Formerly Orthopaedic Associates USA Due to a depressed real estate market in the region, the doctors were in the unenviable position of having debt on their medical condo of more than 1.5x the appraised value.  A creative debt stack arranged by CMAC allowed them to refinance, lower their rate by 1.5%, reduce their monthly payment, and cover all closing costs with no money out of pocket. They were in an excellent position to wait out the downturn in values until the market rebounded, which it later did with gusto!