Medical Office Feasibility Study in the Washington-Arlington-Alexandria, DC-VA-MD-WV Metro Area

Smaller practices, higher cancellations

Physician offices in the Washington area logged 137 loans and $58.5 million over FY2017 to FY2026, twelfth of 488 areas and ninth of 39 classes locally, at a location quotient near the national share (1.07x). The median loan is $250,000, only 0.73x the class median nationwide, and cancellation after approval reaches at least 16.3% of those approved in FY2017 to FY2024, a high floor. Physician offices here borrow modestly, and a notable share of approvals never close.

Mostly 7(a), few named holders

Programs split the loans into 129 on 7(a) and 8 on 504, with quartile edges at $100,000 and $574,300. Manufacturers and Traders Trust Company shows 25 loans worth $2.5 million; 9 loans at $7.4 million with Wells Fargo Bank National Association, next to Readycap Lending, LLC at 9 loans for $5.9 million; The Huntington National Bank and TD Bank, National Association show 8 each ($4.1 million and $2.8 million). Manufacturers and Traders Trust Company holds the most loans of the group at the smallest average size. These are holder records, not a statement of any lender's approach.

Four jurisdictions, uneven years

Fairfax County, VA has 40 loans, Montgomery, MD 30, Prince George's, MD 25 and the District of Columbia 12, with Loudoun, Frederick and Prince William small. Yearly approvals vary: 27 loans and $8.4 million in FY2025 against 7 loans in FY2019, and FY2026 closes at 12 loans for $2.6 million. Because the area crosses four jurisdictions, a study has to say which one the practice sits in, and the Fairfax County figure of 40 loans is the largest local reference point.

Withheld values and the study

Three values are withheld here on the small-count rule: franchise share, cancellation ceiling, and charge-off rate. None of them is a zero. Area membership turns on project county names matching the 2023 map. A physician-office study should test the specialty and referral base, payer mix, buildout and equipment costs against a small ticket, whether the borrower buys or leases the space, debt service coverage and a valuation that treats the practice and the premises separately. Given the cancellation floor, it should also confirm that every precondition to closing is understood before approval is relied upon. A request at the $100,000 lower quartile edge and one at the $574,300 upper edge call for different coverage tests, and the study should say which applies.