Orthopaedic Practices: Structures, Consent and the Business of Specialist Care

Registration, advertising and professional standards

Orthopaedic surgeons are registered under the Health Practitioner Regulation National Law and regulated by the Medical Board of Australia through Ahpra, with credentialling by the Royal Australasian College of Surgeons. Advertising restrictions under the National Law and Board guidelines apply strictly — including on testimonials and claims of expertise.

Practice structure and associate arrangements

Specialist practices commonly use combinations of service trusts, service companies and partnerships. The interaction between the service entity, individual practitioners and any group structure needs to reflect the personal services income rules under the Income Tax Assessment Act 1997 (Cth) and the ATO's positions on medical services arrangements, as well as state payroll tax rulings that have re-shaped how contractor arrangements in medical practices are viewed.

Consent, informed financial consent and no gap

Beyond clinical consent, informed financial consent — clear disclosure of fees, gaps and rebates — is central to modern specialist practice, particularly in privately insured surgery. Miscommunication on out-of-pocket costs is a recurring source of complaint and dispute.

Hospital rights of practice, devices and conflicts

Rights of practice at private hospitals, day surgeries and public appointments each carry contractual and regulatory obligations. Relationships with implant and device suppliers require careful management to avoid conflicts of interest issues under the Medical Board's Code of Conduct and Medicines Australia / Medical Technology Association codes.

Privacy, records and medico-legal responses

Patient information is sensitive health information under the Privacy Act 1988 (Cth) and state health records legislation. Practices should have documented processes for subpoenas, coronial requests, medico-legal reports and open disclosure conversations. Professional indemnity insurance is central but is not a substitute for good documentation.

Practical steps you may wish to consider

• Review practice structure in light of PSI rules and current state payroll tax rulings
• Formalise informed financial consent processes for private surgery
• Audit relationships with device and implant suppliers against conflict-of-interest codes
• Standardise processes for subpoenas, medico-legal reports and open disclosure
• Align advertising and website content with the National Law and Board guidelines

This article contains general information only and does not constitute legal advice. Envision Legal accepts no liability for any loss arising from reliance on this content. You should seek independent legal advice tailored to your specific circumstances. For enquiries, contact Envision Legal.