In Tunisia, medical professionals currently practice liberal medicine either through individual or group medical offices or as part of a civil professional society. However, there is no existing legal framework for medical liberal exercise societies. Dr. Abdelmajid Mselmi argues that introducing such a framework would allow for more transparent and serene medical practice. This concept has been discussed within the medical profession, with many citing its benefits as seen in other countries.
Dr. Mselmi drew inspiration from France, which introduced a law on December 31, 1990, creating "Sociétés d'Exercice Libéral" (SEL), allowing liberal professions to practice within a capital-based company without losing their civil status or deontology. The SEL structure is reserved for regulated liberal professions such as doctors, lawyers, and dentists. Since then, several regulatory texts have been published to organize liberal medical practice within a capital-based company.
In France, there are several forms of SEL, with the most common being the SELARL (Société d'Exercice Libéral à Responsabilité Limitée) or limited liability SEL. This structure allows a doctor to practice alone or with others, with limited liability to their contributions. Another form, the SELASU (Société d'Exercice Libéral par Action Simplifiée Unipersonnelle), offers more flexibility in statutory writing and governance organization.
Contrary to popular perception, a medical SEL can be unipersonal, with no need to associate with other colleagues. A doctor can choose to transform their medical office into a unipersonal society, which can later become multi-personal as needed. The main change is that, within the society, the doctor no longer practices under their own name but creates an enterprise with moral responsibility.
The medical SEL offers several advantages, including tax benefits, asset protection, and easier association and transmission. By practicing within a SEL, a doctor can reduce their tax burden, as the society is taxed at a lower rate than individual income. Additionally, the SEL structure allows for a clear separation between the doctor's personal and professional assets.
However, there are also constraints associated with the SEL structure, such as the requirement that the majority of capital be held by professionals practicing within the structure. Furthermore, there are higher operating costs, including constitution fees, more complex accounting, and annual general assemblies. Dr. Mselmi emphasizes that the Ministry of Health has a crucial role in introducing this new form of medical practice.
To move forward with this project, Dr. Mselmi suggests that the Ministry of Health needs to be convinced of the national interest in introducing medical SELs. Once convinced, the Ministry can work with the Conseil de l'Ordre des Médecins and representative medical instances to develop and finalize the project. This would allow for the introduction of a new form of medical practice in Tunisia, potentially addressing concerns of certain medical professionals and promoting the development of medical practice in the country.
Key points
- - The introduction of medical liberal exercise societies in Tunisia would provide a new form of medical practice, offering benefits such as tax advantages and asset protection. - The SEL structure, as seen in France, allows for more transparent and serene medical practice, with a clear separation between personal and professional assets. - The Ministry of Health has a crucial role in introducing this new form of medical practice, and convincing them of its national interest is essential to moving forward with the project.
