By Nancy Ferren
Introduction
At first glance, the finished building appears to have been designed as a modern outpatient medical facility. It wasn’t.
The building originally served as the Civic Center for the City of Gardendale before later becoming a church. When Andrews Sports Medicine began searching for a satellite location, the physicians weren’t looking for an adaptive reuse project. They needed a facility that reflected the quality of their practice, supported an exceptional patient experience, and made long-term financial sense.
None of the available retail or traditional medical office options accomplished all three. Looking beyond conventional real estate ultimately transformed an overlooked community building into a purpose-built outpatient medical building.
Project at a Glance
Location: Gardendale, Alabama
Original Use: Civic Center Church
Current Use: Two-Tenant Outpatient
Medical Facility
Building Size: 9,536 SF
Total Development Cost:
Approximately $3.6 Million
Owner Occupant: Andrews Sports
Medicine & Orthopaedic Center
Additional Tenant: Pediatric Dental
and Orthodontic Practice
Looking Beyond Retail
Traditional medical office in the market was scarce, leaving retail space as the most viable alternative. But while several retail properties could physically accommodate the practice, none aligned with the practices branding standards or long-term vision.
The physicians wanted more than adequate square footage. They wanted architectural character, convenient access and parking, a strong patient experience, and a facility that conveyed the quality of the practice. Compounding the problem, the available retail alternatives offered no tenant improvement packages, increasing the practice’s cost to occupy space it still considered less than ideal.
Rather than accepting the best available retail option, the project team expanded the search to evaluate any building capable of becoming an exceptional healthcare facility. That broader perspective changed everything.
An Unexpected Opportunity
One property stood apart. Although operating as a church, the building was originally constructed as Gardendale’s Civic Center. Its simple rectangular footprint offered tremendous flexibility for redevelopment. The site also provided advantages difficult to replicate elsewhere: prominent frontage along a major commercial corridor, visibility adjacent to Chick-fil-A and established commercial activity, ample private on-grade parking, convenient patient access, and a building configuration well suited for adaptive reuse.
The property wasn’t compelling because of what it was. It was compelling because of what it could become.
Making Ownership Compete with Leasing
Finding a building that worked operationally was only half the challenge. Any ownership strategy also had to demonstrate that acquiring and redeveloping the property could produce an occupancy cost equal to—or lower than—leasing comparable space.
The analysis considered acquisition, renovation and medical buildout, financing costs, equity investment, long-term occupancy expense, potential rental income, and future property appreciation. Each scenario was measured against prevailing market lease economics and the other properties considered during the search.
The project would move forward only if ownership provided a better facility without requiring the physicians to pay a premium to occupy it.
Building the Capital Stack
Once the property was selected, attention shifted to structuring the development. The project required balancing acquisition costs, construction financing, physician equity, and long-term investment performance.
Rather than evaluating each component independently, the project was modeled as an integrated ownership strategy that aligned physician occupancy, investors’ ownership, long-term appreciation, rental income from a second tenant, overall project returns.
The result was a financing strategy that allowed the physicians to own a purpose-built medical building while maintaining occupancy costs that were competitive —and ultimately better with leasing.
Designing a Better Investment
The 9,536-square-foot redevelopment was intentionally designed as a two-tenant medical building. One of the most consequential decisions involved the placement of the orthopedic practice itself. Instead of occupying the building’s most visible frontage, physician owners chose the side portion for their 5,253-square-foot clinic. This preserved the highly visible front portion for another healthcare tenant. Giving up the premier storefront strengthened the overall investment. The remaining space became more marketable to prospective tenants, improving its leasing potential and reducing long-term vacancy risk.
A pediatric dental and orthodontic practice ultimately leased the remaining 4,283 square feet. Both occupants entered long-term Triple Net leases. The two uses also created a complementary healthcare mix, with both practices serving many children and adolescents, including patients with sports-related injuries.
Adaptive Re-use in Action
Converting a former Civic Center and church into a contemporary medical building required coordination among physicians, architects, engineers, contractors, lenders, investors, tenants, and the real estate project team. Planning extended well beyond the physical building. Property and location evaluation, patient demographic analysis, clinical space planning, architecture and engineering, construction management, budget oversight, lease structuring, financing, and equity fundraising all had to work together.
The building’s rectangular footprint proved exceptionally adaptable, allowing efficient clinical layouts while preserving the advantages of the existing structure.
The Outcome
The redevelopment achieved the primary objectives established at the beginning of the search: a facility that met the practice’s branding and operational standards while outperforming the available leasing alternatives financially.
A comprehensive occupancy cost analysis demonstrated that ownership produced a lower cost of occupancy than the competing properties evaluated during site selection and compared favorably with prevailing market lease rates. The second healthcare tenant further strengthened the economics by generating diversified rental income and reducing investment risk. The completed development produced healthy cash-on-cash returns while allowing the physician owners to build long-term real estate equity.
The result demonstrates the value of looking beyond conventional healthcare real estate. When the existing medical and retail markets failed to provide the right solution, a broader search uncovered an unlikely property. Financial analysis established what the project could support, the capital stack made redevelopment possible, and thoughtful space allocation reduced leasing risk.
Sometimes the best medical office isn’t a medical office at all.
Project Team
The redevelopment was a collaborative effort among the physician owners and a multidisciplinary project team.
Physician Owner: Andrews Sports Medicine & Orthopaedic Center
Architecture: Brian Roberson, bDot Architecture
Construction: Rives Construction
Real Estate Strategy & Project Management: Veritas Medical Real Estate Advisors
This project illustrates that successful healthcare real estate begins by asking a different question. Instead of searching for available medical office space, the team searched for the best opportunity, transforming a former civic building and church into a modern healthcare asset aligning patient experience, practice operations, financial performance, and long-term physician ownership.