Should Contracting Doctors in Private Practice Use a Discretionary Trust or Operate as Sole Traders?
Clarke McEwan Accountants

Should Contracting Doctors in Private Practice Use a Discretionary Trust or operate as Sole Traders?
If you're a consultant doctor or surgeon working independently in your own business, you’ve probably wondered at some point whether you should operate as a sole trader or consider a more structured setup—like a Discretionary Trust with Corporate Trustee. Both have their place, but the right choice depends on what you're trying to protect, how your practice operates, and who’s helping you run it. Let’s break it down in plain English.
Why Asset Protection Matters More Than Tax Savings
As a sole trader, your personal and professional worlds are closely linked. That means if something goes wrong such as a claim, medical audit or debt problem, you could risk losing personal assets such as your home or savings. A discretionary trust can offer a layer of protection by legally separating your practice’s assets from your own. That’s why many doctors choose a discretionary trust with corporate trustee, not necessarily to reduce tax, but to shield themselves from financial fallout if things go wrong. The more hurdles someone has to go through to get to your assets, the more expensive it becomes to take legal action. It’s never a bullet proof solution but goes some way to making it a lot harder for external parties to get at your hard-earned assets.
What About Employing Your Spouse?
If you have someone helping you in your practice—say, your spouse handles bookings, compliance, admin, or billings, there’s absolutely nothing wrong with paying them for that work. But the payment must be commercially reasonable. They need to be doing real work, be paid commercial market rates, and their role should be documented with contracts, timesheets, and clear responsibilities. Non-commercial payments or poorly documented work can trigger ATO scrutiny.
Why Income Splitting Isn’t Always an Option
Discretionary trusts are often associated with tax flexibility, mainly because they can distribute profits across beneficiaries. But if you're earning personal exertion income, tax law prevents using a trust to split income with family members. Exceptions include multi-doctor practices, businesses with staff and infrastructure creating income such as with pathology and radiology practices, or personal services businesses with genuine business structures where the principal income is not earned by the Sole Practitioner alone.
Are there sometimes other considerations?
Absolutely, as everyone’s circumstances are different. It’s important to seek professional advice tailored to your specific situation. With increased focus from State Governments on areas such as payroll tax in larger medical practices, and depending on the size of the practice, specialist doctors engaged as contractors are often required to operate as sole traders rather than through a corporate trust structure as corporate contracting entities can be treated differently to sole traders when it comes to being included or not for payroll tax purposes. It’s also important to note that payroll tax exemptions for contractors generally apply only to GP practices, not to specialist medical or allied health clinics. If you’d like tailored advice in this area, please contact our office to discuss your situation.
So, What’s the Takeaway?
If you're working alone as a consultant or surgeon, discretionary trusts can help with asset protection and planning, but it is not a tax solution for Personal Services Income and the eventual taxing of this income to the practitioner. Paying a spouse must be tied to real, separate work not already provided under medical centre service agreements or facilities type agreements. The best approach is to seek a specialist medical accountant to determine the structure that best suits your practice and protects your assets.
About Clarke McEwan Chartered Accountants
Clarke McEwan is a specialist medical accounting firm with extensive experience supporting doctors in private practice. John Clarke, the firm’s Principal, is recognised as an expert in medical practice structuring and tax compliance matters, providing tailored, practical guidance to help protect assets and support long-term success for you and your family.
For a confidential no-obligation meeting to discuss your circumstances and how we can assist please book a time to meet with us at this link Book Initial No Obligation Consultation at Clarke McEwan







