Saunter along a Vancouver high street and you may notice a growing trend: health office after health office. After health office.

A recent Reddit post has got Vancouverites talking about this exact phenomenon.

“This trend of dentist/physio/healthcare whatever offices occupying retail street-level storefronts is destroying our high streets and making them dull af [sic],” writes user mukmuk64. “Cities need to pull these healthcare office use from the retail zoning and get these businesses back into commercial office spaces where they belong. This will free up retail spaces for real retail businesses and make our commercial high streets more vibrant.”

The idea certainly has a veneer of truth to it. On Main Street, for example, there are three dentist offices between 2nd and 7th alone.

One reason for this is financial: dentists can afford the city’s increasingly expensive rents.

“It has been noticed by many people across Metro Vancouver, especially when new developments come online, that the developer’s preference is to sign a long-term lease with an established, deep-pocketed, either financial institution or professional service,” says Claudia Laroye, executive director of Marpole BIA, over a video call. “You have security of tenure from the business side, and the owner of the property knows the tenant will be there for a decade—but from the retail mix side, it can be a little bit of a gap.”

Out of the 22 local BIAs, comprising a total of 5,873 street-level storefronts, Marpole has the largest proportion of professional services at 31 per cent. These businesses, Laroye says, have a more “dead” interaction with pedestrians.

“There are no interesting objects in the window to look at that might entice people to go in,” she explains. “It does create these physical or esoteric gaps on the street, which can have an impact on the way that the street feels.”

Still, dentists may not actually be taking over. According to a 2023 City report, food services, at 22 per cent, take the crown as the single highest use of Vancouver’s storefronts. Professional services—which includes dentists, as well as other services like doctors, lawyers, and accountants—make up 16 per cent. A recent business license search counted 498 total dental licenses in the city, down from a peak of 551 in 2019.

Michael Mortensen, director of Liveable City Planning, says it’s not just professional services that can affect the vibe of our streets, either.

“Banks are horrible for shuttering their windows, and dentists, vape shops—it’s a very narrow bandwidth of customers who use them, and they occupy a lot of street frontage,” he says via video. “These types of uses don’t necessarily need to be at grade.”

The root of the problem is more than just which businesses set up where. High rents and property taxes, paired with the ongoing changes in consumer behaviour caused by online shopping and Covid-19, have impacted the stability of independent retail and restaurants.

West Vancouver, worried about similar retail cavities, has attempted to legislate a solution. The council is chewing over a policy that would limit certain businesses (including healthcare offices and pharmacies) to 20 per cent of storefronts in Dundarave and Ambleside.

“The intent of these amendments,” reads the council report, “is to support a range of more vibrant uses at street-level in Ambleside and Dundarave’s commercial centres.”

Laroye suggests convincing developers to rent out multiple small units instead of finding one or two larger tenants.

“The City of Vancouver, and other cities, have the ability to work that into their discussions with the developer and architect and the designer, to put forward a case why the developer should—and perhaps even incentivize them—to do the [small unit] model,” she says. That would lead to “smaller spaces for more independent businesses, creating more businesses on the street, more potential retail variety, and more interest to the public realm.”

Of course, larger systemic issues still need to be treated. That means—like so many other things in Vancouver—sorting out affordability.

For Mortensen, flourishing high streets need to put people first. Successful shopping streets need an anchor—typically a grocery store—that brings demand to the area; so densifying the number of people living near each neighbourhood shopping street, and giving consumers a business they will regularly go to, helps keep foot traffic high and businesses healthy. Secondary anchors, like community centres and schools, can also help get people shopping, and are key to lively neighbourhoods.

“Rather than regulating the heck of it,” he says. “It’s like, ‘How do we make sure there’s enough local population and local demand to let that market work?’”