Employment in a clinic: the healthcare agreement, on-call duty and the 'freelance' with your diary
Nextica Law & Tax organises a clinic's relationship with its professionals: placement under the Catalan healthcare establishments agreement, the difference between a genuinely self-employed collaborating practitioner and one who works with the clinic's diary, facilities and prices, on-call duty and working time, the qualifications required under Law 44/2003 on healthcare professions, and the division of duties between clinical and non-clinical profiles.
The 'self-employed dentist' who works in your chair, with your diary and at your prices is the first thing the Inspectorate looks at in a clinic.
What's included
1. Determining the applicable collective agreement and grading each role
practitioners, nursing, assistants, reception and support staff.
2. A reasoned decision on each collaborating practitioner's arrangement
employment, a genuine commercial relationship, or a senior management contract for the medical director.
3. On-call, availability and split-shift arrangements matched to the collective agreement rather than to the centre's habits.
4. Part-time contracts with the supplementary hours agreement in writing, which is what gets claimed most often afterwards.
5. Activity-based variable pay, designed so that it does not turn a commercial relationship into an employment one through the back door.
6. Day-one documentation
risk information, training and equipment, signed and in a language the person understands.
7. Periodic review when the service portfolio changes or a new unit opens, because grading does not move by itself.
THE 'SELF-EMPLOYED' PRACTITIONER WITH THE CLINIC'S SCHEDULE
It is the sector's most widespread arrangement and the one most often reclassified, because what decides it is not the contract but how the work is done.
A practitioner whose schedule is managed by the centre, working on the centre's premises, with its equipment and to assigned hours: the indicators of employment stack up, and the consequence is contributions for the open years, the surcharge, and a relationship that becomes permanent.
Workers' StatuteBadly designed variable pay
when the percentage of activity comes with exclusivity, imposed hours and the centre's resources, what was agreed as a commercial relationship behaves as employment and is classified accordingly.
Support staff supplementary hours with no written agreement in the part-time contract: without it they cannot be required, and those worked are regularised with their contributions.
Workers' StatuteCURRENT CONTRACTUAL MODALITIES IN 2026
| Mode | When to use | Key requirements and risks |
|---|---|---|
| Ordinary indefinite | The standard modality since the 2021 reform. Preferable in case of doubt. | It can be full-time or part-time. For part-time work, specific hour recording and limitation of supplementary hours. |
| Fixed-discontinuous | Seasonal or cyclical activity, or work that is not provided continuously but is predictable. | Replaces the work and service contract for non-permanent but recurring activities. Incorrect design → can become ordinary indefinite. |
| Temporary replacement (art. 15.1.c ET) | Replace an employee with the right to job reservation (sick leave, maternity, leave of absence) or cover vacancy during the selection process. | The replaced worker or the reason for the vacancy must be identified. 3-month limit for vacancy coverage. |
| Alternating training (art. 11.2 ET) | Unqualified people for the position, under 30 years old. Bonuses in social security contributions. | Duration: 3 months to 2 years. Maximum workload: 65% in the first year, 85% in the second. Minimum compensation of 60%/75% of the minimum wage or the agreement. |
| Senior Management Contract (RD 1382/1985) | Senior management personnel who exercises powers inherent to the ownership of the company with full autonomy. | It is governed by RD 1382/1985 and not by the ET. Compensation in case of withdrawal: minimum 7 days/year unless otherwise agreed. No mandatory maximum legal probation period. |
Ordinary indefinite
Fixed-discontinuous
Temporary replacement (art. 15.1.c ET)
Alternating training (art. 11.2 ET)
Senior Management Contract (RD 1382/1985)
Frequently asked questions
When is a collaborating practitioner genuinely self-employed?
When they organise their work with real autonomy: they set their own diary, bear the economic risk of their work, set or negotiate their prices and are not integrated into the clinic's organisational structure. If the clinic provides the premises, the equipment, the patients, the schedule and the fee, and the professional only provides their hands, the indicators point to an employment relationship no matter what commercial contract was signed or what invoices are issued.
Can a beautician perform treatments that a doctor performs?
No. Law 44/2003 on healthcare professions reserves certain acts to those holding the corresponding qualification, and the split is not decided by the clinic or the device manufacturer. For the centre it is not only an administrative risk: it answers for what happens on its premises, and some conduct can reach the criminal sphere. It is solved with a map of procedures by profile and qualification before hiring.
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