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, 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.

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-privacyact

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.

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.

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.

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

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.

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.

Informed Consent

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.

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.

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 OBA’s osteopathy guidelines for informed consent are available at www.osteopathyboard.gov.au/codes-guidelines.aspx

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.