Notifying Patients of Physician Leaving Practice In all the steps we discussed above, you may have noticed that informing your patients about your departure is crucial. The analysis will always depend on the particular circumstances involved. (I) Posting such notice on the physician's or practice website; OR The newspaper ad may have been effective in 1990 when daily newspaper circulation in the US was over 62 million, but with that figure now less than 20 million and declining rapidly, newspaper alone is no longer practical. 8. Texas Medical Board. First, ensure proper notice is provided to patients as well as all interested governmental entities and other organizations. AMA Principles of Medical Ethics Opinion 1.1.5, (1) Notify the patient far enough in advance to permit the patient to secure another physician; and (2) Facilitate transfer of care when appropriate. Keep a copy of the notification letter in the patient's record. (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.) The notice must be published at least 1 time per month over a 3-month period in advance of discontinuing the business or leaving the State and must explain how a patient can procure that patients patient records. A long notice period is often difficult for a non-retiring physician to give, but these issues deserve consideration. This growth [], Filling out patient records requests at Cariend just got a whole lot easier. When you compare any random series of practice types for example, psychiatry, dental, OB/GYN, or pain management you quickly realize a one-size-fits-all approach does not work for notifying patients of your closing practice. A noncompete covenant may prohibit you from practicing within a certain geographic radius of your current practice for a designated period of time, often two years. Texas Medical Board Rules Chapter 165.5(a)(1-3) Transfer and Disposal of Medical Records. The employer pulls in one direction, seeking to draft the non-solicitation clause broadly to protect against internal poaching of clients and staff. Voice mail systems can also be modified to provide new contact information after the physician has departed. 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. Mind These Legal Issues. Anyone looking for information on this topic should be aware of the risk in assuming a simple internet search will provide clear and accurate information. 7. We can help you assess your rights and responsibilities. A practice may opt to send a letter to patients about the departure of a physician, but is generally not legally required to do so, and a physician also generally has no legal right to send such letter independently in violation of their contract (and using a practice patient list). Regardless of the state you are in, best practice for physicians is to provide ample notice to their patients regarding changes in practice or closure. The statute adopts the concept of a "records owner." A "records owner" may or may not be a physician. Its an important aspect of [], At Cariend, we understand the challenges faced by healthcare facilities in transition. An inaugural UCF resident who served veterans as a chief resident and whose career goal is to cure diabetes is the new leader of the College of Medicine's endocrinology fellowship in greater Orlando. The notice must include an explanation of how copies of the facilitys records may be accessed by patients. On June 11, 2015, URMC reminded its workforce that all patient information was the property of URMC and could not be copied, shared, removed, or transferred without the permission of both URMC and the patient. 3) The state offers no guidance, but another state association (i.e. 2, When requested, the practice should provide the departing physician with the contact information of his/her patients to ensure the departing physician is allowed to fulfill patient notification responsibilities, and to avoid TMB disciplinary sanctions for the remaining physicians and possible legal risk to the practice. 3. If you didn't sign a non-compete agreement, you can notify your patients that you're leaving and tell them where you're moving. The next generation search tool for finding the right lawyer for you. The patients of a physician who leaves a group practice should be notified that the physician is leaving the group., https://www.commerce.alaska.gov/web/portals/5/pub/MED_Guide_Retiring_Closing_Leaving_Group.pdf, Arizona Revised Statutes Title 32. Say, for example, a provider leaves a dermatology practice to join a medical spa that performs cosmetic procedures not available at the dermatology practice. Why? This content is owned by the AAFP. 2. According to TMB Rules Chapter 165.5(a)(1-3): When a physician retires, terminates employment, or otherwise leaves a medical practice, he or she is responsible for: (2) Notification shall be accomplished by: (A) EITHER: This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. We understand the process can feel daunting. Ensure that their records can be transferred to another health care provider as requested by the patient, and c. Whenever possible, notice shall be provided at least 30 days prior to cessation of treatment; and (10) After transfer of the licensees medical records which meets the requirements of (9) above, the licensee shall be relieved of further responsibility for complying with requests for copies of records., http://www.gencourt.state.nh.us/rules/state_agencies/med100-600.html, State advises in Section 1-15, The doctor must notify the patient, in writing, that he/she will no longer provide care as a date certain, which cannot be less than thirty days prior to the termination date. 456 057 subsection 13 states, records owners shall place an advertisement in the local newspaper or notify patients, in writing, when they are terminating practice, retiring, or relocating, and no longer available to patients, and offer patients the opportunity to obtain a copy of their medical record., https://www.flsenate.gov/Laws/Statutes/2011/456.057, Rule 360 3-.02 (16) states, O.C.G.A 43-1-19 and 43-34-37 authorize the Board to take disciplinary action against licensees for unprofessional conduct. Unprofessional conduct shall include, but not be limited to, the following: Failing to maintain patient records documenting the course of the patients medical evaluation, treatment, and response. Principles of Medical Ethics Opinion 1.1.5 (1) Notify the patient far enough in advance to permit the patient to secure another physician; and (2) Facilitate transfer of care when appropriate. Chiropractors are licensed and regulated by the Florida Board of Chiropractic Medicine. Section 5-5: If a licensee ceases to engage in practice: Publish a notice and the established procedure for the obtaining of records in a newspaper of general circulation at least once a month for the first three months after the practice closes and forward a copy to the Board. The physician fails to allow for patient access to or transfer of the patients health record as required by law. Through our years of experience in the custodial records field, we have worked with clients in almost every health care arena and handled the full spectrum of records management needs. Dont hesitate to contact an attorney if you have any questions. Can I take a copy of my patients records with me, in case they need care from me in the future. Don't worry, I did that on purpose. She can be reached at laura-brockway@tmlt.org. The usage and disclosure of patient information, including patients medical records, are often limited by another form of restrictive covenant in employment agreements: confidentiality clauses. Whether the practice pays for tail coverage often depends on the type of termination effected. Yes. Since most patients do not receive a monthly notice, it is common practice to place a dignified advertisement in two or three editions of the local newspaper notifying the general public, as well as past and present patients., https://apps.ok.gov/osboe/documents/Closing%20DO%20Office.pdf, State advises, If you plan to cease the practice of medicine in Oregon, you are required to ensure safe storage and access to patient records. Dr. Randolph Zuber and his son defense attorney Blake Zuber have a long history of service to TMLT and the physicians of Texas, We are sad to announce the death of Randolph Clark Zuber, MD, a founder and member of our first Governing Board. Make sure that if there are legal guidelines in you state, that you review them. According to, Schneiderman, Other medical centers, hospitals, health care providers, and health care entities should view this settlement as, a warning, and take the time now to review and amend, as, needed, their own policies and procedures to better protect private patient information., Law Enforcement and Healthcare: When Consent, Privacy, and Safety Collide. 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. At our healthcare law firm, our clients frequently voice concerns over the non-solicitation provision in their employment agreements. 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., While the KBHA does not make laws, this organization works closely with both bankruptcy courts and other official state resources, appearing as both a regulatory authority and an independent agency. With respect to patients, solicitation generally requires a targeted, affirmative act by the employee to convince a patient to obtain services from somewhere other than the employers practice. Section 456.057, Florida Statutes, sets forth the requirements that must be followed when a physician retires, closes his office or relocates his practice. Once a decision has been made to discharge a patient from the p ractice, the practice will need to notify the patient of the termination in writing. (B) Placing written notice in the physician's office; AND Alert your state medical board in case patients contact them for information. Ultimately, a patient always has the right to seek out a provider of their choosing. The following are best practices for notifying patients: Send current patients (i.e. Copyright 2023 American Academy of Family Physicians. This will most likely include an employment agreement, a shareholders agreement (if the practice is a corporation) or an operating agreement (if the practice is a limited liability company) and, in some cases, a deferred compensation arrangement. Are you a healthcare provider considering a new employment agreement with a non-solicitation clause? Before you make any decisions, revisit your employment contract and your states laws regarding the issue. Notify other patients who won't be receiving a letter by placing a notice in the local newspaper with the largest circulation, putting a sign up in the lobby and preparing a patient handout. . In addition to paying a $15,000 penalty, URMC agreed to train itsworkforce on policies and procedures related to PHI and notify the Attorney General of future breaches. (C) Notifying patients seen in the last two years of the physician's discontinuance of practice BY EITHER: 6. Consider patient needs. Title: Retention of medical records and patient notification upon closure of a practice Number: OP04 -29 References: Board Minutes January 23, 2004, April 2, 2004; November 7, 2014; September 11, 2020 . However, the information provided does not, and is not intended to, constitute legal advice; instead, all information, content, and materials available on this site are for informational purposes only. You should note, however, that most states allow a patient to request that his or her chart be forwarded to a departing physician, in which case the physician can, at that time, receive the chart from the practice. The sign or notice shall advise the physicians patients of their opportunity and right to transfer or receive copies of their records. Cover your tail. Understand your clients strategies and the most pressing issues they are facing. After all, employers typically exclude information that might prompt patients to seek the outgoing providers services at a new practice. What should a hospital or medical group do now? All of this increases the likelihood that you or one of your colleagues will leave your current practice. For example, including the date in which your Drug Enforcement Administration (DEA) license will expire within the notification message could help patients avoid unexpected disruptions in access to life-saving medications. Med 10.03.2 (o) states, Patient abandonment occurs when a physician without reasonable justification unilaterally withdraws from a physician-patient relationship by discontinuing a patients treatment regimen when further treatment is medically indicated and any of the following occur: 1. Should patients be notified of the physicians departure? Rather than include the providers new practice location, the notice may identify another provider within the practice who can continue to treat the patient. A copy of this notice shall also be submitted to the Board not less than one (1) month prior to the date of termination, sale, or relocation of the practice. In April 2015, GRN sent letters to the patients whose names were on the spreadsheet announcing that the NP had joined the practice and advising them of how to switch to GRN. Questions? For assistance, members of The Doctors Company can contact a patient safety risk manager at (800) 421-2368 or by email. A non-solicitation clause only prohibits solicitation. Meanwhile, about one in three doctors and other health professionals say they intend to reduce work hours in the next 12 months, according to recently published survey research. Texas Medical Board Rules Chapter 165.5(c)(1-2) Prohibition Against Interference. From tail coverage to giving notice, heres how to prepare yourself, your partners and your patients for your departure. These policies and others are discussed separately below. Understand who owns the chart. While it may be convenient to resign shortly before Christmas so that you can spend the holidays at home, it could be a monumental mistake if it results in losing nearly one years worth of retirement benefits. Contact information that enables the patient to obtaininformation on the patient's medical records. Make reasonable efforts to directly notify patients treated within the prior six months letting the patients know about the manner in which the patient can obtain copies of his/her records. Often practices and departing physicians will agree on what to tell patients who inquire about the tenure of the departing physician. 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. 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. (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. Thus, their specialty naturally limits their exposure to allegations of patient abandonment when they leave their jobs. Is a list of patient names without information about the patients medical condition considered PHI? 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. 1997) supports this understanding. Itshould not be used as a substitute for competent legal advice from a licensed attorney in your jurisdiction. In contrast, our goal is to help closing practices gain a better understanding of the process and guidelines when it comes to patient notification. In that circumstance, the list of names may be PHI. The Texas Medical Board (TMB), in an attempt to address this issue, adopted regulations that must be followed whenever a physician leaves a group. The notice may be given by publication in a newspaper of general circulation in the area in which the health care facility is located. There is no specific time period required. It is important to be mindful when reviewing sample closure letters floating around on the internet that most fail to consider many items beyond closure date and how to obtain copies of medical records. 7.03. Hear from top leaders in medicine Health care entities must be prepared for the departure of physicians and other health care professionals. 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. 9. TMB rules for physicians who retire, close, or leave a practice Physicians who are retiring, closing, or leaving a practice can notify patients electronically and by posting a notice on their practice website, according to rules from the Texas Medical Board (TMB). https://www.njconsumeraffairs.gov/bme/Pages/FAQ.aspx, NMAC 16.10.17.9 states, Whenever possible, active patients and patients seen within the previous three years must be notified at least 30 days before closing, selling, relocating or leaving a practice. If you are not familiar with your states requirements, contact a health care attorney in your area for advice. If you are responsible for tail coverage, you may be able to negotiate with your new practice to provide you with sufficient funds to purchase it. This may vary from practice to practice. Does a heath care practitioner have to accept new patients? 3. Once the relationship is formed, Illinois courts consider abandonment to occur when the provider refuses to treat [the] patient [while] needing further treatment, without giving the patient a reasonable time to find substitute care. As a result of such abandonment, the patient must suffer injury. The physician will have the opportunity to mentor new physicians. According to the urologists former employer, such activities violated the non-compete. Not only does this ensure a smooth transition from the current physician to the new treating physician, but it also reduces the liability of patient abandonment. Therefore, to ensure this occurs with a minimum of disruption in continuity of care, the physician terminating the physician-patient relationship should notify patients sufficiently in advance., https://www.mbc.ca.gov/Licensees/Close_Practice.aspx. 1) The state has enacted law regarding patient notification. As these examples show, non-solicitation does not mean no contact. In healthcare, non-solicitation restrictions can extend to patients and other providers who refer patients to the practice or business. What is the health care entitys responsibility when a physician departs? In this way, the provider might avoid claims of patient abandonment. 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. Laura Hale Brockway is the Vice President of Marketing at TMLT. 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. 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. Although the Health Information Portability and Accountability Act of 1996 (HIPAA) prohibits the unauthorized disclosure of PHI, the NP disclosed the PHI to her new employer, GRN, without the patients authorization. Call 713-524-4267, ext. https://regulations.justia.com/states/wyoming/medicine-board-of/medicine-board-of/chapter-3/section-5/. Determine whether solicitation of employees is prohibited. It must protect the patients medical record and not release it without patient authorization. Notifying Patients of Practice Closure When closing a practice, you should send a notification letter to the patients you have seen in your practice within the last three years. Has caused to be published, in the newspaper of greatest circulation in each county in which the physician practices or practiced and in a local newspaper that serves the immediate practice area, a notice which shall contain the date of such retirement or sale that offers to provide the patients records or copies thereof to another provider of the patients choice, and if the patient so requests, to the patient. The Physician should initially notify all patients by a letter which informs the patient of the date the physician will stop practicing and the method by which the patients can obtain their medical records or have them transferred to another physician., http://w.vtmd.org/sites/default/files/Vermont%20Guide%20to%20Health%20Care%20Law%20-%20Nov%202018%20Edition%20Final.pdf, Code of Virginia 54.1-2405 states, No person licensed, registered, or certified by one of the health regulatory boards under the Department shall transfer records pertaining to a current patient in conjunction with the closure, sale or relocation of a professional practice until such person has first attempted to notify the patient of the pending transfer, by mail, at the patients last known address, and by publishing prior notice in a newspaper of general circulation within the providers practice area, as specified in 8.01-324., https://law.lis.virginia.gov/vacode/title54.1/chapter24/section54.1-2405/, State Guideline Number: OP04-29 states, Practitioners continue to have obligations toward patients during and after departure from, or the closing of a medical practice. In our experience at Jackson LLP, rarely are any two non-solicitation clauses alike. This should be posted in your office well in advance of your official retirement. Some require an extraordinarily long notice period (such as one year) before the physician can qualify for deferred compensation payments. Thus, regardless of who is responsible for procuring tail coverage, that party should provide a certificate of insurance to the other party. 2023 Jackson LLP Healthcare Lawyers. Litigating a covenant, either from the employer or employees perspective, is expensive. 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. It is not just a piece of advice; several state and federal regulations make it a mandate. It is the position of the Washington State Board of Osteopathic Medicine and Surgery (Board) that transition from a medical practice is done with a minimum of disruption to the patient. When an osteopathic physician leaves a group practice, the patients of that physician must be notified., https://www.doh.wa.gov/portals/1/Documents/2300/RetentionOfMedicalRecords_And_PatientNotification.pdf, State advises, When a medical practice closure timetable allows, physicians should engage in a conscious and methodical winding down of a medical practice. BUT, the practice has a right to protect its patient list and other confidential data. The penalty was the result of a settlement with New York Attorney General Eric Schneiderman. Wyoming Administrative Code Chapter 3; Section 5 states, (b) Any physician licensed by the board who desires to relocate or close a medical practice shall notify patients of such termination, sale, or relocation and unavailability by causing to be published once during each week for four (4) consecutive weeks, in the newspaper of greatest circulation in each county in which the physician practices or practiced and in a local newspaper that serves the immediate practice area, a display advertisement which shall contain the date of termination, sale, or relocation and an address at which the records may be obtained from the physician or terminating the practice or located or from another licensed physician. Copyright 2005 by the American Academy of Family Physicians. Can a medical doctor perform acupuncture? When a physician retires or dies, patients should be notified and urged to find a new physician and should be informed that upon authorization, records will be sent to the new physician. Texas Medical Board Rules Chapter 165.5(a)(1-3) Transfer and Disposal of Medical Records. And 4) The state is completely silent on patient notification without any guidance available. Learn practical ways to communicate with disruptive or angry patients. Can a health care practitioner terminate a patient relationship?
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