The Buy Box: How Operator Data Turns Site Selection Into a Repeatable System
June 18, 2026
In real estate, everyone talks about location. Fewer people talk about how to actually identify the right one before it becomes obvious. The difference between those two conversations is a buy box.
A buy box is a documented set of criteria that defines exactly what a good investment looks like before you’re standing in front of one. It removes emotion from the decision. It forces clarity before the pressure of a live deal sets in. And when it’s built on operational data rather than financial assumptions alone, it becomes something most investors don’t have: a repeatable system for de-risking site selection.
Ours took years to build. Here’s what’s in it.
The Criteria That Actually Predict Performance
Every location decision we make runs through the same filter. The criteria aren’t complicated, but they’re specific and they’re grounded in what we’ve learned from operating dental practices across North Carolina, not from what a market report told us to look for.
Population-to-provider ratio. We want markets where demand is outpacing supply. Not markets where there are already enough providers – markets where there aren’t enough yet, but the growth trajectory says there will be. Getting there first is the entire game.
Household formation rate. Current population matters less than momentum. We track where new households are moving, not just where people already live. If 4,000 new households are arriving in an area per year, that market needs infrastructure, including healthcare. We want to be there when those families start looking for a dentist, not after three competitors have already opened.
Road visibility and traffic patterns. A healthcare business that patients see on their commute every day has a structural marketing advantage that doesn’t appear on any pro forma. We prioritize road frontage and high daily traffic counts. And we pay close attention to where natural patient boundaries form: major highways, railroad tracks, geographic divides that shape how people actually move through their daily lives. A location on the wrong side of Capital Boulevard in Raleigh might as well be in a different city.
One location per zip code. When a patient searches their insurance network, results populate by zip code. We want one result to appear: one clear choice, no confusion, no split patient base. This discipline has direct implications for how we think about market density as we expand into new geographies, and it’s a decision most investors would never think to ask about.
Retail adjacency. Patients visiting medical providers consistently make secondary stops at pharmacies and grocery stores. We actively seek locations where the co-tenancy mix supports patient convenience rather than working against it. Healthcare tenants and grocery anchors are a stronger combination than most retail investors give credit for.
Lease structure durability. New leases in the medical outpatient sector have averaged terms of over eight years, with escalations built in annually. We structure our leases to reflect the long-term value of the tenancy. That structure creates predictable, growing income that holds through rate cycles in ways short-term retail leases don’t.
The Market That Validates the Model
We built this system in Raleigh-Durham before the broader investment community recognized what was happening here. The data now confirms what our ground-level analysis told us years earlier.
The Raleigh-Durham retail market is posting rent growth of 7.2% annually – nearly four times the national average – with vacancy compressed to 2.3%. Raleigh-Durham ranked second in the nation for medical outpatient building net absorption as a percentage of inventory in 2024, alongside Charlotte. Two North Carolina markets leading the country.
Those numbers reflect a market that was already in motion when we were positioning our early locations.
We weren’t responding to the data. We were generating it.
MOB occupancy reached a cyclical high of 92.7% across the top 100 metro areas in 2025, with absorption outpacing completions by nearly 5 million square feet over the past three years. That supply-demand imbalance means the operators who secured well-located assets early are now sitting on increasingly scarce real estate with durable tenants in place. That scarcity is exactly what the buy box was designed to find before it became obvious.
Real Estate as the Spine
There’s a structural decision that most operator-investors never make because nobody explains it to them early enough: separating business equity from real estate equity.
When we own the building where a practice operates, we control the lease terms, the tenant mix, and the long-term asset positioning. When private equity comes to acquire the operating business, the real estate stays because it was never part of the deal. The dental company can be bought, sold, recapitalized, or restructured. The buildings just keep compounding.
That separation is one of the most consequential decisions an operator-investor can make. And most operators don’t make it, because they’re focused on growing the business rather than thinking about what happens to their equity when someone eventually wants to buy it.
The full picture of what we’ve built isn’t a dental company that also owns buildings. It’s a vertically integrated platform where the operating business and the real estate are designed to reinforce each other structurally from site selection through lease execution through exit.
The buy box is what filters the signal from the noise. The operators who built that filter from years of running and underwriting the business are the ones who consistently find the assets everyone else wishes they had bought earlier.
The buildings are the spine. The data is what holds it together.
About Dr. Hesham A. Baky
Dr. Hesham A. Baky is the Founder and Chairman of AB&B Commercial Real Estate and Vantico Investments, and a co-founder of Triangle Family Dentistry and Carolina Orthodontics & Children’s Dentistry. Since launching his first practice in 2009, he has helped scale a vertically integrated platform spanning healthcare operations, commercial real estate, and private investment. Dr. Baky regularly speaks on leadership, systems-driven growth, and operator-led investment strategy.
To inquire about speaking engagements or to connect, please contact marketing@abbcre.com.
In real estate, everyone talks about location. Fewer people talk about how to actually identify the right one before it becomes obvious. The difference between those two conversations is a buy box.
A buy box is a documented set of criteria that defines exactly what a good investment looks like before you’re standing in front of one. It removes emotion from the decision. It forces clarity before the pressure of a live deal sets in. And when it’s built on operational data rather than financial assumptions alone, it becomes something most investors don’t have: a repeatable system for de-risking site selection.
Ours took years to build. Here’s what’s in it.
The Criteria That Actually Predict Performance
Every location decision we make runs through the same filter. The criteria aren’t complicated, but they’re specific and they’re grounded in what we’ve learned from operating dental practices across North Carolina, not from what a market report told us to look for.
Population-to-provider ratio. We want markets where demand is outpacing supply. Not markets where there are already enough providers – markets where there aren’t enough yet, but the growth trajectory says there will be. Getting there first is the entire game.
Household formation rate. Current population matters less than momentum. We track where new households are moving, not just where people already live. If 4,000 new households are arriving in an area per year, that market needs infrastructure, including healthcare. We want to be there when those families start looking for a dentist, not after three competitors have already opened.
Road visibility and traffic patterns. A healthcare business that patients see on their commute every day has a structural marketing advantage that doesn’t appear on any pro forma. We prioritize road frontage and high daily traffic counts. And we pay close attention to where natural patient boundaries form: major highways, railroad tracks, geographic divides that shape how people actually move through their daily lives. A location on the wrong side of Capital Boulevard in Raleigh might as well be in a different city.
One location per zip code. When a patient searches their insurance network, results populate by zip code. We want one result to appear: one clear choice, no confusion, no split patient base. This discipline has direct implications for how we think about market density as we expand into new geographies, and it’s a decision most investors would never think to ask about.
Retail adjacency. Patients visiting medical providers consistently make secondary stops at pharmacies and grocery stores. We actively seek locations where the co-tenancy mix supports patient convenience rather than working against it. Healthcare tenants and grocery anchors are a stronger combination than most retail investors give credit for.
Lease structure durability. New leases in the medical outpatient sector have averaged terms of over eight years, with escalations built in annually. We structure our leases to reflect the long-term value of the tenancy. That structure creates predictable, growing income that holds through rate cycles in ways short-term retail leases don’t.
The Market That Validates the Model
We built this system in Raleigh-Durham before the broader investment community recognized what was happening here. The data now confirms what our ground-level analysis told us years earlier.
The Raleigh-Durham retail market is posting rent growth of 7.2% annually – nearly four times the national average – with vacancy compressed to 2.3%. Raleigh-Durham ranked second in the nation for medical outpatient building net absorption as a percentage of inventory in 2024, alongside Charlotte. Two North Carolina markets leading the country.
Those numbers reflect a market that was already in motion when we were positioning our early locations.
We weren’t responding to the data. We were generating it.
MOB occupancy reached a cyclical high of 92.7% across the top 100 metro areas in 2025, with absorption outpacing completions by nearly 5 million square feet over the past three years. That supply-demand imbalance means the operators who secured well-located assets early are now sitting on increasingly scarce real estate with durable tenants in place. That scarcity is exactly what the buy box was designed to find before it became obvious.
Real Estate as the Spine
There’s a structural decision that most operator-investors never make because nobody explains it to them early enough: separating business equity from real estate equity.
When we own the building where a practice operates, we control the lease terms, the tenant mix, and the long-term asset positioning. When private equity comes to acquire the operating business, the real estate stays because it was never part of the deal. The dental company can be bought, sold, recapitalized, or restructured. The buildings just keep compounding.
That separation is one of the most consequential decisions an operator-investor can make. And most operators don’t make it, because they’re focused on growing the business rather than thinking about what happens to their equity when someone eventually wants to buy it.
The full picture of what we’ve built isn’t a dental company that also owns buildings. It’s a vertically integrated platform where the operating business and the real estate are designed to reinforce each other structurally from site selection through lease execution through exit.
The buy box is what filters the signal from the noise. The operators who built that filter from years of running and underwriting the business are the ones who consistently find the assets everyone else wishes they had bought earlier.
The buildings are the spine. The data is what holds it together.
About Dr. Hesham A. Baky
Dr. Hesham A. Baky is the Founder and Chairman of AB&B Commercial Real Estate and Vantico Investments, and a co-founder of Triangle Family Dentistry and Carolina Orthodontics & Children’s Dentistry. Since launching his first practice in 2009, he has helped scale a vertically integrated platform spanning healthcare operations, commercial real estate, and private investment. Dr. Baky regularly speaks on leadership, systems-driven growth, and operator-led investment strategy.
To inquire about speaking engagements or to connect, please contact marketing@abbcre.com.
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