Roherty: From the construction side, there are very unique and challenging soil conditions out in that part of the state. The water table is very high, and it requires a very specialized foundation system to support the building so that it doesn't settle. It's in a fairly high earthquake zone, too. Those two things create challenge in building the foundation.

GlobeSt.com: What are the challenges developers and builders face in medical-office projects today?

Roherty: From what I see, the biggest challenge is changes or potential changes in the healthcare law because it doctors' uncertainty about what how much they're getting reimbursed trickles down to the developers. Uncertainty in the insurance world causes doctors to pause and ask, “Can we occupy this space?” They're not certain how much money they're going to be bringing in over the next few years. That lack of certainty in the healthcare industry is the biggest challenge to development.

GlobeSt.com: With more people insured now than in the past due to the ACA, what impact is this having on medical-office project development?

Roherty: I don't think it's slowing it down. There's an increased level of competition between health groups to get new patients and to retain patients. I think most of the health groups are looking at patients as more along the lines of clients, and they need to retain them. In the last six years, we've seen a dramatic improvement tin the level of design and the focus by the doctors and health organizations on patient comfort and making their buildings inviting. Going to a medical-office building or hospital 10 to 15 years ago, it was very institutional and cold, whereas now most places we're building are a little bit more spa-like; developers are trying to make it comfortable.

GlobeSt.com: What else should our readers know about the El Centro project?

Roherty: We're going to do a fair amount of outreach to the local El Centro community to try to hire local subcontractors and workers. That is a fairly depressed area, so any construction project is welcome for that economy. That area is heavily Hispanic and agricultural—it's always been a low-income-level area—and most of the economy is driven by agriculture. Hopefully, this project and others out there can help the local economy a little bit. And one of the tenants is a community health organization, which does receive government grants and focuses on providing healthcare services for low-income folks, so it's a welcome addition. Since they're already in the area, this will be expansion for them.

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SAN DIEGO—Lack of certainty due to Obamacare and its possible repeal is causing doctors to pause before buying buildings or planning expansions, which is the biggest challenge to developers as well, Pacific Building Group's president Jim Roherty tells GlobeSt.com. As we previously reported, the firm has been awarded a 63,000-square-foot medical-building project in El Centro, CA,. by developer Pacific Medical Buildings.

The project will begin construction early this summer and serve tenants Clinicas and Imperial Valley Family Care Medical Group. In addition to the two-story building, the facility will include an 8,000-square-foot ambulatory surgery center and 405 parking spaces. The exterior will showcase tilt-up concrete panels and glass materials as well as sunshades and a large, welcoming walkway. PBG will coordinate all pre-construction, scheduling, cost control and communication efforts, working with Pacific 33 Architects Inc., Nadel Architecture and Javier Diaz Architects to complete the project.

We spoke with Roherty about this project and the challenges to developing medical-office projects today.