For Frank Spencer, president and chief executive officer of Cogdell Spencer Inc. (NYSE: CSA), trends are very encouraging for his company's sector. And the passage of health care reform legislation should only be more good news for the medical office owner.

"If you think about the trends of the last 20 years, technology, cost, patient convenience, they are all pointing to an outpatient delivery system," Spencer says. "With health care reform, you are going to have more people insured, which will drive more people to primary care and be incrementally positive."

Cogdell Spencer got its start as a small, regional player. However, the company has now grown to a leader in the medical office segment. Spencer says the key to making that happen was becoming a public company.

"The access to capital fundamentally changes your strategic alternatives," Spencer says. "When you are a private company you are limited because you have to decide with each deal how to finance it. When you get the public access to capital, you have the ability to look broader."

Spencer says that enabled the company two years ago to acquire Marshall Erdman and significantly ramp up its standing in the market and gain a presence coast-to-coast. Absent the public capital, Spencer says, that deal never would have been possible.

Recently, Spencer announced plans that he would be stepping down as president and CEO at the end of October. The firm has begun a search for his successor.

"I'm excited about bringing in new talent to join an already terrific team," Spencer says. "One of the reasons I was comfortable stepping down is that we have a team of experts who I believe are the best in the industry."

Spencer says the key to ensuring a smooth transition will be the presence of the experienced team and his ongoing presence on the company's board.