyond Fairfax, Loudoun has 7 approvals, Chesapeake and Virginia Beach 6 each and Prince William 5. A feasibility study for a Virginia physician practice has to show the patient base the location can draw against the practices nearby, the referral relationships the physician brings, and the payer contracts in place. The budget has to include build-out to clinical standards, equipment and the working capital to carry the practice until insurer payments arrive. Coverage belongs on net collections after the physician's own pay, with a slower ramp for a start-up than an acquisition. Where 504 money buys the office, the appraiser must value the space as medical office for a later tenant. The industry codes on Virginia physician loans carry no caveat and are not shared with another class, so the Virginia counts stand as filed.