Running your practice like a business Practice assessment Deon Bührs

Practice assessment Practice structure Registrations Agreements and Contracts Financial affairs HR affairs Policies and procedures Defining success

Practice structure Some examples…

HPCSA As a business owner / practitioner in the healthcare environment, we are not allowed to hide behind the “Corporate Veil” We are also not able to have a corporate ownership or corporate involvement in our practices You can outsource your administration, or establish a company to manage your administration – we are liable for the company’s violations of HPCSA rules, should these occur

Companies Act As a business owner in South Africa, we are able to register a business in one of the following forms: Private Company – Pty(Ltd) Personal Liability Company – Inc. Public Company – Ltd AUDIT Non Profit Company – NPC State Owned Company – SOC AUDIT

Companies Act Audit requirements: Determined by its Public Interest Score as follows : One point for each employee (you must take the average number of employees you had during the financial year) One point for each R1 million or part thereof of turnover One point for every R1 million of third party liabilities or part thereof One point for every shareholder

Companies Act If >350 then the Act requires an audit be done If and your financials are prepared by your staff, an audit is required if the financials are prepared by an independent party then an independent review needs to be completed (must be done by a CA(SA)). If <100 points an independent review still needs to be done, but in this case an independent review can be done by a person entitled to sign Close Corporation financial statements.

Companies Act Audit requirements: The exception to the above rules is that, where the company's shareholders are all directors, no independent review is required.

Companies Act But aren't there others? Sole Proprietor – Solo Practitioner Partnerships Associations Close corporations As of 1 May 2011 no longer available Can convert If you already have one, can remain

Scenarios Let’s look at some scenario’s regarding business structures: Practice vs. Business Admin company Shareholding Outsourcing Branches, or second practices Franchises

Registrations HPCSA – Registration number BHF – PCNS Billing number SARS– Tax number – PAYE number – SDL number – UIF number – VAT number DoL – Return of earnings – COIDA cover CIPC– Incorporate company SARS SARS eFiling

Agreements & Contracts Employment contracts Lease agreements & naming rights Sublease agreements Referral agreements Network agreements – DSP’s Outsource agreements Billing and collection services Debt collection agreement NHI and ARM agreements

Financial affairs Management reports Monthly books of accounts Awareness of thresholds SARS compliance & Agent of SARS Tax clearance certificate / statement of accounts Practice valuation Financial policy – reserve funds Good debt vs bad debt Defining financial success

Human resource affairs Employment contracts Job descriptions Awareness of the BCEA requirements CCMA encounters? Staff development CPD activities Team building

Policies and procedures Disciplinary Disciplinary code Grievance Leave Patient confidentiality To dismiss an employee Poor performance Misconduct

Defining success Your thoughts… Patient outcome Development of your profession Financial Life style Reputation Legacy

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