Master Independent Contractor Agreement or Separate Agreements? What Multidisciplinary Clinics in Ontario Need
Updated: Sep 20
A multidisciplinary clinic may work with psychotherapists, social workers, nurse practitioners, peer support workers and other healthcare professionals. Although these practitioners may provide services under the same clinic brand, their professional responsibilities and relationships with the clinic may be very different.
This creates an important question for clinic owners:
Should the clinic use a separate independent contractor agreement for every practitioner, or one master agreement with a profession specific schedule for each role?
There is no single structure that is appropriate for every clinic. The right approach depends on the services offered, the professionals working with the clinic, the clinic’s payment arrangements and the way client services are delivered.
The agreement structure should provide consistency across the clinic while recognizing the differences between professional roles.
Why Multidisciplinary Clinic Agreements Require Careful Planning
Clinic owners sometimes begin with one independent contractor agreement and use it for every practitioner.
This may appear efficient. However, simply changing the practitioner’s name and professional title may leave important issues unaddressed.
For example, a psychotherapist, social worker, nurse practitioner and peer support worker may have different:
Services and responsibilities
Registration and professional requirements
Documentation obligations
Compensation arrangements
Insurance requirements
Client record responsibilities
Professional boundaries
Communication obligations
Supervision requirements
Procedures for ending the relationship
The differences become particularly important when a clinic works with both regulated professionals and unregulated service providers.
A regulated practitioner may be subject to professional standards established by a regulatory college. An unregulated service provider may not be subject to the same regulatory framework, but the clinic may still need to establish clear qualifications, boundaries, confidentiality obligations and service expectations.
The clinic’s agreements should reflect these distinctions.
A Practical Multidisciplinary Clinic Example
Consider an online Ontario clinic that plans to work with:
A registered psychotherapist
A registered social worker
A nurse practitioner
A peer support worker
The clinic may want consistent terms governing confidentiality, use of its technology, invoicing, insurance, termination and client communications.
However, the services performed by each practitioner are not interchangeable.
The nurse practitioner may have different clinical, insurance and record requirements from the psychotherapist. The social worker may be subject to different professional standards. The peer support worker may require clearly defined boundaries concerning the nature of the services being provided and how those services are described to clients.
Using completely unrelated agreements for each person may create inconsistencies.
Using one generic agreement without role specific provisions may fail to address meaningful differences.
A master agreement with separate role schedules may provide a practical structure for this type of clinic.
Option One: A Master Independent Contractor Agreement With Role Schedules
A master independent contractor agreement contains the general contractual terms that apply across the clinic’s contractor relationships.
Depending on the clinic’s operations, the master agreement may address:
The intended contractor relationship
Payment and invoicing procedures
Confidentiality and privacy obligations
Insurance requirements
Use of clinic systems and technology
Ownership and permitted use of clinic materials
Termination rights
Communication with clients when the relationship ends
Responsibility for losses or claims
Dispute resolution
General representations and obligations
A profession specific schedule can then be attached for each practitioner role.
For example, a clinic may develop separate schedules for psychotherapists, social workers, nurse practitioners and peer support workers. Each schedule can address the services and responsibilities associated with that role.
The schedule forms part of the agreement. It allows the clinic to preserve consistent general terms while tailoring relevant provisions to the practitioner.
What Belongs in the Master Agreement?
The master agreement should generally focus on the contractual terms that the clinic intends to apply consistently.
These may include how invoices are submitted, when payments are made, how confidential information is protected, what insurance must be maintained and how either party may terminate the relationship.
The agreement may also address the use of the clinic’s name, branding, systems, forms and other business materials.
If the clinic imposes restrictions concerning client solicitation or communications after termination, those provisions should be drafted carefully. The restrictions should reflect the clinic’s legitimate business interests and the realities of the practitioner’s professional obligations.
The master agreement should not assume that every practitioner performs the same services or has the same regulatory responsibilities. Those distinctions can be addressed in the applicable role schedule or, where appropriate, through a separate agreement.
What Belongs in a Role Schedule?
A role schedule supplements the master agreement by addressing matters specific to the practitioner’s position.
Depending on the practitioner and the clinic’s operations, a schedule may address:
The services the practitioner is engaged to provide
The practitioner’s qualifications and registration requirements
The limits of the practitioner’s role
Compensation and payment calculations
Documentation and record responsibilities
Applicable professional standards
Insurance requirements
Use of clinic systems
Client scheduling and cancellation responsibilities
Communication with clients
Responsibilities when the relationship ends
A schedule for a peer support worker, for example, may need to define the scope and boundaries of peer support services clearly. A schedule for a nurse practitioner may need to address different service, documentation and professional requirements.
The appropriate terms depend on the clinic’s service model and the role being performed. A clinic should not simply reproduce one practitioner’s schedule and change the professional title.
Addressing Compensation and Administrative Fees
Compensation is frequently one of the most important sections of a clinic contractor agreement.
The agreement should clearly describe how the practitioner’s compensation is calculated and when it becomes payable. Depending on the arrangement, this may require consideration of:
The amount charged to the client
The practitioner’s compensation
Administrative or clinic fees
Cancelled appointments
Refunds or payment disputes
Taxes, where applicable
The timing of invoices and payments
Amounts outstanding when the relationship ends
Ambiguous payment terms can create disputes even when the clinic and practitioner otherwise have a positive relationship.
The compensation structure should also be considered in light of the practitioner’s professional obligations and the clinic’s actual operations. Describing a charge as an administrative fee does not resolve every regulatory or contractual issue by itself.
The agreement should accurately explain the services or resources connected to the payment structure.
Client Records and Privacy Responsibilities
Multidisciplinary clinics should also consider how client information and records are handled.
The agreement may need to address:
Where client records are stored
Who may access the records
How information may be used or disclosed
The systems practitioners are required to use
What happens to records when a practitioner leaves
How privacy incidents are reported
How requests for access or correction are handled
The contract should align with applicable privacy law and the practitioner’s professional obligations.
A contract cannot remove obligations imposed by legislation or a regulatory college.
It can, however, help clarify the parties’ operational responsibilities and establish a process for handling records and privacy matters.
This is especially important for clinics using shared electronic platforms or delivering services virtually.
Insurance and Professional Requirements
Insurance provisions should also reflect the practitioner’s role.
The clinic may require practitioners to maintain specified professional liability coverage and provide evidence of that coverage. The appropriate requirements may differ depending on the profession and services provided.
The agreement may also require a regulated professional to:
Maintain active registration
Notify the clinic of restrictions or changes affecting their ability to practise
Comply with applicable professional standards
Maintain required insurance
Provide services within their permitted scope
Unregulated providers may require different qualification and insurance provisions.
The clinic should ensure that the agreement accurately reflects the services they are authorized and expected to provide.
Practitioner Departures Should Be Addressed in Advance
The end of a practitioner relationship can create uncertainty if the agreement does not establish a transition process.
Questions may arise concerning:
Upcoming appointments
Client notifications
Outstanding documentation
Access to clinic systems
Client records
Unpaid accounts
Confidential information
Continued use of clinic materials
Communications with current clients
These issues are easier to manage when the agreement establishes expectations before a dispute arises.
The agreement should balance the clinic’s business interests with applicable legal and professional responsibilities. It should not assume that the clinic can restrict every form of client communication or control every record merely because the agreement says so.
Benefits of a Master Agreement Structure
A master agreement can help a clinic establish consistent expectations across its contractor relationships.
It may also make it easier to update common contractual terms when the clinic grows or changes its procedures. Instead of maintaining several unrelated agreements, the clinic can use one general framework supported by role schedules.
This structure may be useful when:
The clinic works with several types of practitioners
Certain contractual terms apply across the clinic
The clinic expects to add more practitioners
Each professional role requires distinct responsibilities
The clinic wants greater consistency between agreements
However, a master agreement is not automatically the right solution. The document must still reflect how the clinic actually operates.
When Separate Agreements May Be More Appropriate
Separate agreements may be preferable when the practitioner relationships are substantially different.
For example, a separate agreement may be appropriate where:
A practitioner provides a distinct service outside the clinic’s usual model
The compensation structure is significantly different
The practitioner provides services through a professional corporation
The practitioner has different responsibilities for billing or client records
The practitioner operates a separate program through the clinic
The parties have negotiated materially different termination or liability provisions
The clinic is working with only one practitioner in that profession
Separate agreements provide flexibility, but they may create inconsistencies if each document is developed without considering the clinic’s broader contract structure.
The clinic should consider both the individual practitioner relationship and the way its agreements work together.
A Written Agreement Does Not Determine Contractor Status by Itself
Calling someone an independent contractor does not automatically make that person an independent contractor.
The written agreement is important, but the actual working relationship must also support the intended classification.
Relevant considerations may include the clinic’s level of control, the practitioner’s opportunity for profit, the practitioner’s financial risk, the tools used to provide the services and the practitioner’s degree of independence.
Ontario’s employment status guidance explains that an individual may still be considered an employee even if the parties describe the relationship differently. The
Canada Revenue Agency also considers several factors when determining whether someone is an employee or self employed worker.
Clinic owners should therefore ensure that the written agreement and the actual relationship are aligned.
Has Your Clinic Outgrown Its Existing Agreement?
A clinic’s original contractor agreement may no longer be suitable as the business grows.
It may be time to review the clinic’s agreements if:
The clinic is adding a new professional discipline
The clinic is introducing new services
Different practitioners have received inconsistent agreements
The clinic has changed its compensation structure
The clinic is moving to virtual services
The clinic is changing its client record system
A practitioner is providing services through a corporation
The clinic has experienced a difficult practitioner departure
The current agreement does not reflect how the clinic operates
The clinic has been using a generic template
Updating an agreement is not simply a matter of adding another professional title.
The clinic should consider whether the agreement structure still supports its current services and contractor relationships.
Choosing the Right Agreement Structure
A multidisciplinary clinic should not treat its contractor agreements as isolated documents.
The agreements should work together and support the clinic’s service model, payment structure, privacy responsibilities and practitioner relationships.
A master independent contractor agreement with profession specific schedules may provide consistency and flexibility. Separate agreements may be more appropriate where practitioner relationships are substantially different.
The appropriate structure depends on the clinic’s actual operations, the professionals involved and the way services are delivered.
Legal Support for Multidisciplinary Clinics
Delta Law assists Ontario multidisciplinary clinics with independent contractor agreements and related contract structures.
Depending on the clinic’s needs, this can involve a master clinic independent contractor agreement, profession specific role schedules or separate agreements for particular practitioners.
If you are opening a multidisciplinary clinic, adding a new practitioner or updating agreements that no longer reflect your operations, we can help you determine an appropriate contract structure.
Book a consultation to discuss your multidisciplinary clinic and contractor agreements.
