Do you want to be an active investor, building those systems and teams while traveling to do so or would you prefer something more passive?

The idea of escaping the "rat race" is something I have aspired to since I was in my mid twenties.

I would like to do something similar and was wondering on those two questions. 

There are likely larger users out than than what I deal with, but at that SF at least in my world you are likely looking at multiple tenants, not sure if thats what you planned or not.additionally something else to consider is the cost of buildout on a med office space. depending if they are going to have x ray or not its not uncommon to see $500-$800K buildouts in my experience. 

I've had rentals for awhile now, but this is the first time something like this has come up. 

What we found was only one other person contracted under $200 per square foot for clients and they also built within the city of columbus. the numbers have a much higher premium the closer you get to downtown. if you can't get the numbers to work my recommendation would be to get closer to downtown. we do build to rent development and single family home development and every line item is broken out. on the triples we have to build exterior staircases etc there are some things you can't really understand unless you build a lot. hope that helps but no one is going to build you for 110 a square foot. the lowest cost homes in our market at cost without a profit barely dip into 140 a square and we are in one of the cheapest construction markets and states in the country. 

Something like $1,200 for the local “fancy upgrade”.

And what is your price point and are you looking for turn-key properties or something along the lines of a "fixer upper"?

I use something I built out for myself in Clickup. 

You might consider hard money for the initial purchase or going with a DSCR type lender if you find something that is more turnkey.Hey!