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How to Start an Alternative and Complementary Healthcare Business in OntarioLast Verified:
2006-05-30
The Canada-Ontario Business Service Centre (COBSC) in collaboration with the Ministry of Government Services (MGS) prepared this guide to provide information on license, permit or registration requirements when considering the establishment of an alternative and complementary healthcare business in Ontario. Need more information? Click: Canada-Ontario Business Service Centre Some of the organizations listed below are not subject to the federal Official Languages Act or the French Language Services Act of Ontario. Their services may not be available in both official languages. TABLE OF CONTENTS
1. Basics To Getting StartedStarting a business can be a rewarding undertaking, but it comes with its challenges. Before starting a business in Ontario, it is wise to do your research. Ask yourself if you are truly suited for entrepreneurship and understand that significant effort may be required. You should thoroughly enjoy the field you are getting into and you must believe in your service; it may consume much of your time, especially in the start-up phase. There are several issues to consider such as regulations, financing, taxation, managing your business, advertising and much more. For further information: 2. Industry OverviewAlternative health care is a growing industry in Canada. The most recent National Population Health Survey by Statistics Canada (1998/99) found that 3.8 million Canadians aged 18 and over had consulted an alternative health care provider at least once during the previous 12 months. Alternative health care providers for the study included, for example massage therapists, homeopaths, herbalists and acupuncturists. This represented a 2% increase in consultations from the previous study of 1994/95. The Fraser Institute published a report on the use of complementary/alternative medicine by Canadians and found that during the 1997 calendar year, Canadians spent approximately $1.8 billion on visits to complementary and/or alternative health care providers and an additional $2 billion on herbs, vitamins, diet programs, and books. A definition frequently referenced in research comes from the National Center for Complementary and Alternative Medicine (NCCAM) in the United States. They define alternative medicine as a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine (medicine as practiced by medical doctor or doctors of osteopathy and by their allied health professionals, such as physical therapists, psychologists, and registered nurses). Alternative health care is often referred to as complementary and alternative health care. The terms "alternative" and "complementary" refer to using the same therapy in different ways. That is, alternative refers to using a particular therapy instead of conventional treatment; and complementary is used along with conventional medicine. Other terminology used can include:
Types of OperationThere are many different kinds of alternative therapies, and several ways to operate these kinds of businesses. The following are examples of such practices: Acupuncture is an ancient Chinese art based on the theory that Qi energy flows along meridians in the body, and can be stimulated by inserting fine needles at specific points. Acupuncture is used to treat a wide variety of disorders. Aromatherapy involves the use of essential oils (extracts or essences) from flowers, herbs, and trees to promote health and well-being. Chiropractic is a system that focuses on the relationship between bodily structure (primarily that of the spine) and function, and how that relationship affects the preservation and restoration of health. Chiropractors use manipulative therapy as an integral treatment tool. Natural Health Products are defined as vitamins and minerals, herbal remedies, homeopathic medicines, traditional medicines such as traditional Chinese medicines, probiotics, and other products like amino acids and essential fatty acids. Natural health products are available for self care and self selection, and do not require a prescription to be sold. In Canada, natural health products, also referred to as complementary medicines or traditional remedies, are subject to the Natural Health Products Regulations. Homeopathic medicine is a system based on the belief that "like cures like" meaning that small, highly diluted quantities of medicinal substances are given to cure symptoms, when the same substances given at higher or more concentrated doses would actually cause those symptoms. Massage or massotherapy is the manipulation of muscle and connective tissue to enhance function of those tissues and promote relaxation and well-being. Naturopathic medicine is an alternative medical system in which practitioners work with natural healing forces within the body, with a goal of helping the body heal and attain better health. Practices may include dietary modifications, massage, exercise, acupuncture, minor surgery, and various other interventions. Reflexology is a type of deep foot or hand massage designed to relax the whole body through the reflex response. The thumbs are used extensively to break up crystalline deposits that have formed at the nerve endings, particularly on the bottom of the feet. Reiki is a Japanese word representing Universal Life Energy. Reiki is based on the belief that when spiritual energy is channelled through a reiki practitioner, the patient's spirit is healed, which in turn heals the physical body. Therapeutic Touch is derived from an ancient technique called "laying-on of hands". It is based on the premise that it is the healing force of the therapist that affects the patient's recovery; healing is promoted when the body's energies are in balance; and, by passing their hands over the patient, healers can identify energy imbalances. Yoga has been shown to alleviate stress and, at the physical level, has been seen to be useful in the treatment of those who suffer conditions that affect or are affected by posture, such as backache and arthritis. Planning Your BusinessWhat is a Business Plan?A business plan is a recognized management tool used by successful and/or prospective businesses of all sizes to document business objectives and to propose how these objectives will be attained within a specific period of time. It is a written document, which describes who you are, what you plan to achieve, where your business will be located, when you expect to get under way, and how you will overcome the risks involved and provide the returns anticipated. Why Do I Need One?A business plan will provide information of your proposed venture to lenders, investors, and suppliers to demonstrate how you plan to use their money, and to establish a basis for credibility of your project. This plan will serve as a guide to the various areas that you as a manager will be concerned with. As you work through this plan, adapt it to your own particular needs. For further information: Interactive Business Planner (IBP)The IBP is a computer software program that uses the capabilities of the Internet to assist you in preparing a 3-year business plan for a new or existing business. The IBP will help you write your business plan, provide a format for writing your business plan, and take the information you enter and prepare financial projections for you. For further information: Some types of alternative health care are more commonly used than others in Canada. In their study, the Fraser Institute identified the following practices as most commonly used: chiropractic (36%), relaxation techniques (23%), massage (23%), prayer (21%), herbal therapies (17%), special diet (12%), folk remedies (12%), acupuncture (12%), yoga (10%), self-help group (8%), lifestyle diet (8%), and homeopathy (8%). The Statistics Canada study examining patterns of use of alternative health care in Canada found that the use is higher among women, people with higher education and higher income, people experiencing chronic conditions or pain, and in Western Canadians (explained in part due to more flexible provincial health care plans). Further, it concluded that Canadians were visiting alternative health care providers not as an alternative to conventional medicine, but rather to complement it. It is speculated that the demand for services within the alternative health care industry will continue to grow, fueled in part by Canada's aging population and the increase in chronic illness. Some practitioners may specialize in one discipline while others may train to offer multiple therapies. To complement their practice, some practitioners incorporate a retail aspect to their business and may, for example, sell natural health or cosmetic products. For further information: Depending on the discipline and qualifications of the practitioner, teaching alternative healthcare techniques to others could represent another viable business activity. According to International Trade Canada, the high cost of pharmaceuticals for many developing nations creates exporting opportunities for Canadian firms that specialize in alternative and natural health practices. Whether delivering these therapies directly to patients or providing training to individuals within the foreign market, there exists the potential for new and profitable ventures. 3. RegulationsFood and Drug RegulationsThe Food and Drug Regulations specify requirments for standardized foods. In addition, the Regulations specify requirements for the production, labelling, marketing, distribution and processing of pharmaceutical drugs. For further information: Natural Health Product RegulationsThe Natural Health Products Regulations include provisions on: definitions, product licensing, site licensing, good manufacturing practices, clinical trials, labelling and packaging requirements, and adverse reaction reporting. The definitions include the definition of a natural health product (including, for example, vitamins, minerals, herbal remedies and homeopathic medicines) and other terms (recommended conditions of use, adverse reaction, etc.) that are key to the functioning of the Regulations. For further information: Medical Devices RegulationsThe Medical Devices Bureau of the Therapeutic Products Directorate (TPD) of Health Canada is the national authority that monitors and evaluates the safety, effectiveness and quality of diagnostic and therapeutic medical devices in Canada. For further information: Building permitsThe Building and Developement Branch administers the Building Code Act (BCA) and the Ontario Building Code (OBC). These codes govern the construction of new buildings as well as the renovation and maintenance of existing buildings. For information on your organizations specific requirements please contact the Building and Developement Branch of the Ministry of Municipal Affairs and Housing. For further information: Municipal RegulationsEach municipal government has the authority to issue its own business licenses within its jurisdiction. Since there is no uniformity throughout Ontario regarding municipal licenses for businesses, you should consult with the appropriate local officials to determine whether your business will be affected by local regulations and licensing requirements. Businesses must also meet the zoning by-laws that control property uses in their municipalities. For further information: Music licencePerformances of music in public, i.e. offices, stores, etc., require a licence. This licence is necessary whether the music is performed by live or recorded means. For further information: The Smoke-Free Ontario ActAs of May 31, 2006, the Ontario government is prohibiting smoking in all enclosed workplaces and enclosed public places. The legislation will also strengthen measures to ensure only those 19 years of age and older can buy cigarettes and will phase out the display of tobacco products, with a complete ban beginning May 31, 2008. For further information: Certification and trainingFor information on certification and training, you should contact the appropriate association for details. A list of associations is provided below under the heading Associations. For further information: Other RegulationsYou can also get information on permits, licenses, and regulations by contacting your provincial government, local city hall, or rural municipal office. Contacts for local, provincial and federal governments can be found in the government listings of your telephone directory or on the Government of Canada Web site. Regulated Health Professions Act For further information: Food and Drugs Act For further information: 4. FinancingThe Canada-Ontario Business Service Centre has created documents, which provide an overview of some of the main financing options for individuals starting and operating a business in Ontario, including programs offered or supported by the government For further information: Canada Small Business Financing ProgramBusiness Financing Program can assist new and existing small businesses with annual gross revenues not exceeding $5 million (excluding farming and charitable or religious enterprises) in obtaining term loans and capital leases of up to $250 000 to help finance fixed asset needs. For further information : Sources of FinancingSources of Financing is an Internet resource for locating traditional and alternative sources of small business financing. This site provides interactive access to objective information on appropriate forms of public and private sector sources of debt and equity financing: For further information: Sources of Micro-Credit Financing"Micro-credit" can be defined as small loans made to individuals to undertake self-employment or to start small businesses. This type of financing may be provided through a number of different sources including independent non-profit organizations, community economic development programs, commercial financial institutions, etc. For further information: 5. Managing Your OperationDealing with Business TaxesAll businesses must be aware of the various taxes that may apply to their product or service. Depending on the type and location of products or services being offered, federal, provincial and/or municipal business taxes may apply. For further information: Income Tax InformationBusiness owners must be aware of the requirements of Income tax that may apply to their product or service. There are different tax implications for incorporated and non-incorporated businesses. For information specific to your organization you should consult an accountant or financial professional. For further information: Below are links to publications that cover some of the general tax requirements for business owners in Ontario. Ontario Small Business Guide EHT Guide for Employers For further information: Retention/Destruction of Books & Records Voluntary Disclosure InsuranceInsurance needs for businesses vary greatly. It is best to choose an insurance agent or broker familiar with your size of business and, in particular, an agent familiar with your type of operation. If you don't have an insurance agent, consider asking other business owners in your area to recommend one. The following list is included to remind you not to overlook the complex areas of business insurance. It is best, however, to discuss your specific requirements with your insurance agent. Basic insurance:
Marketing/AdvertisingWord-of-mouth advertising and good public relations are often the best ways of promoting your business. Depending on your market and its size, also consider flyers, business cards, brochures, newspapers (especially for holiday promotions), radio, TV, the phone book and the Internet. Also bear in mind that a satisfied customer is good advertising. Referrals are also a valuable way of making customers aware of your products or services. A Web site is also a good marketing tool. It should have details to describe the location (your address, telephone and fax numbers, and directions on how to get to your establishment), hours of operation, services offered, credentials and anything else you think may be of interest to potential customers. However, once you launch a Web site, you should update it on a regular basis. Participating in community events is another way of advertising your business. You may also hold events that will promote your business. No matter how you choose to market your business, it is wise to track how your clients became aware of your establishment - this may help determine your future advertising strategies. For further information: The Online Small Business Workshop - The Marketing Basics section covers the basics from developing your customer profile to promoting your business. For further information: The federal Competition Act governs misleading advertising and deceptive marketing practices for most businesses in Canada. The Act defines which marketing practices are illegal and the process of complaint investigation. For further information: Market ResearchSuccessful businesses have extensive knowledge about their customers and their competitors. Acquiring accurate and specific information about your customers and competitors is a critical first step in market investigation and development of a marketing plan. In developing a marketing plan, your primary functions are to understand the needs and desires of your customer, select or develop a product or service that will meet customer needs, develop promotional material, and ensure that the product or service can be provided effectively at a profit. For further information: Selecting Professional ServicesThe use of professional services is essential to the success of a small business. Professionals can provide knowledge and expertise in the areas where you may have little. They can round out your management team to ensure your business is operating efficiently. Professional services often used by entrepreneurs may include:
For further information: Accounting/BookkeepingA good record keeping system should be simple to use, easy to understand, reliable, accurate, consistent and designed to provide information on a timely basis. Note: All staff working with cash should be trained to recognize counterfeit currency. Setting-Up a Pay SystemPay administration is a management tool that enables you to control personnel cost, increase employee morale, and reduce workforce turnover. For further information: Setting the Right PriceSetting the right price can influence what consumers will buy, which in turn affects total revenue and profit. In the end, the right price for the product/service is the price that the consumer is willing to pay for it. Hence, correct pricing decisions are a key to successful management. For further information: Profit WatchingMaking a profit is the most important -- some might say the only objective of a business. Profit measures success. It can be defined simply: revenues - expenses = profit. So, to increase profits, you must raise revenues, lower expenses, or both. To make improvements, you must know what's really going on financially at all times. For further information: Employing peopleWhat are the rules on working conditions in Ontario? For further information: Choosing Your LocationPractitioners of alternative health care may be home-based, practice from an office or spa-like environment, or take their business directly to the client at their home or office (for example, chair massages in the workplace); or even a combination of these. For further information: Furnishings and EquipmentBefore you open your business, you may need specialized equipment. The kind of service you are offering will determine the type of equipment you will require. For assistance in this area, you may get the advice of a sales representative or consult trade publications and manufacturers' Web sites. List that equipment and its cost to you. An important factor to consider when choosing equipment is the after-sales service and repair and their affordability. Used Equipment - Consider buying used equipment as a cost-saving measure. Sources of used equipment could be similar businesses that are closing or dealers in second-hand equipment. The drawback to this approach is that, often, there are no guarantees with the purchase. Leasing Equipment - Another alternative is to lease equipment to help keep start-up costs down. For further information: Personal Information Protection and Electronic Documents ActThe Personal Information Protection and Electronic Documents (PIPED) Act sets out ground rules for how private sector organizations may collect, use or disclose personal information in the course of commercial activities. Since January 1, 2002, the personal health information collected, used or disclosed by these organizations is also covered. For further information: 6. AssociationsExamples of associations include, but are not limited to:
7. Resources and Web Sites of InterestAdditional resources which may help alternative health care business owners include, but are not limited to: Related PublicationsOntario public libraries provide a variety of business information and services. Reference materials, online information databases, CD-ROM and other format material as well as standard business information such as books, newspaper and journal articles and business directories are available to the general public, including small businesses, entrepreneurs, career-changers and job seekers. Workstations provide public Internet access to business information from Web sites and access to government electronic information and services of interest to business. Most information and services available at the public library are free of charge. Some examples of relevant publications are: StatisticsStatistics Canada Contact with alternative health care providers, by sex, household population aged 12 and over, Canada and provinces, 1994/95-1998/99 Contact with alternative health care providers, by age group and sex, household population aged 12 and over, Canada, 2000/01 Web Sites of Interest
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