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Setting Up Your Private Practice

A Guide For Medical Practitioners

Introduction

Opening a private medical practice is undoubtedly one of the most challenging tasks you could undertake as a practitioner. Despite the years spent studying and training, most doctors find that business skills are absent from that training.

Fortunately, it’s not as overwhelming as it looks. We’ve put together this guide to help medical professionals who are ready to take the next step to private practice commencement - and want to know what practical steps they need to take to start out smart.

Benefits of having your own practice

Here's some of the reasons why you might choose to go down the private practice route:

  • Private practice means you control your time, the number of patients you see, and every aspect of how your practice operates. You also avoid the internal ‘office politics’ that can create stress or inefficiencies in larger hospitals and medical practices.
  • To develop long term relationships with your patients, with better continuity of care.
  • Better control of the patient experience including billing and other financial decisions for your practice.
  • Enjoyment of greater flexibility in your work hours and a work-life balance that suits you.
  • To invest in your own business, rather than someone else's (as an employee).
  • The ability to build your own team of support and administrative staff.
  • To treat patients with various conditions related to your speciality in a geographic location that will grow and mature over time.
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Know your business requirements

All new Australian businesses are subject to some general legal and regulatory requirements before they are ready to operate. Generally, a new business must:

  • Apply for an ABN;
  • Register your business or company name, based on your accountant’s input. Don’t forget to check the ASIC business registry first to make sure it’s not taken, or you could face unnecessary legal issues later on;
  • You may want to consider the use of a trust assuming you have the ability to distribute income and take advantage of the added asset protection layer that comes with a trust;
  • Potentially register a trademark for your name or logo as this is the only true protection of your brand;
  • Register an online domain for your website, even if you don’t have one yet. Your domain name should match your business name - avoid using acronyms though;
  • Set up a payroll system and incorporate mandatory superannuation payments into staff compensation packages - online cloud solutions are the way to go here, drop us a line for recommendations;
  • Comply with any relevant tax conditions, such as registering for GST; and,
  • Obtain insurance for your business.
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Once you know the locations you will operate from, you should reach out to Medicare to get your provider numbers and prescriber number. 

For multi-clinic businesses, each location must have its own provider number which you can link to your software provider’s location ID for claiming. You will then also need to arrange:

  • A Medicare provider number; and
  • Any other registrations or licenses that may apply in your State or Territory.

It’s recommended that when starting any business, you engage the skills of a business lawyer who understands the standards and legal processes that apply to you.

The Australian Business Licence and Information Service (ABLIS) helps you find the government licences, permits, approvals, registrations, codes of practice, standards and guidelines you need to know about to meet your compliance responsibilities.

As the legal requirements and tax structures applicable to the healthcare industry can be complex, we recommended that you seek the advice of a business lawyer and accountant with medical experience who understands the standards and legal processes that apply to your situation.

Finding the right location

Choosing the right location for your practice isn't just about convenience. In fact, it's one of the most influential factors in determining the long term success of your business.

Firstly, think about the patient demographic you're looking to reach. Where do they live? What areas are they most likely to frequent? For instance, if your practice focuses on young adult health, look for areas nearby a school, recreation centre or University.

Alternatively, you might seek a more centralised location in the CBD to cater for office workers, so they fit appointments in around their workday with minimal disruption.

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Other questions to ask when considering a location for your practice include:

  • Is there parking available for patients with mobility issues?
  • Is the property easy to reach via public transport?
  • If the property was previously leased by a small business, why did they leave?
  • If they were not successful in that location, will you suffer the same issues?
  • Is there potential for new infrastructure to be built around the property which will increase the area’s population or traffic?
  • Are there any nearby competitors?
  • Are there any nearby health services that would complement your practice, such as pathology, imaging services or allied health?
  • Are there a large number of potential referrers that could refer to you if you are a specialist?

Designing your practice

There’s a lot to think about when designing a practice, so make sure you’ve got the basics covered first, such as:

  • Council zoning or building regulations that apply to the construction of your practice;
  • Temperature control (bearing in mind that larger spaces or offices with high ceilings will be more costly to cool or heat);
  • Electricity, water, telephone line and any other utility connections that may be required for your specific practice;
  • Accessibility for those with mobility concerns (including ramps and railing on steps);
  • Any other rooms that may be required to support your practice - such as an area for minor surgical procedures, blood tests or X-rays;
  • Using sufficient lighting near workstations;
  • And, ensuring there’s enough room for storage of equipment, manuals and paper files.
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Designing your practice doesn’t need to be a complicated process, involving a team of architects, interior designers for a nice finished product is essential. Get the right team on board to consider all of the above and you can focus on the niceties and functionality of the space. Remember, you’ll spend a large portion of your week in there.
Make the practice a inclusive space for you, your staff and above all, your patients - putting them at ease when they might feel stressed, anxious or unwell.

Don’t under service your patients - with web and social media being a prominent source of information, your patients know better and won’t settle for less. Yes, there are regulatory requirements you need to meet but don’t let that hold you back from making it a nice environment.

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Decor

Use decor which is practical, comfortable and uncluttered. Avoid colours, fabrics or styles which are fashionable right now, as they date faster than more simple, classic designs.

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Paint the walls

Paint the walls in subdued pastel colours such as pale blue, green or pink. Avoid using stark white on the walls as it tends to make spaces feel overly clinical and cold; if you want to use a more neutral colour choose a cream or beige tone that has a little warmth.

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Wifi access

Some modern practices have also provided wifi access to keep patients entertained during long waiting times.

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Patient amenities
Patient amenities such as water, up-to-date magazines and toys for children will also help patients to feel more at ease.
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Signage

Ensure there’s clearly visible signage to indicate reception, waiting rooms, toilets and exit doors. Don't forget street signage and signals for parking areas and wheelchair accessible entry points.

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Patient privacy

For patient privacy, consulting rooms should be located as far away as possible from reception and waiting room areas. In small spaces or where walls are particularly thin, consider soundproofing.

Using technology and the cloud

There was a time when medical practitioners were weighing up the benefits of computerising the practice.

Fifteen years later the question became “Should I manage my practice from the cloud?” and not long after this, the question is changing to “What else can I expect from the cloud?”

This is the beginning of a transformation in healthcare that will empower you and your team to do more, better engage your patient, optimise your operations and transform your practice. Not to mention the significant cost savings for a new practice.

Technology and the cloud have made it that much easier to stay connected with patients. Here are the essentials you’ll need in order to get up and running:

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Hardware

  • Desktop computers - brands matter less today
  • Mobile tablets
  • Server for data storage (not required with cloud-based software)
  • Printers
  • Scanners
  • Backup power source
  • Microphone and webcam for online consultations and video calls
  • Internet - the faster the better; find a good provider with a support plan
  • Payment terminal such as EFTPOS

Software

  • Practice management software (cloud-based and mobile technology recommended)
  • Accounting software such as Xero
  • Device and operating system agnostic technology (eg. Microsoft Windows, Apple OSX)
  • Cloud-based data storage
  • Eclipse for Medicare payments
  • Dictation software
  • MIMS connectivity

An integrated practice management system such as Clinic to Cloud merges many of these software tools into one centralised program. By hosting the platform on the cloud you won’t need servers for data storage and registered users are able to access information about their patients and practice from any location and mobile device.

Always watch your costs - less Capex and more Opex are ideal for medical practices and it helps to seek your accounting advice on this matter. Our suggestions include:
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  • Use subscription-based software
  • Keep your base costs under control
  • Maintenance of hardware and software
  • On and off-site IT support
  • Firewall protection
  • Backups
Capex

Capital Expenditure, when you pay a large upfront cost for an item and your accountant then depreciates the asset over a period of time. Capex purchases often require loans.

Opex

Operational Expenditure, when the upfront investment is low and you pay for consumption of a product or a service on a frequent basis (e.g. monthly). The amount is immediately deductible and does not require to be depreciated, therefore your cashflow is impacted less.

The 3 advisors you need

There are three professionals you need on your advisory team from day one.

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  1. Get in touch with your accountant. They will be able to advise you on how to structure your business in order to access any tax concessions and deductions that apply to your practice, and help to minimise any payments you may be liable for. You may also wish to hire a bookkeeper or invest in a cloud accounting system such as Xero - both of which can manage your finances throughout the year (and save on the billable hours you spend on your accountant come tax-time).
  2. A legal advisor is imperative for any new business. For anyone who is not a legal expert, it can be easy to make simple and avoidable mistakes - so save yourself the stress by doing it right from day one.
  3. Your mentor (or mentors) are key to your advisory team. These are the role models who you trust and respect, and who have been through it all before. A mentor is invaluable for offering advice and guidance (especially on subjects your lawyer and accountant don't handle) An ideal mentor is someone who is not a clinician, but yet understand business and the healthcare space.

Hire staff

Hiring the right people is a major challenge for any business - and it’s one that remains an issue no matter how much experience you have in your industry.

When putting together the ideal team of professionals to support your practice, think about the following:

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Experience and attitude, not just qualifications
Just because a candidate has the right skills on a page doesn’t mean they can translate that into practice. Likewise, many talented people have built their skills through practical experience and not formal education. As an business owner, it can pay off to be open to potential employees regardless of their level of education.
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Investing in the perfect practice manager

A practice manager is arguably your greatest resource. Unlike other administrative staff, a practice manager oversees the operation of your practice from a business perspective - including finances, maintaining industry alliances, planning and other activities associated with your clinic that are not related to medicine.

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Trust your instinct

It might sound simplistic, but if you don’t feel good when talking to a potential employee, chances are your patients won’t feel comfortable either. Seek out staff who can contribute to your practice by creating a relaxed and inviting environment; a positive workplace culture can have an immense impact on patient satisfaction.

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Personality profiling
Another innovative approach to finding the right staff is to use personality testing as part of the hiring process. DISC profiling is a human resource screening test which helps employees identify people who possess the characteristics which would most suit their business. Unlike other forms of personality testing, the DISC profile refers only to the way people behave and interact with others in the workplace - irrespective of their personal lives.
It’s rare for a business to get staff mix perfect from day one, so don’t be disheartened if initial attempts to attract or retain the ideal employees don’t work out. Over time you will learn which skills you value most in your staff, the kinds of roles you need them to fulfill and the personalities you work best with.

Building trust in the medical community

It can be difficult for medical professionals to branch out into private practice if they don’t have a long history of experience behind them.

But even when a practitioner already has a positive reputation, they might feel like they’re starting from scratch when they move to a new location or community where nobody knows them. So how can they build trust within the medical community - and the public? 

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Professional affiliations and industry groups

One way is to be active in the local medical community by attending workshops, seminars and conferences. Networking with colleagues and making new connections will not only raise your own profile as a practitioner, it will lead you to new opportunities within your industry and profession.

If you’re time-poor, there’s still ways to get involved with your community online. Try engaging with other professionals by joining LinkedIn Groups, or participating in other online forums relating to your field of expertise.

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Build a network

Whether you are a specialist or a GP, your network of care is your asset. Building a network of referrers from within your discipline or other disciplines, including the allied health space is an important part of your business. Loop your team in on your plans to build your network and have a process in place for maintaining those relationships. Hosting educational nights with inexpensive catering are always a good way to keep your followers engaged and interested. 

Begin by contacting affiliate health providers in your area - including pharmacists, complementary medicine practitioners and allied health professionals - and setting aside a time to meet with them face to face. The people you choose to work with will ultimately reflect back on your own practice - so it’s important to find people who you trust yourself, before asking your patients to do the same.

Marketing your practice

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The service economy has undergone significant change over the past decade, due to advancements in technology and movements in consumer preferences.

 Savvy healthcare providers have adapted to this by introducing new ways of interacting with their patients - even before they step into the clinic.

As more and more people go online to book services (anything from restaurants to GP appointments), medical practices are seeing the value in having a digital marketing strategy. Without having an online presence, practices face the risk of not being found by the people who need their services.

Like any startup, the best way for a new medical practice to raise awareness about their brand and stay competitive is by employing a well thought-out marketing strategy. Fortunately, this doesn’t need to be expensive; there are many free and low cost tools available which can help to promote your business.

Basic marketing toolkit for startup practices:

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Website

You can provide information about your practice, your own skills and experience, and even provide a bookings portal via your website. DIY (Do-It-Yourself) website builders such as Wix and Squarespace offer simple, cost effective website templates that can be set up without the help of an expert designer. 

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Social media

Platforms such as Facebook, Twitter, Instagram and Yelp are wonderful avenues for establishing a reputation for yourself and your practice. They also give you an opportunity to create a ‘voice’ for your brand, and share useful healthcare information with your target audience (the patients most likely to visit your practice).

It’s also possible to place advertisements about your practice on social media feeds. Not only are they inexpensive to run, you can have the opportunity to target them to specific locations and demographic groups.
There are special regulations that apply to medical marketing. For complete guidelines, visit the APHRA website.