It is not just a piece of advice but also a legal requirement by several state and federal laws. To prevent this, you need to procure a supplemental endorsement policy, commonly referred to as tail coverage, which appends to the primary policy and insures you for claims made after your employment terminates. Cover your tail. For example, some retirement plans require an employee to work the entire year prior to becoming eligible. An official letter to your patients is highly recommended. When preparing your notifications: Looking at the closing medical practice notification guidelines of all 50 states, some are silent on providing guidance, while others provide a vague range of recommendations. Copyright 2006 - 2023 Law Business Research. A physician in a multi-physician practice is retiring or leaving the geographic practice area. A letter placed in the patients monthly billing notice is one method. In contrast, our goal is to help closing practices gain a better understanding of the process and guidelines when it comes to patient notification. Ultimately, a patient always has the right to seek out a provider of their choosing. These assets belong to the practice and cannot be taken by the physician without the practices consent. Understand your clients strategies and the most pressing issues they are facing. workforce on policies and procedures related to PHI and notify the Attorney General of future breaches. Voice mail systems can also be modified to provide new contact information after the physician has departed. This notice shall be no less than two columns wide and no less than two inches in height. The radius is usually determined by your practices location and could range from five miles in a suburban area to 50 miles or more in a rural area. A physician shall provide a patient written notice of the termination of the physician-patient relationship. A Must-Do List for the Departing Physician | AAFP Rarely do practices agree that patient charts are the property of the employed physician. Courts have, however, held physicians liable for breach of non-solicitation agreements and misappropriation of trade secrets when If possible, consider posting your retirement in your local newspaper(s) as well as on your website and/or social media pages (if applicable). In fact, you must notify them- you can't just leave and let them find out you're no longer their provider. The physician may, but is not required to, place a sign in a conspicuous location on the faade of the physicians office or notify patients by letter, of the termination, sale or relocation of the practice. Such clauses generally cover a specific geographic area and period of time. Closing or leaving a practice: Tips for primary care physicians Posted 3:52:36 PM. Such property is confidential and, therefore, not to be used or disclosed following termination of the providers employment. In healthcare, non-solicitation restrictions can extend to patients and other providers who refer patients to the practice or business. Pursuant to the Health Information Technology for Economic and Clinical Health Act, state attorneys general are empowered to enforce HIPAA regulations through civil actions against violators. While the Board rule does not specify the mode of notification, it would be difficult to ensure patients received notification by a newspaper ad. For assistance, members of The Doctors Company can contact a patient safety risk manager at (800) 421-2368 or by email. Notifying Your Patients When You Leave a Practice If youre in one of the states where we practice, schedule a complimentary phone consultation with one of Jackson LLPs healthcare attorneys. TMB rules for physicians who retire, close, or leave a practice. One in five physicians say it is likely they will leave their current practice within two years. Offer to send copies of their medical records to their new physician and include an authorization for release of medical records., https://health.maryland.gov/mbpme/Pages/patientabandon.aspx, Michigan Public Health Code 333 16213(3)(b) states, licensee or the personal representative of the licensee, if the licensee is deceased, sends a written notice to the last known address of each patient for whom he or she has provided medical services and receives written authorization from the patient or his or her authorized representative, destroy the records required under subsection (1). As the above discussion shows, solicitation and patient abandonment claims are not limitless. The Physician should have 3-5 years of experience of running an OB/GYN practice with leadership skills. And 4) The state is completely silent on patient notification without any guidance available. For example, practices often agree to pay for tail coverage in the event that employment is terminated by the practice without cause. According to Rule 64B8-10.002(3), FAC : A licensed physician shall keep adequate written medical records, as required by Section 458.331(1)(m), Florida Statutes, for a period of at least five years from the last patient contact; however, medical malpractice law requires records to be kept for at least seven years. Can Physician Assistants Own Independent Medical Practices? Retiring members can reference our Retirement Checklist for additional guidelines and to find information about Tribute Plan award payments. Texas Medical Board. A physician must give notice to patients of his or her leaving or closing a practice, otherwise face a possible claim of patient abandonment. The legal guidelines regarding patient notification vary for each state. Examples include social media pages, website banners, email, or even utilizing the practices existing patientportal. For example, you would not want to plan your departure during a week in which you are anticipating five deliveries. For TMB rules on notification requirements and more, refer to Chap 165.5 - Transfer and Disposal of Medical Records. Keep the phone number of the closed practice active for a minimum of 90 days and include key information on the voicemail after the practice has closed. A long notice period is often difficult for a non-retiring physician to give, but these issues deserve consideration. https://www.health.ny.gov/facilities/adult_care/dear_administrator_letters/acf_closure_guidelines.htm, The North Carolina Medical Society advises, practitioners and other parties that may be involved to ensure that: patients are notified of changes in the practice, sufficiently far in advance (at least 30 days) to allow other medical care to be secured, which is often done by newspaper advertisement and by letters to patients currently under care (Sample letter Attachment A); patients clearly understand that the choice of a health care provider is the patients; patients are told how to reach any practitioner(s) remaining in practice, and when specifically requested, are told how to contact departing practitioners; and patients are told how to obtain copies of or transfer their medical records., https://www.ncmedsoc.org/wp-content/uploads/2013/06/Closing-a-Medical-Practice.pdf, Rule 4731-27-03 states, When () a health care entity provides to patients a notice of the termination of a physicians employment, the notice shall be provided in one of the following ways: (1) A letter sent via regular mail to the last address for the patient on record, with the date of mailing of the letter documented; (2) An electronic message sent via a HIPAA compliant electronic medical record system or HIPAA compliant electronic health record system that provides a means of electronic communication between the health care entity and the patient and is capable of sending the patient a notification that a message has been received and is in the patients portal., https://codes.ohio.gov/ohio-administrative-code/rule-4731-27-03, State advises, Whenever a physician is leaving or has left practice and the actual office is being closed, several different methods of patient notification can be used. Board Rule 540-X-9-.10 states reasonable notification must be provided. Consider patient needs. But it is highly recommend for the protection of the physician and the patient. The agreement provided that for 12 months following termination of employment, the urologist would not engage in the practice of medicine within a 50-mile radius of the employer. The health care entity, which is the party responsible for maintaining custody of the medical record, should send the notice. At Cariend, [], When physicians retire or close their practice, there are many tasks to complete to ensure the process [], No matter the size or scope of their operations, hospitals and medical facilities are driven to reduce [], Hospital and medical facility managers recognize EMR systems as a necessary part of managing patient medical data. The physician must notify the TMB and his/her patients, and advise who has custodianship of the medical records and how a copy may be obtained. Confidentiality clauses usually define patient information and records generated during the providers employment as the practices property. Abandonment is the unilateral termination of the physician-patient relationship by the physician without giving the patient adequate notice of such termination and without giving the patient sufficient time to establish a relationship with a new physician. Continued. Your contract may require that you give your practice advance written notice of your departure. You Can't Take It with You - Davis Wright Tremaine URMC responded by sending breach notification letters to the affected patients and notifying the media. This settlement addresses several questions that often arise when a physician (or other health care professional) departs a hospital or medical group (health care entity). 219, or send a letter to Harris County Medical Society, John P. McGovern Building, 1515 Hermann Dr, Houston, TX 77004-7126. A health care practitioner can terminate a patient relationship at any time, but the practitioner may not abandon a patient and should provide continuity of care in accordance with the prevailing professional standard of care. Illinois General Assembly Public Act 84-7; 92-228 states health care facilities must provide the public with at least 30 days prior notice of the closure of the facility. https://texreg.sos.state.tx.us/public/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&p_tac=&ti=22&pt=9&ch=190&rl=8, Additional Resources: Texas Medical Association advises, Texas Medical Board (TMB) regulations say a physician leaving a group must notify his or her patients by: Publishing a notice either: On the physicians or practices website or In the newspaper of greatest general circulation in each county in which the physician practices or practiced, and in a local newspaper that serves the immediate practice area; and Placing a written notice in the physicians office; and Sending patients the physician has seen in the last two years either: A notice in a letter or A notice in an email in a manner compliant with state and federal law. How to Ensure Continuity of Care If a Physician Leaves Your Practice The notice shall provide the patient with 30 days to request a copy of his or her record or to designate where he or she would like his or her medical records transferred and shall request from the patient within 30 days written authorization for the destruction of his or her medical records., http://www.legislature.mi.gov/(S(qm1p2yrrhuxenh2d4yfgk1dd))/mileg.aspx?page=GetObject&objectname=mcl-333-16213, Mississippi State Board of Medical Licensure Policy 3.17 advises, whether by relocation, retirement, disability or death, the patient should be advised of the right to have the medical records sent to the physician of their choice. A 24-year-old pregnant woman came to her ob-gyn with a headache and high blood pressure. The Florida Medical Association (FMA) recommends to a practitioner who wishes to terminate a relationship that the practitioner should give the patient adequate notice in writing, and the practitioner should remain available to the patient for at least 30 days in order to allow time for the patient to find a new practitioner. For instance, general advertisements, mailings to certain zip codes, and routine marketing activities normally would not meet this standard. Placing a sign on the door of the closed practice only works if the space will not have future tenants. A provider who has not solicited a patient cannot, and should not, encounter barriers to providing treatment to that patient. A physician may choose whom to serve. (Abandonment is defines as the termination of the physician patients relationship at an unreasonable time and without giving the patients the chance to find an appropriate replacement.) Health care entities must be prepared for the departure of physicians and other health care professionals. 3. 1) The state has enacted law regarding patient notification. Departing Physicians and Patient Notification - Krugliak, Wilkins 1, 2. Among the factors in the decision, the court concluded that physicians obligations not to commit patient abandonment militated against interpreting the non-compete as the employer proposed, stating: To conclude that telephone inquiries from existing patients to their physician constitute the practice of medicine in the context of a restrictive covenant would effectively force a physician to neglect or abandon his patients whenever they telephone or page him with medical-related questions, concerns, or emergencies at a time when he happens to be in the restricted geographical area. These policies and others are discussed separately below. A physician shall ensure that emergency medical care is available to the patient during the 30-day period following notice of the termination of the physician-patient relationship., https://www.legis.iowa.gov/docs/iac/rule/09-22-2010.653.13.7.pdf, Kansas Board of Healing Arts (a regulatory board created by legislature for the purpose of education, administration, regulation enforcement) advises providers follow AMA Guidelines. California health care entities should review CMA guidance before sending the notice. If you fail to give notice, the practice could claim breach of contract, with damages equal to the cost of hiring a locum tenens physician to fulfill the remainder of your term. The answer is yes. Having undertaken the care of a patient, the physician may not neglect the patient. Some require an extraordinarily long notice period (such as one year) before the physician can qualify for deferred compensation payments. If you are planning to make such a move, or to ask one of your partners to leave, follow these steps to avoid getting burned. This is referred to as nose coverage. A non-solicitation clause only prohibits solicitation. (1) Other licensed physicians remaining in the practice may not prevent the departing physician from posting notice and the sign; (2) A physician, physician group, or organization may not withhold information from a departing physician that is necessary for notification of patients. 1. Such an approach may frustrate the provider who is leaving. HIPAA protects information that relates to the past, present, or future physical or mental health or condition of an individual when there is a reasonable basis to believe the information can identify the individual. 3. How does the estate of a deceased or incapacitated physician provide 30-day notice? All patients of record who have not requested their records 30 days before the person discontinues the medical-practice business or leaves the State must be notified by first class mail by the person to permit that persons patients to procure their records., http://delcode.delaware.gov/title24/c017/sc05/index.html, Florida Statute Title 32 Ch. A critical criterion for patient abandonment claims is the need for further treatment. The Texas Medical Board (TMB), in an attempt to address this issue, adopted regulations that must be followed whenever a physician leaves a group. Hear from top leaders in medicine When Would My Healthcare Practice Use a Promissory Note? A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Breaking Up is Hard to Do: Notifying Patients When a Physician Leaves See the bottom of this page for a state-by-state comparison of the available guidelines. Approximately sixty days prior to closure, patients who require frequent follow up should be referred to other physicians and patients with acute medical problems should have appropriate follow up arranged., https://www.maine.gov/md/sites/maine.gov.md/files/inline-files/2017summer_0.pdf, State advises, adequate time must be given to allow the patient to obtain a new practitioner. Contact information that enables the patient to obtaininformation on the patient's medical records. She can be reached at laura-brockway@tmlt.org. Is a list of patient names without information about the patients medical condition considered PHI? In March 2015, the NP was preparing to leave URMC for a position at Greater Rochester Neurology (GRN). The unique facts and circumstances related to a patients condition and care should be used to determine how much notice a patient should be given prior to the actual termination of the physician-patient relationship, and whether the physician should facilitate the transfer of care to another provider., Louisiana State Medical Society Guidelines The physician cannot abandon the patient. For providers who form more continuous treatment relationships (e.g., surgeons providing post-operative care to a patient following a procedure), patient abandonment liability can be limited by furnishing notice of termination of the relationship. Jennifer Bendokas, PA-C. Otolaryngology (ENT) 1110 Hospital Road Fort Walton Beach, Florida 32547 850.863.8275 Education Doctor of Medicine Science University of Lynchburg Save my name, email, and website in this browser for the next time I comment. In contrast, patient abandonment is more prone to arise from the failure to properly act. Many states require that patients be notified when a physician is departing a practice. https://www.texmed.org/Template.aspx?id=6676, The Vermont Guide to Healthcare Law by the Vermont Medical Society advises, In order to avoid a claim of abandonment, the physician should take several steps to terminate the physician-patient relationship. For example, you would never want to be in a situation where you felt compelled to lie to a patient. In addition to sending letters, think carefully about how you will address this topic when you speak with patients. The American Medical Associations Ethical Opinion E-7.03 provides that [t]he patients of a physician who leaves a group practice should be notified that the physician is leaving the group., Health care entities must be prepared for the departure of physicians and other health care professionals.