This is not legal, financial, tax or clinical advice. Opening a specialist clinic touches company law, Medicare, state regulation, tax, superannuation, workplace relations, insurance, lease, clinical records and your professional college’s requirements — each with its own professional advisor. The checklist below is a starting point to brief your solicitor, accountant, MDO and college.

Start here

What’s different from a GP practice

Most of the operational and compliance scaffolding is the same — staff, incidents, equipment, policies, bills, key dates, insurance. A specialist clinic differs in six specific places:

College, not RACGP. Your professional college (RACP, RACS, RANZCO, RANZCR, RANZCP, RCPA, ACD, ANZCA, ADA, etc.) governs CPD, Fellowship and training requirements — not RACGP.
Accreditation body differs. If you offer day-procedure services, NSQHS Standards (ACSQHC) + state day-procedure licensing apply. Consulting-only specialist rooms are not under the NGPA/RACGP scheme at all.
Medicare items & patient pathway. You bill specialist attendance item numbers (not GP item 23); patients come via a GP referral; MyMedicare does not apply.
Financial model. Typically fee-for-service with higher consult fees, rarely bulk-billed; service-fee arrangements with the trading entity are standard.
Indemnity premium tier is higher. Specialist professional indemnity costs more and is procedure-tier-weighted (interventional cardiology, surgery, obstetrics are top tiers).
Equipment is discipline-specific. ECG / Holter / echo (cardiology), slit-lamp / phoropter (ophthalmology), dermatoscopes / excision kits (dermatology), scopes / sedation (gastroenterology) — and the service, calibration and consumables for each.

Everything else — staff compliance, infection control, incidents, workplace health & safety, privacy, patient-records custodianship, software subscriptions — works the same as any clinic. The checklist below focuses on the specialist-specific pieces first and then runs the shared operational items.

Section 1

Business entity & tax

Choose and register the trading entity (company, trust, service entity, or sole trader) — accountant drives this.
ASIC filings for directorship / shareholder structure.
Register for ABN via ABR; GST (if above threshold or voluntarily); PAYG withholding.
State payroll tax — specialist clinics typically fall outside the GP-specific concessions announced in several states. Register and model the exposure under the standard “relevant contracts” rules in your state. See the agreements guide (payroll-tax section) — the GP concessions there generally do not apply to specialists.
Trading bank account, merchant facilities (eftpos / Tyro / Hicaps for allied).
Accounting software set up (Xero or similar) and your accountant has access.

vs GP: payroll-tax concessions (QLD GP exemption, NSW GP rebate, VIC partial exemption, SA bulk-billed exemption, ACT exemption) are GP-specific and generally do not cover specialists. Model exposure under standard rules.

Section 2

Premises & fit-out

Lease signed — location, car parking, accessibility (DDA compliance), consulting rooms, treatment / procedure room(s) if applicable.
Fit-out meets state health department requirements for the services provided (day procedure rooms have specific plumbing, ventilation, resus and recovery space requirements).
Local council approvals (use permits, parking, signage).
Hand-wash basins, PPE storage, sharps bins, waste streams (clinical / cytotoxic / general) set up.
IT infrastructure — secure network, encrypted backups, VPN for teleconferencing with the hospital, imaging viewer workstations if radiology-heavy.
Phone system, patient portal / booking integration, SMS reminders.

Section 3

Medicare, DVA & patient pathway

Each specialist’s Medicare provider number for this location (apply via Services Australia / HPOS) — the number is specialty + location specific.
PRODA / HPOS / online claiming (ECLIPSE for in-hospital claims) set up for each practitioner.
Confirm the MBS specialist attendance items you’ll bill (initial consult, subsequent, prolonged, Telehealth, procedure items) and your fee schedule.
Referral workflow — GPs refer in; letters back to GP must go within 48 hrs by professional standards. Set up a secure messaging channel (HealthLink, Argus, Medical Objects, or secure email).
Prescriber details — PBS prescriber number, S4 / S8 authority to prescribe, script pads (or e-scripts via your PMS).
DVA provider arrangements, WorkCover authorisation (jurisdiction-dependent).
My Health Record / HI Service (HPI-I and practice HPI-O) — set up access for discharge summaries and referral letters.

vs GP: MyMedicare registered-practice status does not apply to specialists. GP-centric items (23, 36, 44, 721, 723) are not relevant; use the specialist attendance item range. Referral management (incoming + outgoing letters) is a core workflow that doesn’t really exist in GP work.

Section 4

College, accreditation & CPD

Each practitioner’s AHPRA registration lists the clinic as a principal place of practice.
Fellowship / specialist registration confirmed with the relevant college: RACP, RACS, RANZCO, RANZCR, RANZCP, RCPA, ACD, ANZCA, ADA, APS, etc.
CPD plan recorded with the college (annual requirements vary by college).
If offering day procedures: NSQHS Standards (ACSQHC) compliance + state day-procedure licensing + accreditation agreement with QPA / AGPAL day-procedure track or equivalent.
If consulting-only: no RACGP-equivalent accreditation applies — your college’s standards and NSQHS Partnering with Consumers / Clinical Governance remain the reference points.
MDO notified of practice location + scope + procedure list. Indemnity tier confirmed in writing.

vs GP: no RACGP Standards for General Practices. If you offer day procedures, NSQHS + state day-procedure rules fill that role. If you’re consulting-only, you’re governed by your college and the generic ACSQHC standards for the areas that apply (open disclosure, incident management, infection control).

Section 5

People — specialists, registrars, nurses & admin

Specialist(s) — service agreements drafted (fee-for-service, service-fee percentage, or trust-based). Agreements guide.
Specialist registrar if hosting a trainee — college term plan, NTCER contract where applicable, supervisor assigned, rotation registered with the college.
Clinical staff (practice nurse, cardiac technician, sonographer, orthoptist, dermatology nurse — discipline-specific) with appropriate AHPRA / qualification registration.
Reception / practice manager — employment contracts, induction, system logins.
Immunisation records & TB screening for clinical staff (per national guidelines).
WHS induction, incident reporting training, infection-control training.

Section 6

Insurance & vendors

Professional indemnity — MDO cover at the right tier for each specialist (procedural specialties are top tier; cardiology interventional is tier 4+; dermatology ex-skin-cancer is tier 2–3).
Public liability (minimum $20M typical).
Building / contents / business interruption.
Management liability (D&O cover for the trading entity).
Workers’ compensation under the state scheme.
Cyber liability (recommended; patient-data breach exposure).
Software subscriptions: PMS (BP / MD / Genie / Zedmed), online booking (HotDoc / HealthEngine), accounting (Xero), SMS, imaging viewer, secure messaging — each registered in the entity’s name.

vs GP: specialist indemnity premiums are materially higher. Confirm the tier in writing with your MDO before signing a service agreement with a specialist — it affects the service-fee economics.

Section 7

Equipment, procedures & consumables

Resus trolley + AED — universal. Weekly checks, drug expiries recorded.
Discipline-specific major equipment:
- Cardiology: ECG machine, Holter monitor fleet, echo machine (stress / resting), BP cuff fleet, treadmill if stress testing.
- Dermatology: dermatoscopes, cryo (liquid N₂), excision setup, suture kits, phototherapy if provided.
- Gastroenterology: endoscopes, reprocessor, sedation setup, endoscopy suite kit (if day-procedure).
- Orthopaedics / sports medicine: ultrasound, injection setup, cast / splint supplies, X-ray referral workflow.
- Ophthalmology: slit lamp, phoropter, auto-refractor, OCT, visual-field machine, tonometer.
- ENT: endoscopes (nasal / laryngeal), audiometer, impedance / microscope.
Each piece on an equipment register with calibration / service schedule and expected service interval.
Autoclave / reprocessor validated (biological indicators + Bowie-Dick as applicable) — if sterilising reusable instruments on site.
Clinical stock levels: emergency medications (adrenaline, hydrocortisone, O₂), discipline-specific consumables.
Waste contracts: clinical / sharps / cytotoxic streams (as applicable).

Section 8

Policies, SOPs & records

Infection prevention & control policy (RACGP IPC guidelines + AS 5369:2023 for reprocessing — applies to any clinic that reprocesses).
Emergency & resuscitation policy; CPR currency for all clinical team members at least every 3 years.
Medication / S8 register (if prescribing or holding controlled drugs).
Incident reporting & open disclosure policy (NSQHS Standard 1).
Privacy policy (Privacy Act 1988 + APPs); patient-records retention plan.
Patient identification policy (3 identifiers; applies to specialist practice too).
Consent policy — specialist consent is often written for procedures.
Complaints & feedback policy; escalation to state health complaints commissioner.
Business continuity / cyber-incident response plan.

The RACGP policy templates in clinic-admin are GP-flavoured but much of the content (IPC, open disclosure, incident reporting, privacy) is RACGP wording of universal NSQHS obligations — usable with specialist edits. A dedicated specialist template library is on the roadmap; for now, treat GP templates as a starting point to adapt for your specialty.

Section 9

How clinic-admin fits for specialists

clinic-admin recognises specialist clinics (set the Practice type to Specialist in Settings) and adjusts accordingly:

What’s hidden on specialist clinics: Policy Library (RACGP templates), Accreditation Readiness (RACGP-specific), Vaccine Orders (GP vaccine-ordering workflow), Knowledge Hub (GP KH). The sidebar removes these to reduce noise.
What stays, works the same: Staff + Compliance (CPR, AHPRA, Indemnity, Agreement review dates), Equipment Register, Incidents, Actions, Complaints, Bills, Key Dates, Clinical Stock, Consumables, Fridge Logs (hide via feature flag if you don’t hold vaccines), Sterilisation Logs (relevant if you reprocess), Cleaning Logs, Risk Register, Roster, Staff Attendance, Monthly Review.
Create the clinic as usual; after signup, open Settings and change Practice type from GP to Specialist. The sidebar re-renders.
Add your specialist equipment list in Equipment Register with calibration / service dates.
Add your college / Fellowship renewal dates, PI renewal, lease anniversaries and other annual items into Key Dates — they’ll surface on the Overview and in weekly reminders.
Load each specialist as a staff member and complete their Compliance (CPR, AHPRA, Indemnity, Agreement) — same as any clinic.

Section 10

Official sources

AHPRA — practitioner registration
Your college: RACP (physicians & paediatrics), RACS (surgery), RANZCO (ophthalmology), RANZCR (radiology / radiation oncology), RANZCP (psychiatry), RCPA (pathology), ACD (dermatology), ANZCA (anaesthesia)
Services Australia — Health professionals (Medicare, HPOS, provider numbers, ECLIPSE)
ACSQHC — NSQHS Standards (day-procedure accreditation, open disclosure, Standard 3 IPC)
ASIC, ABR, ATO (business registration, GST, PAYG)
Your state revenue office for payroll tax (the GP-specific concessions do not generally apply to specialists)
A health-law solicitor, a practice-experienced accountant, and your MDO — essential for the business setup, service-fee structure and indemnity tier

Related guides

🏥 Opening a GP clinic

The GP-focused companion to this guide.

📝 Staff & doctor agreements

What contracts should cover. The payroll-tax section below is GP-specific — specialists check standard rules.

🤝 Transferring practice ownership

For when the clinic later changes hands.

Opening a specialist clinic? clinic-admin carries the operational side from day one.

Set the Practice type to Specialist in Settings and the GP-only noise (RACGP accreditation, vaccine orders, Knowledge Hub) steps aside. Everything you actually need day-to-day stays.

Compliance in one place

CPR, AHPRA, indemnity (specialist tier aware), agreement review dates — one tracked list with expiry alerts.

Equipment register

Specialist equipment (ECG / echo / dermatoscope / scope / slit lamp) with service dates and overdue alerts.

Operations in one place

Incidents, actions, bills, key dates, complaints, risk, roster, staff attendance — applies to any clinic.

Specialist demo available

Try a demo clinic pre-flavoured for cardiology / orthopaedics / gastroenterology before signing up.

Start 14-day free trial → Try the specialist demo

A$49 per clinic/month · 14-day free trial, card required · cancel any time · or email info@clinic-admin.com

Opening a specialist clinic in Australia