PHOENIX—The New Trends in Marketing and Leasing panel met Wednesday at the Phoenician Resort as part of RealShare's Healthcare Real Estate forum. Kate Morris, senior vice president of Transwestern, moderated the group.

Changes in lease deals for medical office buildings was a hot topic, with many on the panel seeing great changes in the past 12 months.

Amanda Houghton, executive vice president of asset management with Healthcare Trust of America Inc., said 60% of leases were larger. “We're seeing 4,000- to 10,000-square-foot leases. We're seeing facilities with pharmacy, training and lab space,” she said. “Still, the average suite size is 2,500 square feet.”

“We're seeing shorter term leases by smaller physician groups as they prepare to join hospitals or larger groups,” said Michael Noto, senior vice president of the Management Services Group at Health Care REIT “Larger physician groups that are more comfortable are going with larger leases.” He cited an average suite size as 3,000 square feet.

In terms of physicians alignment, Houghton said she's seen a lot of physicians who want to maintain autonomy and decision making power, and this has shifted the spectrum of alignment.

“But in California, physicians cannot be employed by hospitals so the market is highly fragmented. It's hard for them to forecast. They don't know where they'll be next year, let alone in three years and this is affecting leases,” said John Wadsworth, VP, Irvine, and national director of Colliers International's Healthcare Services Group. He cited that in 2000 57% of physicians were independent; in 2012, that decreased to 36%.

Noto commented that doctors coming out of medical school today are vastly different from those of 20 years ago. “They don't want 80-hour work weeks, they want to spend time with their families, they want leisure time,” said Noto. “And all this is contributing to how they are structuring their practices and that is affecting their leases.”