How to Start a Private Practice in South Africa
Why should you start a practice?
Starting a private practice in South Africa can be an exciting and rewarding endeavor for healthcare professionals, therapists, counselors, and other professionals in various fields. Whether you're a medical doctor, psychologist, social worker, or any other practitioner, running your own private practice allows you to have greater control over your career, provide specialized services, and build a strong connection with your patients or clients. However, starting a private practice involves careful planning, dedication, and a thorough understanding of the South African healthcare landscape. In this guide, we'll walk you through the essential steps to start a successful private practice in South Africa.
Before you see your first client:
1) Establish a vision for your private practice:
Do you know where you are going? You cannot make a plan without knowing the desired result. It is important to think about why you are going in to private practice, and what kind of practice you want to have.
The vision you have for your practice will guide you in making decisions in your practice from a legal, financial, operational and human resources perspective.
2) Put together a rough business plan:
Be honest, you freaked out a little and the words ‘business plan’ am I right?
Don’t stress 🤗
Your business plan need not be a scary undertaking. It should be a living working document that evolves over time. So it doesn’t have to be this big scary formal document that the banks need to give you a business loan. As you work through this list, you will have all the most pertinent info you need for your first draft business plan. It is simply a document that outlines where you are going and how you plan to get there.
In fact, I even have a nifty template you can use to plug in all the relevant information, and hey presto! you have a business plan. You can download it for free here >>
3) Be properly licensed
You MUST have up to date registration with the HPCSA as an independent practitioner to treat patients privately. If you are registered with the AHPCSA or the regulatory authority for social work or nursing, please also consult your relevant body for licensing requirements to practice in your private capacity.
4) Name your practice
This is a very topical issue because, whilst the HPCSA has very clear rules with regards to the naming of practices, they have not been regulating this and so many new practices have been breaking the rules in this regard. The more practices do so the more it becomes the norm. However the HPCSA has made it very clear that the only reason there has not been consequences is because they have not
had the capacity to regulate this, but that they are working towards changing that.
To find out more information about the naming of practices, visit the HPCSA website and download the latest ethics booklet wherein booklet 2 you will find the rules. I also have a video on the topic of naming your practice on YouTube which you can find here >>
5) Decide which business entity you will practice as:
As an HPCSA registered health care professional, you may only operate as a sole proprietor, a private company (Incorporated), a partnership, or an association. This is one of the decisions that will be informed by the vision you have for your practice.
Here is a handy video to help you make this decision:
Tax and Financial Planning for a New South African Private Practice
In order to operate as a private company you will have to register with Companies and Intellectual Properties Commission (CIPC).
6) Open up a business bank account:
As a sole proprietor you don’t have to have a business bank account from the outset because you and your business are one entity, however I strongly advise that you still get a separate bank account to receive revenue and pay expenses from for your practice. As your practice grows you are going to want to switch to business banking so it might be better to get setup this way from the outset to avoid the hassles of switching accounts down the line.
7) Get a practice number:
In order for you or your clients to claim from medical aid, you will need to be registered with the Board of Healthcare Funders (BHF) through the Practice Code Numbering System (PCNS). Even if you plan to be a cash-based practice, your clients may want to claim from their medical aids so it is best to have one. To register you need to download the relevant form the PCNS website and follow the instructions therein.
8) Get Insurance:
It is in your best interest to have malpractice insurance in place before you take on any clients. And if you will be seeing clients at your practice rooms, it is also advisable to have public liability insurance. There are a number of companies that specialize in medical insurance, but you can also find out if your professional association has partnerships with any providers that provide preferential rates.
9) Decide your rates:
Before you see a client, you need to be clear on what your rates are and how you will accept remuneration. You can choose to be a cash practice, meaning the client pays cash up front and claims from their medical aid themselves; or you can choose to claim from your client’s medical aid on their behalf. You also need to decide if you will be charging medical aid rates according to each client’s medical aid scheme, or if you will be charging the rate of one specific medical aid scheme, or if you will set your own private rates.
Check out this video that explains how you can decide what your rates should be to ensure your practice is profitable.
10) Familiarize yourself with the billing codes of your profession:
In order to invoice your client, you will need to know which codes to use. This will vary from profession to profession and this information is usually available from your professional Association. You will also find a list of billing codes on the medical scheme’s rates list for your specific profession.
11) Decide where and when you will see your clients:
Finding a practice location will depend on your budget and runway when starting, and whether you will be offering telehealth or not.
When you are just starting out and do not yet have an established client base, you might want to consider initially renting sessional space and only settle on a full time lease when you have consistent income coming in. If you are offering telehealth you will need to
research platforms that are covered by your malpractice insurance, and are POPI compliant. Aside from the technology, you will also need to decide where you will offer telehealth sessions from in order to ensure confidentiality in your sessions.
Opening a practice from your home is also an option, but there are important considerations you need to be aware of which I will cover in a separate article.
You also need to decide on your availability so that when clients enquire you are able to book them accordingly and plan in time to work ON your practice as well. When working with private practice owners 1:1 I provide spreadsheets coaching that helps them work out their maximum capacity and based on that plus your rates what you expected maximum practice revenue will be. If you would like to book a 1:1 consult, you are welcome to book a session here >>
12) Get a practice phone number:
It is advisable to keep your personal number and your practice number separate. This doesn’t mean you have to invest in a brand new smart phone. If you have a dual sim phone you can easily put a new sim card in that phone. If you don’t have a dual sim phone and plan to use this number for calls and text messages only, you could even get yourself
a basic feature phone. The advantage of this is that you can leave this phone at your practice rooms or turn it off outside practice hours in order to set boundaries.
13) Set up a practice email address:
Ideally you want to have a domain email to look more professional, but it is absolutely not essential to get started. However do not use your personal email address to communicate with clients and also keep client communication separate from general practice email. Using a free email service like Gmail will suffice to get you started. If you do want to set up a domain email, I recommend using Hostking. I currently have multiple domains and other hosting services with them and their customer support is alway sexcellent.
14) Have the necessary paperwork:
The 2 most important forms every practice MUST have when onboarding a new client is:
- Informed financial consent, and
- Informed clinical consent
- If you offer telehealth services then you MUST also have informed consent relating to Telehealth. You cannot treat a client without these signed by the patient or patient guardian. You can create these forms yourself by looking at the forms from other practices and simply tailoring it to your own practice, or you can purchase legally constructed templates from Elsabe Klinck and Associates here >>
Nice to have from the start, but not essential. You can start seeing patients before this:
15) Join your professional association and/or special interest groups:
Your professional association is there to represent your interests and is a great source of support and connection to your profession.
16) Decide on a practice management software or billing administrator
A billing administrator is a 3rd party service that you outsource your billing, medical aid claims and follow up, and sometimes also basic bookkeeping functions to. This is a great alternative to employing a practice manager and can save you tons of time and admin compared to doing it yourself. Of course when you are just starting out and don’t have many clients then doing it yourself means you save on the administrator fees. However as your client load increases and you spend more time in client contact, you may want to consider the additional help. Of course an alternative to outsourcing this function is to invest in good practice management software. This will enable you to continue fulfilling this function yourself, only more efficiently. This is also an option you can consider only once you are in the position to employ a practice manager in-house as this person would then use the practice management software in
the practice. You will have to weigh up the options and make the decision that is best for you.
17) Get a card payments processor:
Even if you are planning claim from medical aids, there may be clients who opt to pay out of pocket or who do not have medical aid. In these instances it is best for your practice cash flow to accept payment immediately after the treatment session. Not having card payment facilities can turn potential clients away to avoid the inconvenience of having to draw cash before coming for their appointment. However, this is by no means essential when you are just starting out. Modern day banking means it is quick and easy for clients to make payment via EFT so you do always have the option to invoice the client and wait
for them to settle their account electronically. You will need to weigh up the cost of having and processing payments with a payment device versus the cost impact on your practice cash flow if clients are tardy on making payments electronically.
18) Get an accountant:
If you use a medical billing administrator you could find someone who also provides basic bookkeeping. The level of service you require also depends on your business structure and complexity. As a sole proprietor you could easily do your own accounting or outsource the tax functions once per year to an accountant. However if you register as a partnership, an association or a private company it is important that you comply with all the CIPC financial requirements and tax can get complicated. As your practice grows you may want to consider outsourcing your accounting to a credible accountant who has experience with healthcare practices and is therefore knowledgeable about the requirements that are unique to us compared to other businesses.
19) Create a Google My Business page:
Most people turn to Google first when looking for a healthcare provider. Google My Business is free and helps you get found by the people looking for your services. You can find a video tutorial showing you how to set up a Google My Business page for your practice linked below as well.
20) Start networking and reaching out to potential referrers:
Doctors, complimentary healthcare service providers and even community and non profit organizations who serve your ideal clients are all potential sources of referral. Reach out and make your services known and ask them to consider referring to you.
21) Register a domain:
Even if you are not ready for a website, you can still register a domain for a small annual fee. You can also upgrade your domain package to include email hosting which will enable you to have a domain email without having a website. My preferred domain and hosting providers are: Hostking, Xneelo and Afrihost.
21) Build a website:
Having a website adds to your credibility and enables you to show up professionally online. You are also able to add contact and booking functionality to your site to make it easy for your prospective clients to book an appointment with you. However, it is better to have no website at all than to have a poorly designed website that is not kept up to date and maintained. There are many website builders you can use to easily create your own beautiful website but only go this route if you are willing to take the time to learn how to do this. If you are planning to pay someone to build you a website, rather save up and pay for a professional and experienced service provider with a good portfolio of work and experience in building medical websites than choosing someone based on price.
Start building an online presence on social media:
It is important to establish yourself online to market your practice and to build your personal professional brand. However, I want to caution you about trying to be on every social media platform under the sun. First identify who your ideal client is, figure out where they typically hang out online and focus on just 1 or 2 of those platforms. Trying to be everywhere will only leave you feeling overwhelmed and you will end up not being consistent in your social media marketing efforts. It is also important to be cognizant of the ethical guidelines set out by the HPCSA regarding the use of social media. This can be
found in booklet 16.
Get support and/or mentorship:
Starting a private practice and becoming self employed can be a lonely journey. It is important that you surround yourself with others who are on a similar journey to you. The Private Practice Growth Club free Facebook group is a great place to network, share ideas and get support from other health professionals in private practice. It is also advisable to get clinical mentoring or support. This can be a 1:1 mentor or via your private practice professional representative group or special interest groups Of course there are many more steps involved in starting and growing a private practice, but these are the bare minimum requirements to get you off to a good start. If this all sounds too overwhelming and you don’t know how you are going to get is all done, just do one thing and go from there.
Tasneem is an Occupational Therapist in private practice and the founder of the Private Practice Growth Club. She is passionate about developing the mindset and business skills of health professionals. She is a book lover, is passionate about supporting female entrepreneurship and always sees the potential of every glass to be filled.
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