2023 Graduate Guide

Graduate Guide

Your transition into practice

Contents INTRODUCTION........................................................................................................................................................................................................................................................................ 5 You’ve Nearly Finished!...................................................................................................................................................................................................................................................... 5 STEPS INTO PRACTICE – A QUICK REFERENCE GUIDE............................................................................................................................................................................................. 6 QUICK CONTACTS.................................................................................................................................................................................................................................................................... 7 WORKING WITH CHILDREN CHECKS............................................................................................................................................................................................................................... 7 ABOUT OSTEOPATHY AUSTRALIA ................................................................................................................................................................................................................................... 8 BACKGROUND OF OSTEOPATHY AUSTRALIA...........................................................................................................................................................................................................10 HOW DOES OSTEOPATHY AUSTRALIA BENEFIT ITS MEMBERS AND THE PROFESSION?......................................................................................................................11 Information, Advice and Support...............................................................................................................................................................................................................................11 Advocacy................................................................................................................................................................................................................................................................................11 Telehealth...............................................................................................................................................................................................................................................................................11 Advanced Practice Recognition...................................................................................................................................................................................................................................12 HR Service..............................................................................................................................................................................................................................................................................12 Continuing Professional Development (CPD).......................................................................................................................................................................................................13 Free Webinars.......................................................................................................................................................................................................................................................................13 eLearning...............................................................................................................................................................................................................................................................................13 Insurance................................................................................................................................................................................................................................................................................13 Print and Online Publications.......................................................................................................................................................................................................................................14 Free Classified and Locum Service for Members.................................................................................................................................................................................................14 Patient Enquires and Referral Service.......................................................................................................................................................................................................................14 STEPS INTO PRACTICE..........................................................................................................................................................................................................................................................15 SCOPE OF PRACTICE.............................................................................................................................................................................................................................................................16 REGISTRATION.........................................................................................................................................................................................................................................................................17 National Registration........................................................................................................................................................................................................................................................17 Registration Standards.....................................................................................................................................................................................................................................................18 General AHPRA Codes and Guidelines.....................................................................................................................................................................................................................18 COVID-19 Specific Codes and Guidelines...............................................................................................................................................................................................................18 Use of the Title ‘Dr’..............................................................................................................................................................................................................................................................18 Needling Techniques in Osteopathy.........................................................................................................................................................................................................................19 REGISTRATION BOARD.........................................................................................................................................................................................................................................................19 CONTINUING PROFESSIONAL DEVELOPMENT (CPD)............................................................................................................................................................................................20 PROVIDER NUMBERS............................................................................................................................................................................................................................................................21 Locums of up to 2 weeks................................................................................................................................................................................................................................................21 PRIVATE HEALTH INSURANCE FUNDS...........................................................................................................................................................................................................................22 Health Fund Receipts........................................................................................................................................................................................................................................................23 Treating Family and Business Associates.................................................................................................................................................................................................................23 HICAPS........................................................................................................................................................................................................................................................................................24 HICAPS Codes......................................................................................................................................................................................................................................................................24

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Contents NATIONAL DISABILITY INSURANCE SCHEME (NDIS)..............................................................................................................................................................................................25 WORKERS’ COMPENSATION SCHEMES.........................................................................................................................................................................................................................26 THE TRANSPORT ACCIDENT AUTHORITIES................................................................................................................................................................................................................27 DEPARTMENT OF VETERANS’ AFFAIRS..........................................................................................................................................................................................................................28 MEDICARE CHRONIC DISEASE MANAGEMENT SCHEME FOR ALLIED HEALTH.........................................................................................................................................28 GST................................................................................................................................................................................................................................................................................................28 THE BUSINESS OF OSTEOPATHY......................................................................................................................................................................................................................................29 INTRODUCTION......................................................................................................................................................................................................................................................................30 AUSTRALIAN GOVERNMENT BUSINESS WEBSITES.................................................................................................................................................................................................31 Australian Capital Territory.............................................................................................................................................................................................................................................31 New South Wales................................................................................................................................................................................................................................................................31 Northern Territory..............................................................................................................................................................................................................................................................31 Queensland...........................................................................................................................................................................................................................................................................31 South Australia....................................................................................................................................................................................................................................................................31 Tasmania.................................................................................................................................................................................................................................................................................31 Victoria.....................................................................................................................................................................................................................................................................................31 Western Australia................................................................................................................................................................................................................................................................31 SEEKING WORK AS A LOCUM OR ASSOCIATE...........................................................................................................................................................................................................32 GST AND LOCUMS/ASSOCIATES.....................................................................................................................................................................................................................................32 BUSINESS NAMES...................................................................................................................................................................................................................................................................33 WORKING FROM HOME......................................................................................................................................................................................................................................................34 PURCHASING AN EXISTING PRACTICE OR ESTABLISHING A NEW PRACTICE.............................................................................................................................................35 BUSINESS STRUCTURE.........................................................................................................................................................................................................................................................36 Sole trader..............................................................................................................................................................................................................................................................................36 Partnership............................................................................................................................................................................................................................................................................36 Company................................................................................................................................................................................................................................................................................36 Trading Trust.........................................................................................................................................................................................................................................................................36 Clinical Record Keeping...................................................................................................................................................................................................................................................37 Privacy......................................................................................................................................................................................................................................................................................37 Professional Indemnity Insurance Cover.................................................................................................................................................................................................................37 Informed Consent..............................................................................................................................................................................................................................................................37 Know the Health Practitioner Regulation National Law...................................................................................................................................................................................37

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Introduction You’ve Nearly Finished!

You are almost reaching the end. However, prior to the final examinations and celebrations you will need to consider the next steps that you must take to begin the transition to practising as an osteopath.

This Graduate Guide walks you through the steps you need to take to begin practice, and provides some useful reference information with a quick contact list.

The guide is divided into three sections: About Osteopathy Australia. Information on how the association can support your journey as an osteopath.

Steps Into Practice. Information about the scope of practice, registration, insurance and continuing professional development. This information was current at the date of publication; however, please note things can change quickly and frequently so make sure you stay up to date with the latest developments, rules and legislation.

The Business of Osteopathy. General information about the development and management of private practice.

During your education, you have focused on set skills; however, as you are likely to be self-employed, it is in your own interest to develop business skills that may be outside your current skills or experience.

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Steps Into Practice – A Quick Reference Guide Compulsory

1

Apply for AHPRA Registration

Application and registration fees apply. .You can apply to the Australian Health Practitioner Regulation Agency (AHPRA) for registration four to six weeks before completing your course.

www.ahpra.gov.au/Registration/ Graduate-Applications.aspx www.osteopathyboard.gov.au 1300 419 495

Note: AHPRA will not process incomplete applications.

Recommended

2

Join Osteopathy Australia

FINAL YEAR OSTEOPATHY AUSTRALIA STUDENT MEMBERS ONLY Graduate membership special offer!

Go to https://www.osteopathy.org.au/ membership/graduates

Join at www.osteopathy.org.au/membership/ graduates Contact us on (02) 9410 0099

Graduate members are entitled to receive the negotiated Guild Professional Indemnity Insurance discounted membership rate.

Compulsory

3

Organise Professional Indemnity (PI) Insurance

Professional Indemnity cover is required for registered, practising osteopaths in Australia and must meet Osteopathy Board of Australia (OBA) standards.

Osteopathy Australia members can choose to insure through Guild Insurance, our endorsed provider.

Compulsory for rebates

4

5

Apply for provider number(s)

Get a Working With Children Check

6

Get an Australian Business Number (ABN)

7

Register for GST

8

Get Agreed Value Income Protection Insurance

A provider number is needed for each place of practice.

Look for information under Organisations/Health professionals on the Services Australia website.

Note: You must be on the AHPRA register before applying for a provider number.

www.guildinsurance.com.au/ professional/osteopaths Contact Guild on 1800 810 213

www.servicesaustralia.gov.au/ organisations/health-professionals/ forms/hw093 132 150 How to apply for provider numbers www.osteopathy.org.au/help-resources/ schemes/medicare/medicare-providernumbers

Recommended or required In many states and territories, you are required to have a Working With Children Check. Contact the relevant agency in your state or territory.

Optional Depends on individual circumstances. Online applications available.

See list of websites on page 7

www.abr.gov.au

Optional Depends on individual circumstances and whether you earn/have a turnover of more than $75,000 per annum.

www.ato.gov.au

Optional

Various providers

Premiums may be deducted from your tax.

Be sure to increase your cover as your income increases

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Quick Contacts Service

Organisation

Osteopathy Australia Membership

Osteopathy Australia

Registration

Osteopathy Board of Australia

Professional Indemnity Insurance

Guild Insurance

Contact Information

www.osteopathy.org.au 02 9410 0099 www.osteopathyboard.gov.au 1300 419 495 (AHPRA) www.guildinsurance.com.au/professional/osteopaths 1800 810 213 www.servicesaustralia.gov.au/organisations/healthprofessionals/allied-health-professionals

Provider Numbers

Medicare Australia

Health Fund List

Private Health Insurance Ombudsman

www.privatehealth.gov.au/dynamic/insurer

Australian Tax Office

ABN number, Tax File Number, GST

www.ato.gov.au Online ABN applications at www.business.gov.au

132 150

For information about registering for third-party schemes, see pages 26 to 28.

Working With Children Checks Working With Children Checks are required in most states or territories. Some states and territories may exempt some health care workers, but Osteopathy Australia recommends you obtain a check anyway. Parents of patients may request evidence of your check. Many organisations will want you to have this check whether you are a healthcare practitioner or not. Contact the relevant agency in your state or territory for more information.

State

Website

Australian Capital Territory

www.afp.gov.au/what-we-do/services/criminal-records/national-police-checks

New South Wales

www.ocg.nsw.gov.au/working-children-check

Northern Territory

www.pfes.nt.gov.au

Queensland

www.bluecard.qld.gov.au

South Australia

www.screening.sa.gov.au/types-of-check/working-with-children-check

Tasmania

www.cbos.tas.gov.au/topics/licensing-and-registration/work-with-vulnerablepeople/applications/apply

Victoria

www.workingwithchildren.vic.gov.au

Western Australia

www.workingwithchildren.wa.gov.au

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About Osteopathy Australia

PART A

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Osteopathy Australia NATIONAL OFFICE PO Box 5044, Chatswood West NSW 1515 T (02) 9410 0099 | F (02) 9410 1699 | info@osteopathy.org.au www.osteopathy.org.au

Osteopathy Australia Board of Directors Our Board is a mix of osteopaths (always a majority) and other merit-appointed directors based on skills and experience in diverse fields.

Osteopathy Australia strives to ensure that our Board reflects the gender, cultural and clinical mix of our profession.

President: Michelle Funder Directors: M atthew Cooper Joey Calandra Georgia Ellis Donald Hunter Cris Massis Kathryn Refshauge Brett Wiener CEO (non-Director): Antony Nicholas You can learn more about our directors at www.osteopathy.org.au/about-us/our-board

About Osteopathy Australia

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Background of Osteopathy Australia • Y ou are joining a proud and effective professional association built by the hard work and dedication of other osteopaths, both past and present. Your own contribution to the profession and to the association will be appreciated and valued.

• O steopathy Australia provides a unified voice in advocating, enhancing, promoting and representing osteopathy, while delivering quality educational and professional support.

• O steopathy Australia was established in 1955 and, following the amalgamation of individual state associations, became one national association in 1991.

• O steopathy Australia works with the osteopathy universities, Osteopathy Board of Australia (OBA), the Australasian Osteopathic Accreditation Council (AOAC), as well as many national and international associations and bodies such as Allied Health Professions Australia, Osteopathic International Alliance, the American Osteopathic Association (AOA), the UK Institute of Osteopathy (iO) and Osteopaths New Zealand and some international regulators.

• O steopathy Australia also works closely with a range of government bodies and stakeholders such as the Department of Health and Ageing, various State Health Departments, Department of Veterans’ Affairs and the statebased workers or traffic compensation schemes.

About Osteopathy Australia

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How does Osteopathy Australia benefit its members and the profession?

Information, Advice and Support One of the huge benefits of being a member of Osteopathy Australia is the support and advice you can receive over the phone or through our website. After all, we are here to help you. Being an osteopath requires you to have good clinical knowledge, but it may not prepare you for all you need to know about national regulation, requirements of Commonwealth and State schemes, health fund rules and privacy requirements. The business of health care is increasingly complex, and a key role of Osteopathy Australia is to make your life a little easier.

Advocacy The key role of a professional body is to provide services and advice to its members and represent the profession.

A strong Osteopathy Australia gives osteopathy a strong voice with government and others.

Osteopathy Australia is the only national body in Australia that solely represents osteopaths. Our most important role is working with key stakeholders such as federal and state governments, major government departments, universities and the Osteopathy Board of Australia (OBA) to improve the profile of osteopaths and maintain their status with other health professions.

The advocacy we provide falls into two main groups: profession-wide and individual.

We represent the general interests of the profession to government, regulators, schemes, third-party funders and private health insurance funds in all states and territories. You can see the type of work we do in profession-wide advocacy on our dedicated ‘advocacy’ and ‘lobbying’ webpage at www.osteopathy.org.au/advocacy-and-lobbying

We also provide individual advocacy when appropriate. For example, we work with Medicare, the Department of Veteran’s Affairs (DVA) state and territory worker’s compensation schemes, motor accident schemes, the National Disability Insurance Scheme (NDIS), aged care services and facilities, and other bodies to clarify if correct processes have been followed. We also work with individual members to appeal decisions and give personalised advice for practice risk management.

Telehealth During COVID-19 we successfully advocated for interim telehealth privileges in osteopathy Medicare items, Department of Veteran’s affairs items, most worker’s compensation schemes, and many motor vehicle accident schemes. For the first time ever, this gave osteopaths the ability to get paid for consulting people over a device such as a computer, tablet or smart phone, instead of having an in-person consultation.

We also completed the first research on telehealth in osteopathy and its outcomes can provide information to the public and government on the benefits.

You might use telehealth when you start practice for private patients paying out of pocket or, circumstances depending, patients of third-party programs. Check with us before you use it in any third-party funding scheme for updated advice about its role and rebates that could apply.

About Osteopathy Australia

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When using telehealth, osteopaths must apply the same duty of care principles as within an in-person consultation. For example, all AHPRA guidelines continue to apply as do state and/or territory guidelines, such as mandatory reporting of child abuse, neglect or harm.

We have a range of guidelines and resources to help you check if telehealth is appropriate for a patient, what to consider, and how to manage telehealth risks while giving quality clinical care and advice. Go to www.osteopathy.org.au/ article/telehealth-and-osteopathy

Advanced Practice Recognition Full members of Osteopathy Australia can apply to become Advanced Practitioners, providing they meet certain eligibility requirements and conditions to show that they have expanded their scope of clinical practice to include skills and knowledge shared by other clinical health professionals. This allows them to become publicly titled and promoted as Advanced Practitioners.

Advanced Recognition application is possible via two pathways: • Tertiary. This requires a further university qualification in a focus area.

• V ocational. This requires relevant work experience, professional development, professional references and reasoned case studies.

In the future, we hope to have extended pathways to help direct learning to develop career pathways.

Advanced Practitioner recognition is currently possible in the following areas: Sports Practice, Paediatrics, ExerciseBased Rehabilitation, Pain Management or Occupational Health (work injury prevention, management and rehabilitation).

The process involves a review of clinical knowledge by medical practitioners/medical specialists, other allied health professionals and senior osteopaths, which gives Advanced Practitioner Recognition privileges high value within and beyond osteopathy, which can open new career opportunities and referral pathways. Advanced Practitioners work in their practices as well as other multidisciplinary health care settings.

Current students can learn more about becoming an Advanced Practitioner at www.osteopathy.org.au/osteo-careers/ professional-development. Full members of Osteopathy Australia can obtain access to an exclusive application page at www.osteopathy.org.au/article/advanced-practice to view the application process and forms.

T o find out more about becoming an Advanced Practitioner, email clinicalpolicy@osteopathy.org.au or telephone (02) 9410 0099.

HR Service

HR Hotline 1300 143 602

An integrated workplace advisory service for all practising members only. This includes: • A dedicated HR hotline for employees, contractors or business owners • Speak to qualified workplace relations advisers to discuss issues and seek advice • A comprehensive online library of technical resources • I nformation-packed articles in Osteo Life and continuing education presentations on workplace relations matters Visit www.osteopathy.org.au/article/hr-hotline on the website for further information.

About Osteopathy Australia

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Continuing Professional Development (CPD) Osteopathy Australia is committed to supporting a culture of lifelong learning in the profession.

Osteo Brain, Osteopathy Australia’s learning platform, makes education, upskilling and networking easier for osteopaths, with its suite of tools, including eLearning modules and courses, webinars and face-to-face learning.

We will continue to expand our range of accessible and low-cost CPD resources and events to help members meet their registration obligations for CPD. We want to ensure practitioners keep that extra edge to thrive for their entire career.

For more information, visit the CPD page on the Osteopathy Australia website.

Free Webinars Osteopathy Australia is committed to holding at least 20 webinars a year, covering a broad spread of topics that allow for contributions from experts in the industry.

These webinars run for one to two hours with a Q&A session at the end and cover a range of clinical, policy and business subject matter. Some webinars also cover the OBA’s mandatory topics.

eLearning Osteopathy Australia’s e-learning portal includes specially designed up-to-date courses written by some of the top people in allied health. The courses available include Paediatrics, Pain Management, Caring for the Clinician, Critical Appraisal of Research, Prevalent Sports Injuries and Exercise Rehabilitation.

Course content, including quizzes, have been sourced from clinical experts inside and outside osteopathy, and modules are created by instructional designers. The courses are designed for members to access at a time of their choosing on various mobile devices.

Osteo Talk Podcasts Osteopathy Australia’s e-learning portal Osteopathy Australia’s Osteo Talk clinical podcasts deliver clinically relevant education for osteopaths to learn, connect and collaborate. This podcast is a professional development resource that aims to provide osteopathically relevant content by drawing on the wealth of knowledge seen in practice, as well as experts in other disciplines.

Each episode explores real clinical issues through interviews and discussion with top practitioners in Australia and internationally. The aim is to inspire and be inspired by colleagues to help grow clinical knowledge among osteopaths to ensure better clinical practice. This podcast is available free via the Osteopathy Australia website and on Spotify, Amazon, Google or Apple.

Insurance Before you can start treating patients, you must have adequate insurance to protect yourself. Osteopathy Australia negotiates a group professional indemnity insurance scheme for its members through Guild Insurance, thereby keeping premiums at a competitive rate and providing additional policy benefits. The following is provided as general information and not as financial or insurance advice, so contact Guild Insurance directly for specific policy advice.

Osteopathy Australia members receive quality, broad protection offered through Guild’s liabilities insurance that provides protection for: • Breach of professional duty (i.e. professional indemnity) • Goods sold and advice on goods sold • Public liability • Ongoing cover if you cease working or retire (run-off cover) • No ‘excess’ or ‘deductibles’ as standard

About Osteopathy Australia

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Guild’s policy for Osteopathy Australia members also includes pay-by-the-month at no extra cost (very popular among new practitioners finding their feet in the workforce).

So, if you are shopping around for insurance, check your quotes are like-for-like insurance. You can contact Guild Insurance on their Toll-Free number 1800 810 213 In addition, your Guild cover for legal expenses associated with disciplinary inquiries, such as those by Osteopathy Board of Australia, other regulatory authorities or coronial inquiries, is up to $100,000.

Further, Guild and Osteopathy Australia encourage all osteopaths to renew their focus on risk management in the year ahead.

Osteopaths who take a proactive approach to the management of risk help to protect their reputation and that of the profession.

To aid osteopaths in managing their risks, Guild has a dedicated website called RiskHQ www.riskhq.com.au Remember, you are responsible for having appropriate professional indemnity insurance arrangements in place – don’t risk your registration with non-compliant insurance.

Print and Online Publications Osteo Life. A quarterly magazine for members featuring news, quality editorial, changes to the profession, clinical practice, continuing professional development and eLearning articles. It has a strong focus on member clinical and opinion editorial features, offers business management articles from our core partners plus all the exciting things various osteopaths are doing in Australia and around the world.

Osteo Matters eNews and eFlyers. Member news, research articles, lobbying and policy e-updates.

Osteopathy Australia Factsheets. See the Osteopathy Australia website for a range of factsheets and practice briefings for members only.

Free Classified and Locum Service for Members Members can place classifieds for free through the Osteopathy Australia website for associates, locums, locum work, student placement or the sale of a practice.

Patient Enquires and Referral Service Osteopathy Australia assists in answering enquiries from the public, making patient referrals to members and distributing information about osteopathy to the public or community services.

Members receive a free website listing for their clinics in Osteopathy Australia’s online directory, Find an Osteo, which is available to the public to search for an osteopath in their local area.

Approximately 5000-page views are made via this online service each month.

About Osteopathy Australia

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Steps Into Practice

PART A

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Scope of Practice It is important you understand the consequence of acting outside your scope of practice. Generally, scope is based on what you have been trained to do in university; or the additional skills and training you can demonstrate that are aligned with what you learnt in university. The further a topic is away from that area of scope, the more likely you are to be acting ‘outside of scope’. Just because you can undertake some training does not mean the regulator will accept you can practice within that area.

Potential complications associated with ‘scope of practice’ • What is considered appropriate levels of training and how you keep that current?

• Whether your insurance covers you to practice in a new area or with a specific technique?

• T he regulator does not specifically define scope; therefore, you have to judge if the regulator would consider something outside osteopathic scope. The OBA does give some guidance (for example, any vaccination advice is considered outside of osteopathic scope).

• T he multitude of rules associated with any third-party funder, such as Medicare, private health insurance or other schemes and what they consider they are paying for via rebates. Failure to follow these rules can result in rulings to reimburse significant funds.

• T he recent specific government exclusion of a range of treatments from private health insurance rebates such as Alexander technique, aromatherapy, Bowen therapy, Buteyko, Feldenkrais, herbalism, homeopathy, iridology, kinesiology, naturopathy, Pilates, reflexology, Rolfing, shiatsu, tai chi and yoga.

If you are going to work in other areas of practice, under the name (or billing) of osteopathy, Osteopathy Australia strongly advises you should seek additional advice before proceeding.

The Osteopathy Australia Statement of Scope of Practice can be viewed on the Osteopathy Australia website at www.osteopathy.org.au/article/osteopathy-scope-of-practice

Steps Into Practice

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Registration National Registration As of 1 July 2010, the Health Practitioner Regulation National Law came into force in each state and territory. This law means that, in Australia, 15 health professions, including osteopathy, are regulated by nationally consistent legislation under the National Registration and Accreditation Scheme.

Australian Health Practitioner Regulation Agency (AHPRA) supports the 15 National Boards that are responsible for regulating the health professions. The Osteopathy Board of Australia (OBA) is the national registration board.

The primary purpose of the National Law is to protect the health and safety of the public, not the reputation of osteopaths.

The OBA’s registration standards, codes and guidelines have direct bearing on your practice, and it is therefore important to ensure you are aware of and understand your obligations. Any breach of those standards, codes or guidelines could result in complaints, being called before a tribunal or even deregistration.

The functions of the OBA include: • Registering osteopaths and students • Developing standards, codes and guidelines for the osteopathy profession • Handling notifications, complaints, investigations and disciplinary hearings • Assessing overseas trained practitioners who wish to practice in Australia • Approving accreditation standards and accredited courses of study

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Registration Standards Registration standards define the requirements that applicants, registrants or students need to meet to be registered. The OBA has developed the following registration standards, available at: www.osteopathyboard.gov.au/Registration-Standards.aspx

• Osteopathy Continuing Professional Development Registration • Standard Osteopathy Criminal History Registration Standard • Osteopathy English Language Skills Registration Standard • Osteopathy Professional Indemnity Insurance Registration Standard • Osteopathy Recency of Practice Registration Standard

General AHPRA Codes and Guidelines With the national registration of osteopaths come a range of codes and guidelines by which all osteopaths must abide.

These are available online on the OBA website at www.osteopathyboard.gov.au/codes-guidelines.aspx.

NOTE: READING THESE DOCUMENTS COUNTS TOWARDS YOUR MANDATORY CPD HOURS. You must read and understand each of the following codes or guidelines. In particular, it is important to develop your soft skills, such as appropriate communication with patients and thorough note taking, while understanding the nuances of risk management and the complaints procedures.

• Continuing Professional Development – your requirements to meet the 25 hours of CPD per year. Applicants who are registered part-way through a registration period must complete the first aid requirements, and six hours of CPD for every three months of registration remaining in the registration period. Find out more at https://bit.ly/3NnxMeQ • M andatory reporting – what you need to do when you find out about inappropriate behaviour by another practitioner • C ode of Conduct – the rules according to the OBA, which, if breached, can lead to a Regulation Board tribunal • Clinical Records guidelines • Guidelines for Infection Control • Advertising – what you can and can’t do in advertising regulated health services • Professional Indemnity Insurance – the minimum requirements needed to practice • Informed consent – guidelines on obtaining a patient’s informed consent • P rofessional boundaries – specific guidance on professional boundaries in the osteopath-patient relationship

COVID-19 Specific Codes and Guidelines COVID-19 raised the need for infection control approaches in practice specific to COVID-19, its modes of transmission and contamination risks. Various states and federal departments have released advice and additional guidance for health professionals. For more information, visit our dedicated web page at www.osteopathy.org.au/help-resources/ practice-resources/covid-resources

Use of the Title ‘Dr’ Under National Registration, AHPRA uses the title ‘Dr’ in the register*. However, osteopaths must make it clear, including in their advertising, that they are not registered as medical practitioners by including a reference to their health profession whenever the title is used. E.g. Dr David Smythe (Osteopath). *Osteopaths who wish to change their title back to Mr/Mrs/Ms etc can do so by lodging a change of details form with AHPRA. Steps Into Practice

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Needling Techniques in Osteopathy Dry needling and other acupuncture related techniques are increasingly common in osteopathic practice.

Osteopathy Australia advises members to undertake a formal course of training in these techniques and only use them to the extent of the competence the training provides. At present, there are no agreed minimum training requirements to practice needling-related techniques and these are not restricted practices under the Health Practitioner Regulation National Law. The title Acupuncturist is, however, a title protected under the National Law and only those registered with the Chinese Medicine Board of Australia may use it. In the same way, only those registered with the Osteopathy Board of Australia may lawfully refer to themselves as an osteopath. You must avoid any advertising, written or verbal claims that could mislead patients and other parties that you are an Acupuncturist or carrying out acupuncture.

This is known as holding out which is a legal concept that means to present yourself in a way that suggests to others that you are something or someone that you are not. AHPRA may investigate and, where appropriate, seek to bring prosecutions. This is a complex area and it is the courts that will decide the merits of the case.

The maximum fine for holding out by an individual is $30,000 and an incorporated entity $60,000 (per offence). So be sure to describe your proposed treatment in such a way that it clearly establishes that the needling techniques are within the context of osteopathic practice and that you are not a practitioner of Chinese medicine or an Acupuncturist.

Guild Insurance – Osteopathy Australia’s partner that provides professional indemnity cover for members – will insure osteopaths that use needling techniques. This is included in the general cover where an osteopath has undertaken a course of training which was at least 16 hours in duration and had practical component.

If you choose not to meet this minimum requirement Guild may include needling in your cover for an additional premium. If you intend to use needling techniques and you have not had the minimum training specified, Osteopathy Australia strongly recommends that the cover is noted on your policy schedule. Without such cover, you may not be adequately insured and may be personally liable for civil claims.

Osteopathy Australia is currently developing a Clinical Practice Group for Needling in Osteopathic Practice to support this area of members’ practice. Check our website for developments.

Registration Board Contact the Osteopathy Board of Australia (OBA) Website: www.osteopathyboard.gov.au Phone: 1300 419 495 (AHPRA) Online Enquiry Form: www.ahpra.gov.au/About-AHPRA/Contact-Us/Make-an-Enquiry.aspx Postal address: Chair Osteopathy Board of Australia GPO Box 9958 Melbourne VIC 3001

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Continuing Professional Development (CPD) The OBA states that continuing professional development is the means by which members of the profession maintain, improve and broaden their knowledge, expertise and competence, and develop and maintain the personal and professional qualities required throughout their professional lives. All registered osteopaths (except students and those with nonpractising registration) must undertake CPD to maintain their competence to practise.

Osteopathy Australia provides members with a range of accessible and free or low-cost CPD resources to help meet their registration obligations for CPD. The OBA has advised that CPD should be relevant to the osteopath’s area of professional practice and have clear learning aims and objectives that meet his or her requirements. CPD activities should also have a focus on the clinical aspects of practice including diagnosis, treatment and management, according to best practice standards and safety of patients.

The OBA CPD is a reflective practitioner model.

Osteopaths are required to identify their learning needs related to the practice of osteopathy, identify means of meeting them and reflect on the outcomes and how these have been applied to practice. There are many useful links and advice on CPD on the Osteopathy Australia website.

The OBA CPD requirements are: • U ndertake 25 hours of CPD annually, which includes at least 4 hours of mandatory topics as listed by the board; and • M aintain a current first aid certificate at the minimum standard of a Senior First Aid certificate or equivalent, which is updated every three years. This is a standalone requirement and is not counted towards your 25 hours of annual CPD learning.

The OBA has divided CPD into three categories: (1) OBA Mandatory Activity (4 hours minimum) In each 12-month CPD cycle, the OBA requires osteopaths to complete a minimum of four hours related to one or more of the following topics: • O steopathy Board of Australia registration standards, codes and guidelines and overview of the National Law, particularly when new or updated versions are published • A dvertising a regulated health service and social media policy • Evidence-based practice • Risk management • Record keeping • Informed consent • Effective communication • Professional boundaries • Confidentiality and privacy Some Osteopathy Australia webinars cover these topics so please use this FREE member benefit available online.

(2) Learning with Others (at least 8 hours recommended but not compulsory) Learning with Others can take many different formats and may include: courses, lectures, discussion/ seminar groups and conferences, real-time webinars, being coached or mentored by another health professional and peergroup reviews.

(3) Learning by Oneself (no minimum required) Learning by Oneself may include journal/book reading, distance learning, internet research or production of a publication in relation to your professional work as an osteopath.

The OBA’s Continuing Professional Development Guidelines are available on their website at www.osteopathyboard.gov.au/registration-standards/cpd-resources.aspx or via the Osteopathy Australia website.

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Provider Numbers It is necessary to register with Medicare Australia (132 150) to be recognised as a provider of osteopathic services and to enable your patients to claim any rebate to which they may be entitled. Not having a provider number does not prevent you from practising, only from providing rebates. You will have to fill out an application form and provide proof of your registration.

A different provider number is required for each practising address.

You can download an application form for Allied Health Professionals from www.servicesaustralia.gov.au/organisations/ health-professionals/forms/hw093

Once you have registered for your first provider number, you can apply for additional numbers via the Health Professionals Online Service (HPOS) on the Services Australia website.

You can read more about how to register for HPOS and what it enables you to do on the Services Australia website: www.servicesaustralia.gov.au/organisations/health-professionals/services/medicare/hpos

It is important to keep your HPOS account active by logging in regularly – access to HPOS is suspended after six months of inactivity, but can be easily reactivated by logging in again.

NOTE: It is against the law to use somebody else’s provider number or let somebody use yours. Breaching this condition can have serious consequences for practitioners. Osteopathy Australia strongly recommends cancelling your provider number when you cease practising in a location.

Locums of up to 2 weeks Practitioners who provide services at a location for less than two weeks and do not expect to ever return to that location may be able to use an existing provider number from another location (but not the number of another provider). You must contact Medicare to seek permission prior to using one of your existing provider numbers.

Osteopaths doing any other type of locum work, or if you return to locations on a regular basis even for short periods, must make sure they have a separate provider number for each different practice location.

Provider number enquiries should be directed to Medicare on 132 150 or www.servicesaustralia.gov.au

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Private Health Insurance Funds Approximately 50% of Australians have private health insurance. This is an important area for the osteopathic business model. There is a great deal of variation in the reimbursement rates for osteopathic services between the funds and with different levels of cover in a single fund. Most funds, but not all funds, will reimburse for osteopathic treatment.

Osteopathy Australia is committed to ensuring that osteopaths are treated equitably by the funds when compared with other manual medicine professions. We monitor the cover and advocate for increased reimbursements where osteopaths are treated less favourably than chiropractors or physiotherapists.

Individual private health funds may not operate in all states and territories. Some funds restrict their eligibility for membership to particular professions. With some funds it is necessary to ‘register’ as a provider with the fund and they may provide you with their own provider numbers. The Commonwealth regulates private health funds and there is a great deal of information on the funds available for the public and practitioners: www.privatehealth.gov.au The most widely recognised private insurance funds by market share are BUPA, Medibank Private, Hospital Contribution Fund (HCF), NIB and HBF. Visit their websites for more information.

Look for links such as Providers, Information for Health Professionals or Information for Allied Health Professionals.

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Health Fund Receipts Rebates can vary from fund to fund.

In order for patients to claim a rebate from a health fund, the following information must be provided: • Patient’s name • Date of service • Item number • Allied health professional’s name and provider number • Address of location of service • Referring medical practitioner’s name and provider number (or practice address), if applicable • Date of referral, if applicable • Amount charged, total amount paid, and any amount outstanding in relation to the service • N ature of the consultation (e.g. initial or standard treatment). It is not necessary to write ‘osteopathic spinal manipulation’ on the receipt, ‘osteopathic treatment’ will suffice for a claim to be processed. Osteopathy Australia continues to negotiate with the various funds to improve rebates for patients Ultimately, a patient’s rebate is a matter between the patient and the health fund, and you should take care not to promise rebates. Countless reasons exist why patients with private insurance may not obtain rebates, and these are beyond your knowledge. Examples include a patient not paying their premium, a patient hitting a rebate limit, or a patient using other health services on the same day in the same rebate category (i.e. physiotherapy and osteopathy on the same day).

It is generally against fund rules to claim a rebate where the osteopath treats a family member, and often also with work colleagues (see box below). As a general rule of thumb, either don’t process a claim (i.e. you could still bill privately) or get the patient to check with their fund BEFORE treatment.

Many osteopaths have said that patients are asking them for advice about which health insurer to go with for better rebates. The industry is too complex and osteopaths are not qualified to provide financial advice. Better rebates in osteopathy may mean lower rebates for other services, so it’s best to give general advice only. Tell patients to ring their health fund for a better deal, research and shop around, or visit www.privatehealth.gov.au (a Government website) to help them understand their options.

Treating Family and Business Associates Many funds do not provide rebates for treating family and business associates, so it is best to either avoid processing these as a rebated service or get the patient to check with their fund first. Health funds are cracking down and auditing this area heavily.

This does not prevent you from doing it, just from claiming a rebate. However, if you decide to treat family, friends or staff, there are also ethical, privacy and other considerations to think about when doing this – for example, what would happen if your treatment caused an injury?

Osteopathy Australia has resources which will help you at www.osteopathy.org.au/article/treating-family--friends-and-staff

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HICAPS The Health Industry Claims and Payments Service (HICAPS) allows patients to present their health fund card at the clinic, saving the patient the hassle of claiming manually at the fund’s retail location. HICAPS user guides Practitioners must register with HICAPS at each location they practice (and a Medicare provider number is required for each location). We caution members to clarify the arrangements at each clinic where they work. Even if you do not handle transactions, you are accountable for all transactions generated on your behalf.

Osteopathy Australia recommends that when you cease working at a clinic that you ensure that you are removed from the HICAPS system at that location. You can do this by visiting the HICAPS website at www.hicaps.com.au, and navigating to the section on Admin & Support, clicking on Admin & Support home and then on See all forms to amend your account details online.

If you remain active on the system, claims may be made using your code, either inadvertently or otherwise, and this exposes you to investigations by the funds for inappropriate claims. Health funds may suspend or withdraw your right to have patients submit claims for your services through HICAPS if there are irregularities and this would adversely affect your practice while investigations are completed.

HICAPS CODES Item no Full description Abbreviated Description 1801 Consultation/Treatment and Supportive Therapy

Consult/Treatment

1802 Consultation/Treatment and Additional Therapy

Std Consult

1803 Consultation/Treatment and Extended Therapy

Long Consult

1804 Initial Consultation Examination Treatment

Initial Consult

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National Disability Insurance Scheme (NDIS) Many osteopaths work to improve the lifestyle and participation goals of people with a disability who have NDIS funding. Osteopaths work specifically on goals for mobility, movement and growing skills for activities of daily living.

Many members of Osteopathy Australia work with what are known as clients with ‘Plan-Managed’ and/or ‘SelfManaged’ clients. When an osteopath works with NDIS clients, they generally do not provide manual therapy services.

Instead, they provide exercise programs for maintenance or retention of skills for clients living with a significant lifelong disability.

Your role with NDIS clients is significantly different to any other scheme where you participate in musculoskeletal injury and health care management.

We have resources and policy staff to assist you in understanding the NDIS and how to seek approval for eligible clients. They can also advise you on many other schemes which represent individuals to client case managers and NDIS planners.

You can find lots of information about what to do, your roles and responsibilities and things to consider with NDIS clients at www.osteopathy.org.au/help-resources/schemes/ndis NDIS national websites www.ndis.gov.au www.ndiscommission.gov.au

Look in particular for information about the purpose of the scheme, the role of allied health providers and what services and interventions the NDIS excludes for its clients.

Steps Into Practice

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Workers’ Compensation Schemes Osteopaths can participate in all state and territory workers’ compensation schemes for injured workers, as well as within the Commonwealth’s Comcare scheme, specifically for injured federal public servants. These schemes aim to enable timely return to work through evidence-based musculoskeletal injury management services. Some schemes require an application for registration and/or training programs. There are many guidelines, policies and protocols needing to be followed by an osteopath in areas of management planning, documenting plans, measuring outcomes, seeking approval, amounts payable, receiving payment, invoicing and beyond.

We can assist you to understand the schemes. Note you need to register with these schemes before treating any patients.

You can find lots of information about what to do, your roles and responsibilities and things to consider in your state or territory at www.osteopathy.org.au/article/providing-services-under-worker-s-compensation-schemes.

Commonwealth, state or territory websites Commonwealth

www.comcare.gov.au

ACT

www.accesscanberra.act.gov.au

NSW

www.sira.nsw.gov.au

NT

www.worksafe.nt.gov.au

QLD

www.worksafe.qld.gov.au

SA

www.rtwsa.com

TAS

https://worksafe.tas.gov.au

VIC

www.worksafe.vic.gov.au

WA

www.workcover.wa.gov.au

Look for links such as Health Providers or Allied Health Professionals, or information for osteopaths.

Steps Into Practice

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The Transport Accident Authorities As with workers’ compensation schemes, osteopaths can participate in transport accident schemes aiming to improve health and functional outcomes for people injured in a motor vehicle accident.

These schemes are state or territory based; they help people to return to work and other activities of daily living.

Some transport accident schemes require an application for registration and/or training programs. There are often guidelines, policies and protocols that need to be followed by an osteopath in areas of management planning, documenting plans, measuring outcomes, seeking approval, amounts payable, receiving payment, invoicing and beyond.

We can help you understand your roles and requirements within the schemes, as well as represent you individually for complaints, concerns, giving feedback or following up.

State or territory websites NSW

www.sira.nsw.gov.au

NT

www.tiofi.com.au

QLD

www.maic.qld.gov.au

SA

www.ctp.sa.gov.au

TAS

www.maib.tas.gov.au

VIC

www.tac.vic.gov.au

WA

www.icwa.wa.gov.au

Look for links such as Health Providers or Allied Health Professionals, or information for osteopaths.

You can also find lots of information about what to do, your roles and responsibilities and things to consider in your state or territory at www.osteopathy.org.au/help-resources/schemes/accident-compensation-schemes/motor-accidents.

Steps Into Practice

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Department of Veterans’ Affairs (DVA) Osteopaths can provide treatment to veterans and dependents, widows and widowers in certain circumstances and with a medical referral. Conditions apply. Clients may have either a gold or a white card. A gold card means that the client is eligible to receive DVA benefits for any condition. A white card will specify the eligible conditions.

If you are registered with Medicare and have at least one provider number, you are automatically eligible to treat DVA patients. There are referral and reporting requirements, so please visit www.dva.gov.au/providers for information, in particular the ‘Notes for Allied Health Providers’ and the fee schedule. Find out more about how to become a DVA health care provider.

Treatment is provided under the Allied Health Treatment Cycle, where the client can be referred for up to 12 services at a time. Read more about the treatment cycle and your obligations at www.dva.gov.au/providers/notes-fee-schedules-andguidelines/allied-health-treatment-cycle-and-referrals

DVA legislation does not permit providers to charge a gap payment to the patient where the scheduled fee is less than the clinic’s charges. You cannot charge the client directly. After the service, you need to make the claim directly from DVA. To claim, it’s best to use DVA web claim at www.dva.gov.au/providers/claiming/use-dva-webclaim

Medicare Chronic Disease Management Scheme for Allied Health Medicare can fund a maximum of five allied health services per calendar year for eligible patients (note these five are spread across all allied health; not every patient will have five osteopathic services).

A referral form from the patient’s GP is required, and reporting and other conditions apply. Check practice requirements and confirm how many services have already been claimed by the patient by calling 132 150.

See our resources and templates for reporting requirements at www.osteopathy.org.au/help-resources/schemes/medicare/claims-and-rebates.

GST Osteopathic services are generally GST-free. This refers to the transaction to which the patient is a party – see information about GST and locums/associates (page 32), which may have different GST implications.

Certain non-clinical services may not be GST-free (e.g. services to businesses about office design or layout).

Case conference, report writing and travel services provided by an osteopath in relation to their treatment of a worker’s compensation patient are subject to GST.

Steps Into Practice

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The Business of Osteopathy

PART A

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Introduction There is much to consider before starting a new venture. It is in your interest to formulate a business plan for yourself as an independent contractor, even if you do not intend to open your own business. Specialised assistance will come from a variety of sources such as Osteopathy Australia, our HR Resources Library and HR Hotline, your colleagues, accountants and solicitors.

The first consideration is where you wish to work. There are a range of possibilities such as working from home, renting a room – perhaps sharing expenses with others, leasing premises or even purchasing an existing practice. This all depends on your personal circumstances, and it is important to understand the drawbacks and advantages of the various options.

Generally, Osteopathy Australia would recommend that it is best to gain experience working in an established practice when you first graduate.

What government schemes may be able to assist?

There are many government schemes that offer new or established business tools and strategies for business management and marketing. These schemes vary from state to state and can be found by searching through government business websites (see page 31).

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Australian Government Business Websites www.business.gov.au | www.asbfeo.gov.au

ATO Information Essentials for your new business Australian Capital Territory Business (ACT) www.act.gov.au Run by the ACT Government, this website offers services and information for businesses operating or investing in Canberra and the ACT region.

Doing business in Canberra www.business.act.gov.au Business ACT is the business development arm of the Australian Capital Territory (ACT) Government. It is also the entry point for business information, programs and services that create a competitive advantage for business within the ACT region.

New South Wales Business (NSW) www.nsw.gov.au As the official business site managed by the NSW Government, this site provides information for businesses, including business regulation, doing business with government, employing staff, programs and grants, and environmental planning and services.

Help for business (NSW) www.industry.nsw.gov.au The NSW Department of State and Regional Development (DSRD) helps businesses to set up, develop and grow in NSW. Regional NSW offers a wide range of opportunities for people thinking of investing, moving a business or starting a new enterprise.

Northern Territory Business (NT) https://business.nt.gov.au This site includes information on many areas of business, including business and skilled migration, business development, business regulation, skills development, working with government and much more. This website offers links to an alphabetical list of topics relating to doing business in the NT. Queensland Business and Industry (QLD) www.business.qld.gov.au

South Australia Business, Industry and Trade (SA) www.sa.gov.au This website provides information on business laws, primary industries and running a business.

South Australia Business www.sa.gov.au/topics/business-and-trade

This website promotes South Australia’s economic development, investment opportunities and business migration and is a one-stop gateway to the services supporting business and investment growth in South Australia.

Tasmania Business and economy (TAS) www.service.tas.gov.au This website provides information for businesses and industry in Tasmania.

Victoria Business & Industry (VIC) www.vic.gov.au Managed by the Victorian Government, this website provides information and resources on permits, building inspections and regulations, consumer protection, business directories, small business affairs, import and export controls, including customs and quarantine, general industry information, electricity, gas and water.

Business Victoria www.business.vic.gov.au Business Victoria is a comprehensive online resource designed to help you start, run and grow your business.

Western Australia Business (WA) www.smallbusiness.wa.gov.au Managed by the WA Government, this website offers access to information and services for business. It has links to a range of topics, including WA trade and export, investing in WA, selling to government, business awards and grants, business and the law, training and workplace safety. It also has business links for business opportunities, business services and support, statistics and publications.

This site provides information about investment, primary industries and business in Queensland.

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Seeking Work as a Locum or Associate In the first instance, new graduates should consider seeking work at an established practice. This will help you to consolidate your clinical skills and gain further experience, particularly relating to general practice management. It also allows you to earn an income, while perhaps preparing to start your own practice, without the burden of additional business management concerns.

the work, you are an employee and should be engaged

In seeking a position, you are in effect marketing yourself. The preparation of a resume or advertising on Osteopathy Australia’s website may prove useful.

GST and Locums/ Associates

It is good business practice to use a formal written contract for locum and associate positions. This helps to manage both parties’ expectations so that everyone is clear about the agreed terms. It also clarifies roles and responsibilities and helps to prevent disputes down the track.

Whether you become an employee or whether you remain an independent self-employed practitioner affects ultimate responsibility and taxation.

as such. The Osteopathy Australia HR Hotline is available for all members to call and discuss issues or seek advice on 1300 143 602. This service is available to employees, associates and business owners alike.

You are advised to seek further legal and accounting advice for more information.

Practitioners are strongly recommended to consult an accountant or other financial professional for advice concerning the treatment of GST with contracts between locums or associates. The following information is general and should not be considered financial or accounting advice.

If a practitioner is charging a service fee for use of treatment rooms and administration support to the locum or associate (which may be calculated as a percentage of

Most osteopathic practices operate on the basis that the locum or associate does not become an employee but remains an independent contractor despite the arrangement where the principal practitioner takes a percentage of the associate’s earnings.

patient receipts), then a tax invoice must be generated

Current law and rulings defining these relationships state that, regardless of the terms in a service agreement/ contract, it’s the actual relationship that counts. In other words, just because you and your boss say you’re a contractor doesn’t mean you’re not an employee in the eyes of the law (and in the eyes of both WorkCover and the ATO).

If the associate or the locum is charging the practitioner

Various considerations may point to an obligation of the proprietor to nevertheless deduct tax, pay superannuation, WorkCover fees, holiday pay, etc.

has a Guide for Small Business available at

Generally, if you work regular hours (no matter how many or how few) at a regular location, take directions from a clinic director, and the clinic provides all or most of the equipment, tools and other assets required to complete

they may not have to register for GST but cannot claim

The Business of Osteopathy

as per the ATO specifications and the locum or associate must pay the GST. In turn, if the locum or associate is registered for GST, they may claim back the GST as an input tax credit. for providing osteopathic consulting services for patients (this may be calculated as a percentage of patient receipts), then a tax invoice must be generated as per the ATO specifications and the practitioner must pay the GST. In turn, if the practitioner is registered for GST they may claim back the GST as an input tax credit. The ATO www.ato.gov.au

Where the individual earns less than $75,000 per annum, input tax credits. See ATO website for further information. www.ato.gov.au. This information was correct at time of

publication.

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Business Names A business name is simply a name or title under which a person or other legal entity trades.

If the business structure you have chosen is as a sole trader, a partnership or a trust, and not as a company, you are required to register your business name in the state or territory in which you will operate. You don’t need to register a business name if you plan to conduct your business under your or your partner’s first name and surname.

If you are planning to set up your business in more than one state or territory, you need to register your business name separately in each state or territory.

Other conditions to consider • Names that are the same or similar to names that have already been registered will not be allowed • Displaying the name • The timing of registration and the commencement of its use • Notification of any changes Registration of a business name does not in itself give you any proprietary rights – only a trademark can give you that kind of protection.

Ensure you have exclusive use of your name now and in the future throughout Australia by registering a trademark.

You should be aware of this as you could be fined should there be a breach of these regulations. See more info at www. business.gov.au

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Working from Home Running a business in the same premises where you live may be feasible in practical terms and has the advantage of minimising costs such as rent, overheads and travelling expenses. Osteopathy Australia can provide further information if you are considering this option.

Visit the Osteopathy Australia website at www.osteopathy.org.au/article/running-a-clinic-from-home for more information.

Key considerations Planning and zoning law. Restraints on the business use of residential premises are imposed by planning schemes administered by local councils. You will need to check these with your local council.

Accounting and taxation. Expenses such as charges for power and telephone, and rent may be apportioned between domestic and business use.

Insurance. Insurance requirements should be re-examined. Domestic property insurance does not normally cover business equipment or losses caused by business use.

Telehealth. Please refer to telehealth information on Page 11.

Other considerations. You must consider the set up at home and the implications this has on staff or patient amenities, privacy, etc. as well as your (and your family’s) privacy and security.

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Purchasing an Existing Practice or Establishing a New Practice As with any major business purchase, due diligence of what is on offer is required plus a good knowledge of business and management. Good advice is essential. Unless you have previously run a business, it may not be wise to start your own practice immediately after graduating. Experienced practitioners have advised Osteopathy Australia that obtaining some experience in various clinics to increase both your clinical and business knowledge is a great way to learn about which models work and which models do not.

Key considerations • L ocation is a critical factor for success with any business. You must also consider personal factors such as where you will be happiest living, your desired lifestyle – rural or urban, how far you are prepared to travel etc.

• C heck whether there are competing practices in the area and consider how this may impact on demand for a new service.

• A ny special permits that may need to be acquired. You will need to check this with the local Municipal/Shire Council, particularly with reference to car parking requirements and zoning.

• Accessibility and safety, particularly for disabled or less mobile people.

• Proximity to public transport.

• O ffice space and layout and whether it is adequate for functional demands and with enough room for future expansion (i.e. reception and waiting area, size of treatment rooms, toilet facilities, storage etc.).

• L easing business premises. Before signing any business property lease, it is advisable to consult your solicitor and/or property consultant. Make sure you are fully aware of the commitment you are undertaking.

• I f money is to be borrowed, the lender will need to be satisfied that the loan will be secure. Hence, you will need to show them your business plan, complete with your estimates for start-up costs, projections, personal financial statement, security offered for the loan and information about osteopathy and your practice.

The Business of Osteopathy

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Business Structure There are several mainstream forms of business structures and it is important to be aware of the different forms of proprietorship possible. Discussion with an accountant would help you decide which business structure best suits your needs. The following comments are a brief outline of these four entities. This is general information and you should consider seeking additional professional business, accounting and tax planning advice.

Sole Trader A sole trader carries a business in their own right, as the only proprietor in their own name or under a business name. This will most likely be the choice of business for osteopaths starting in practice.

A sole trader is liable to taxation as an individual and will be required to declare the income from the business in their own personal tax return, and to pay income tax at personal tax rates and will also be liable to pay provisional tax.

The sole trader owns the assets and is responsible for the liabilities of the business. Liability is unlimited and will extend to the total personal assets including their share of those assets jointly owned with another person.

Partnership A partnership is formed when two or more people go into business. It is regulated by the Partnership Act and the agreement between the partners. This agreement should be in writing and prepared on the advice of a solicitor.

The advantages are the sharing of expenses and responsibilities. However, there is unlimited liability of all the partners for the debts of the business, meaning if one partner cannot pay, the other partner may need to cover all expenses. Hence, a partnership should only be considered where there is a high degree of loyalty,

The Business of Osteopathy

competence and complete understanding between the partners.

A partnership is required to lodge an income tax return.

The partners are liable individually for personal income tax on their share of the profits and would individually be subject to provisional tax.

Company A business may be conducted as a company by incorporation under corporate law. A company has shareholders who are the owners and directors and who run the company. The shareholders may also be directors.

The liability of the shareholders is limited to their shares in the company. The decision to form a company is usually made when a practice is earning a sufficiently high income to gain a taxation advantage by incorporation.

This would also justify the legal and accounting fees, and the establishment costs.

Trading Trust It is beyond the scope of this Guide to describe trading trusts in detail. It has been included for the sake of completeness. An accountant should be consulted for further information and can explain the benefits and risks of such a model.

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Clinical Record Keeping You must follow the OBA’s guidelines on clinical records: www.osteopathyboard.gov.au/codes-guidelines.aspx

Osteopathy Australia has a range of resources to help you as well. These are available at www.osteopathy.org.au/article/clinical-records-and-the-privacy-

Professional Indemnity Insurance Cover It is essential you have adequate insurance and that you notify your insurance company immediately if there is a potential problem. Guild Insurance can also assist you if the OBA investigates any complaints against an osteopath.

act

Informed Consent

You need to protect yourself by keeping accurate, understandable and legible records: good records mean good defence. If an osteopath receives a subpoena, it may require not just your presence in court but that you also produce the patient’s clinical records. These records need to be both accurate and unaltered.

Remember that a written consent form does not necessarily equate to informed consent. The use of written consent forms may be useful to guide the osteopath and patient through some basic concepts through the use of standard statements, but informed consent should be viewed as a dynamic and ongoing process which is highly dependent on the quality of communication between both parties on each occasion where injuries and/or treatment varies.

Apart from the more standard type of information in the patient’s record such as name, age, address and occupation, you must record specific health history.

Clinical records must contain sufficient detail to enable another practitioner to take over the care of the patient if necessary.

Written consent cannot be relied on in the absence of continual consent that is related to the particulars of that patient. Thus, general statements in the consent form cannot cover all aspects of examination and treatment.

The OBA’s clinical record guidelines apply to all osteopaths and any personnel working under their supervision in the practice of osteopathy. These guidelines address how osteopaths should maintain clinical records (including e-health records) related to their practice.

You should feel free to obtain written information from your patients, and you can request they sign to agree to clinic policies (e.g. cancellation/lateness policy), but this is not a substitute for informed consent.

The guidelines outline the minimum requirements for clinical records, whether in paper or electronic form.

www.osteopathyboard.gov.au/codes-guidelines.aspx

If you receive a complaint, the OBA will request a copy of your notes and judge them against these guidelines.

You must also keep business, financial and tax records.

Privacy The Privacy Act and National Privacy Guidelines must also be adhered to. Please refer to www.oaic.gov.au for more information.

Visit the Osteopathy Australia website at www.osteopathy. org.au/article/private-practice-privacy-guide for more information.

The Business of Osteopathy

The OBA’s osteopathy guidelines for informed consent are available at Additional articles about informed consent are also available on the Guild Insurance RiskHQ website at https://riskhq.guildinsurance.com.au

Know the Health Practitioner Regulation National Law You should familiarise yourself with the Health Practitioner Regulation National Law and read all standards, codes, and guidelines, and newsletters published by the OBA. These documents change from time to time. It is your responsibility to practice in accordance with the versions in force.

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Best wishes for your future as an osteopath!

This Graduate Guide is published by Osteopathy Australia to provide information to members. It is designed to guide and support new graduates through your important first steps in your career as an osteopath, and we wish you every success in this growing profession.

Graduating soon?

Click here for your FREE Graduate membership!

Ends 31 December 2022

Advocacy • Advice • Support • Education

We’ve got your back

Osteopathy Australia is not responsible for statements made by any contributor. Unless otherwise stated, material published in this Graduate Guide does not reflect the attitude or official position of Osteopathy Australia, nor does inclusion of advertisements imply recommendation by Osteopathy Australia for the advertised products or services.

The information in this Guide is not intended to be individual legal, business or financial advice. Osteopathy Australia strongly recommends seeking the advice of an appropriate specialist professional.

The Business of Osteopathy

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