When early career doctors have finished their qualifications and are ready to begin their next chapter there are many factors to consider in determining what is the right pathway for you and your career.

If this applies to you, it is likely that you have been working for public or private hospitals for some time and you’re looking to move into some form of private practice.

Each option presents individual advantages and pitfalls.

Regardless of the size of the practice, it is essential that the structures are in place to ensure effective management and compliance and allow you, the doctor, to focus on your core business of caring for patients and practising medicine.

In the early stages of transitioning to private practice, it is also likely that you will want arrangements that are cost effective and flexible so that you can determine exactly how much or how little work you wish to do, and to determine if the private practice lifestyle is right for you.

Flexibility can often have a premium attached, in terms of cost, but often this extra cost can be worthwhile to ensure that the work you do suits your needs and lifestyle and that you are not bound to longer term arrangements if you decide it is not for you.

If you are joining an established practice, some basics you need to consider are:

1. What is the structure of the business – is it a trust, associateship, partnership or company (or a combination)?
2. How will you be brought into the practice and will you have an option to ‘buy-in’ in the future?
3. If you are brought in under a Service Agreement, what is included in the Service Fee and what is excluded?
4. If you are going to operate within the practice under a Sessional or Licence Agreement, what are your entitlements in addition to using the room? Is there any equipment included and will you have access to support staff?
5. What are the business liabilities and what will you be liable for when you join? What is the fee structure and does it provide flexibility to work less than full time?
6. How easy is to to extricate yourself from the arrangements if they are not working out? Are there any restraints or other barriers to doing something different in the future if you decide to leave? What length of notice are you required to give to end the contractual relationship.
7. Who maintains referral and patient lists and data and relationship?
8. Have you obtained legal and accounting advice?

Some of the basics that need to be considered before opening a new general or specialist medical practice include:

1. Will you be ‘going it alone’ or will you be starting the practice with some friends/colleagues?
2. Where will your practice be located?
3. Do you have advisors in place who can assist with accounting, tax, IT, recruitment and the law?
4. How will you structure your business, for example shareholder agreements and service agreements?
5. Have you considered your staffing requirements?
6. Asset protection and estate planning.

Usually if you are starting a practice, you may be entering into arrangements that are longer term (like a lease or equipment finance arrangements) or where there may be more significant liabilities overall, so it is important that you undertake significant accounting and legal due diligence and take advice before entering into these arrangements.

Ordinarily, we find that doctors in their early career are looking to join existing practices under either a Service, Licence or Sessional Agreement. While these agreements should be relatively straightforward and clear, there are potential tricks and traps that can cause you grief in the long run.

For example, the agreement may contain a restraint, confidentiality or waiver in relation to your patients and the area you practice. While this may not be problematic at the time, when you progress in your career and look to move out into your own private practice, these restraints/waivers can prevent, delay or otherwise hinder, your future options.

As you can see from the above, regardless of whether you are joining an established practice, or going out on your own, there are several considerations to evaluate before you should put pen to paper. We have prepared a medical practice checklist which is available here for your consideration.

If you are looking to move into private practice, please reach out to us so that we can assist and help make the process as smooth and stress free as possible.