Preparing for independent medical practice
We’ve put together this page of useful tips and recommendations to prepare you for independent practice. Please note these are not in any order of priority but are listed under the broad headings of “professional” and “business” to make it a little easier to navigate.
- Join the AMA. The State and Territory AMAs provide support to their members and the Federal AMA provides relevant and useful resources.
- Download a copy of the AMA’s Code of Ethics
- Register for doctorportal learning (www.learning.doctorportal.com.au) including the CPD tracker. Check the CPD requirements of the Medical Board of Australia which is part of your annual renewal of registration.
- Find yourself a GP who will be your healthcare adviser. You recommend that your patients have a GP; so you should too.
- Notify AHPRA of your change of practice details and update your qualifications if necessary.
- Inform colleagues of your move into independent practice – if setting up a specialist practice, notify the GP community from whom you will need referrals. Your State AMA may be able to assist you do this; also see if your local Primary Health Network will advertise for you too.
The Medical Board of Australia has produced Guidelines for advertising. These Guidelines for advertising regulated health services were jointly developed by the National Boards under section 39 of the National Law. The guidelines have been developed to help practitioners and others understand their obligations when advertising a regulated health service.
All obligations outlined in the MBA document are those required under the National Law unless stated otherwise.
- Inform the general and allied health community with which you work (if applicable) of your move into independent practice. Check with your State AMA for details of advertising in their publications; write to colleagues; and advise the public via local newspapers. Bear in mind the Advertising Guidelines produced by the Medical Board of Australia.
- Apply for your provider and prescriber numbers (if necessary)
Here’s a link to an Australian Medicine article of 2013 titled “Can I prescribe …?” which you might find of interest.
- Make sure you have the prescribed level of professional liability insurance (medical indemnity insurance). Check the Medical Board of Australia (MBA) for their liability insurance requirements.
The insurers are: Avant, MDA National, MIGA (Medical Insurance Group Australia) and MIPS (Medical Indemnity Protection Society)
- Download the AMA Guidelines on Service Contracts between Doctors and Medical Practice Principals(Member only resource). The information will provide the basis for conversations and negotiations between you and your colleagues. It covers issues such as:
- whether a person is an employee or an independent contractor;
- amount and basis of payment;
- access to non-fee for service income;
- share and mix of patient load;
- obligations and payment for on-call and after hours service;
- arrangements for holidays and other time off;
- any agreed conditions for becoming a partner in the practice.
- Charging for your services. All medical practitioners are, of course, and should at all times regard themselves as being free, and indeed duty bound, to make their own judgement as to what fees they will charge for any service. Medical practitioners should satisfy themselves in each individual case as to a fair and reasonable fee having regard to their own practice cost experience and the particular circumstances of the case and the patient.
The AMA encourages medical practitioners to determine their fees based on their own practice costs. The cost of running medical practices which varies across the country, includes employing practice staff and operating expenses such as computers, rent, electricity, general insurance and professional insurance.
AMA members receive the resource, “AMA List of Medical Services and Fees” issued annually in November or can access on line. www.ama.com.au/resources/fees-list
- Informed Financial Consent (IFC) works best when doctors, hospitals and health insurers work together to provide information to patients about the costs associated with treatment, and the private health insurance benefits payable, prior to admission to hospital.
In 2013-14, 93% of all privately insured in-hospital medical services had either no gap or a known gap for the patient to pay.
The AMA encourages good IFC practice and the provision of information about medical fees to patients. Patients should always ask their doctor about his/her fees, and the fees of other doctors involved in their care, before going to hospital as a private patient.
Find out the AMAs recommendations on “informed financial consent” www.ama.com.au/article/ama-informed-financial-consent
- Issuing Death Certificates and related matters. Check your State legislation for the legal requirements for certification of death, issuing of death certificates, cremation certificates and when referral to the Coroner is required. Members should contact their State AMA if further information is required.
- Check the requirements of work health and safety legislation (including workers’ compensation) in your jurisdiction.
Workplace Health and Safety Queensland, Office of Industrial Relations (WHSQ)
Visit the website of the Office of the Australian Information Commissioner for more information on your rights and responsibilities under the Privacy Act. www.oaic.gov.au/privacy-law/rights-and-responsibilities
- What does the Privacy Act mean for your medical practice?
The Privacy Act 1988 (Privacy Act) applies to all health service providers in the private sector throughout Australia. A ‘health service provider’ is a person or entity who provides a health service and holds health information, even if providing a health service is not their primary activity. Health service providers are covered by the Privacy Act for all activities involving the handling of personal information, not just activities that relate to providing a health service.
The Privacy Act does not apply to state and territory public sector health service providers, such as public hospitals.
New South Wales (NSW), Victoria and the Australian Capital Territory (ACT) have specific health privacy legislation that covers all health service providers (public and private sector) in those jurisdictions. This means that private sector health service providers operating in NSW, Victoria and the ACT must comply with both Commonwealth and state or territory privacy legislation when handling health information.
Queensland, the Northern Territory and Tasmania have privacy legislation that applies only to their public sector, including public sector health service providers. Western Australia and South Australia do not have specific privacy legislation although South Australia has administrative directions and codes that apply to the public sector, including public sector health service providers. South Australia also has health care legislation that contains some privacy related provisions.
For information on privacy regulation of health service providers in the states and territories, please refer to the appropriate links below. You may contact the OAIC Enquiries line if you have further questions about what aspects of privacy are dealt with by the OAIC. www.oaic.gov.au/privacy-law/other-privacy-jurisdictions
- Australian Capital Territory
The Health Records (Privacy and Access) Act 1997 (ACT) regulates the handling of health information by both public and private sector health service providers in the ACT. The ACT Health Services Commissioner is one of three Commissioners within the ACT Human Rights Commission and handles health record privacy complaints.
- New South Wales
The Health Records and Information Privacy Act 2002 (NSW) (HRIP Act) outlines how NSW health service providers and public sector agencies must manage the health information of individuals in NSW. The HRIP Act applies to organisations (public sector agencies or a private sector person) that are health service providers or that collect, hold or use health information. The NSW Information and Privacy Commission administers the HRIP Act and accepts complaints about the handling of health information.
The Health Records Act 2001 (Vic) provides for the protection of health information held by the Victorian public and private sectors. The Act is administered by the Office of the Health Services Commissioner, an independent statutory body which conciliates complaints between consumers and health care providers.
- Northern Territory
The Information Act 2003 (NT) applies to NT public sector bodies, including to their handling of health information. The Office of the Information Commissioner for the Northern Territory is the independent statutory body responsible for overseeing the privacy provisions of the Act and accepts complaints from consumers relating to the privacy of health information. The Health and Community Services Complaints Commission is also able to accept and resolve complaints about health, disability and aged services in the Northern Territory.
The Information Privacy Act 2009 (Qld) regulates the handling of personal information, including health information, by the Queensland public sector. Queensland Health’s website has a comprehensive list of privacy and confidentiality contact officers for public hospitals throughout the state. The Queensland Office of the Information Commissioner receives and conciliates complaints related to the privacy of health information. Queensland’s Health Ombudsman can also receive and investigate complaints about health services and health service providers, including registered and unregistered health practitioners.
The Personal Information and Protection Act 2004 (Tas) covers the Tasmanian public sector including public hospitals. The Office of the Ombudsman and Health Complaints Commissioner of Tasmania can receive and investigate complaints in relation to complaints under the Act.
- South Australia
The state public sector in South Australia does not currently have a legislative privacy regime. However, South Australian government agencies are required to comply with a set of Information Privacy Principles – PC012 Information Privacy Principles Instruction. The Privacy Committee of South Australia oversees the implementation of these Information Privacy Principles by the South Australian public sector.
In addition, the South Australian Department of Health and Department of Families and Communities have developed a Code of Fair Information Practice which outlines what the Departments and their service providers should do, and what clients can expect, in protecting personal information. The Code also has its own set of privacy principles which have specific requirements for the handling of health information.
The handling of personal information by public sector employees is also addressed in the Health Care Act 2008 (SA). A public health sector employee can be fined up to $10,000 if any personal information relating to a client is divulged inappropriately.
The Health and Community Services Complaints Commissioner also receives complaints about government, private and non-government health and community services.
- Western Australia
The state public sector in Western Australia does not currently have a legislative privacy regime. Various confidentiality provisions cover government agencies and some of the privacy principles are provided for in the Freedom of Information Act 1992 (WA) overseen by the Office of the Information Commissioner (WA). The Health and Disability Services Complaints Office (HaDSCO) is an independent statutory authority that also handles complaints relating to health and disability services in Western Australia.
Source: website of the Office of the Australian Information Commissioner (www.oaic.gov.au)
- Check the MBA Code of Good Practice for information on aspects of expected behaviours including the mandatory reporting requirements, and advertising your services. http://www.medicalboard.gov.au/Codes-Guidelines-Policies/Code-of-conduct.aspx
- Visit Medicare Australia (www.humanservices.gov.au/health-professionals/forms /hw019) to view and download a range of forms including:
- Application for initial Medicare provider number for a medical practitioners
- Application for recognition as GP Fellow of the Royal Australasian College of General Practitioners
- Application for recognition as GP Fellow of the Australian College of Rural and Remote Medicine
- Application for recognition as a specialist or consultant physician
- Approval to prescribe medication under the Pharmaceutical Benefits Scheme (PBS) by a registered medical practitioner
- Banking details on-line claiming form
- Medical certificate forms
- Consider employing a professional and qualified practice manager who can help with assessing the staff needed, employing those staff, calculating the liability you have in terms of the job description and salary paid, etc. Some State AMAs can assist with this, so check them out first.
AMA Skills Training (RTO No. 40880), provides the core business skills and knowledge required for high performing workplaces, competitive advantage and business success.
AMA Skills Training offers practice staff the following qualifications:
Nationally Accredited Qualifications
- HLT57715 Diploma of Practice Management
- BSB51915 Diploma of Leadership and Management
- HLT47315 Certificate IV in Health Administration
- BSB31115 Certificate III in Business Administration (Medical)
For more information http://www.amasatraining.org.au/
This is an initiative of AMA SA and available to practices across the Nation.
- The Australian Association of Practice Managers may be able to assist you find a consultant practice manager www.aapm.org.au
- Find an insurance broker who can advise on general insurance, including workers compensation, sickness insurance, property and equipment insurance, public liability insurance etc. The AMA or your State AMA may be able to assist through their preferred providers or corporate arrangements.
- Find a bank you with which you are prepared to have a long relationship. The AMA or your State AMA may be able to assist through their preferred providers or corporate arrangements.
- Find out about the benefits of leasing vs purchasing equipment. The AMA or your State AMA may be able to assist through their preferred providers or corporate arrangements.
- Find a lawyer you can trust to talk you through medical partnerships, locum tenens arrangements, associateships etc. Your State AMA may be able to help you through their preferred provider or corporate partnerships. The AMA has produced a guide for principals seeking to enter into arrangements with other medical practitioners
- Find yourself a financial adviser and an accountant – they will be critical to your business success. Your State AMA may be able to help you through their preferred provider or corporate partnerships.
- Check out the range of medical software packages. You should consider engaging an IT adviser who will advise on hardware and software and who will be available when interruptions occur (as they inevitably will) and talk to your colleagues about which packages they recommend. The basic requirements might be – if you want to be semi-paperless: the facility to manage accounts; prescribe; send and receive correspondence; patient progress notes; pathology and other diagnostic results. You should also consider the ease of use of any software package before purchase.
- Check out the AMA resources – Fees Book, GP toolkit, social media guide, guide to images on personal devices, code of ethics, etc www.ama.com.au/resources