4 Compliant Examples of Letters for Notifying Patients of Physician Many practices obtain claims made malpractice insurance policies that insure you for claims made during your term of employment. If the practice has social media, post the notification message there as well. Understand your clients strategies and the most pressing issues they are facing. The comparison is intended to serve as a resource to help retiring physicians and closing practices navigate their obligations and avoid regulatory penalties as a result of the patient notification process. Closing or Relocating a Healthcare Practice - The Doctors For instance, general advertisements, mailings to certain zip codes, and routine marketing activities normally would not meet this standard. You should: (1) Notify patients by letter that your practice will end and give the effective date (2) Notify patients of the record location and how to access them (3) Advise patients that they must seek the services of another health care provider or refer them to another provider (4) Advise patients that their records will be forwarded to the provider of their choice upon receipt of a properly signed release form., https://www.oregon.gov/omb/Topics-of-Interest/Pages/Patient-Records.aspx, Pa. Code 16.61(a)(17) states, (a) A Board-regulated practitioner who engages in unprofessional or immoral conduct is subject to disciplinary action under section 41 of the act (63 P. S. 422.41). Notice to Patients on the Departure of a Physician September 2007 Texas Medical Board Regulations When a physician departs a group, the issue of continuity of care for patients should be considered. 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. The notification letter should be professional and nonconfrontational, and it should set a tone that aims to maintain the best possible relationship with the patient. Ultimately, a patient always has the right to seek out a provider of their choosing. It is critical that you understand what you have promised to do and what has been promised to you via these documents. Closing or Relocating? | Emerald Coast Medication Association Just because a provider ends patient relationships following termination of employment and cannot, by contract, solicit the employers patients for further treatment, does not mean that the provider is necessarily at risk of liability for patient abandonment. For many providers, mitigating the risk of patient abandonment requires formally ending the patient-provider relationship and providing information about how to receive the same or similar services. Such an approach may frustrate the provider who is leaving. 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. Why? Employment contracts usually reinforce this notion. 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 . Each state treats notification guidance differently, but their approach generally falls within four distinct categories. This creates a quandary because although you may need new employees, you do not want to appear to be soliciting from the existing practice. Additional Resources: The Kansas Medical Society advises physician, Develop and send a letter notifying patients of closing date and contact information of the custodian., https://www.kmsonline.org/resources/practice-operations/26-general-topics/120-transitioning-a-medical-practice. 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. As this case shows, the interests of an employer in enforcing a restrictive covenant must be balanced by a providers duty not to abandon their patients. If a non-solicitation attempted to forbid any treatment whatsoever of patients from the employers practice, then it would likely be unenforceable in Illinois. The next generation search tool for finding the right lawyer for you. In this instance, the departing physician and/or practice should send a letter notifying patients of the change, and offering to provide continuous care for the patients, or offering to transfer records to another provider upon request. The physician fails to provide for continuity of prescription medications between the notice of intent to withdraw from the physician-patient relationship and the date on which the physician-patient relationship ends, if the prescription medications are necessary to avoid unacceptable risk of harm. It is, however, not uncommon for employees to solicit the departing physician prior to departure. Failure to practice in an acceptable professional manner consistent with public health and welfare within the meaning of the Act includes, but is not limited to: (j) termination of patient care without providing reasonable notice to the patient. When Physicians Leave a Practice: Seven Keys to a Smooth Transition 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. 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. 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. There may also be different rules for different types of medical facilities or practice types, such as hospital vs. private practice, or psychiatry vs. dentistry. The notice to patients should be a minimum of 30 days. TMB rules for physicians who retire, close, or leave a practice. How to Ensure Continuity of Care If a Physician Leaves Your Practice https://regulations.justia.com/states/wyoming/medicine-board-of/medicine-board-of/chapter-3/section-5/. Can a medical doctor perform acupuncture? The health care entity has the dual role of safeguarding the medical record while facilitating continuity of care. All rights reserved. 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. In these cases, patients do not expect the same provider to perform related services in the future. Harris County Medical Society. Mailing letters to every patient in your statutory retention window may not be effective either, especially if your state has a baseline of 7-10 years for medical records retention. This content is owned by the AAFP. Contrary to common conception, the federal Health Insurance Portability and Accountability Act(HIPAA) and similar state laws do not entitle providers to access or copies of their employers patient information and records. https://docs.legis.wisconsin.gov/code/admin_code/med/10/03/3/j. Each patient should receive a letter and notices should appear in local newspapers at least three times over a few months or more. Podiatrists are licensed and regulated by the Florida Board of Podiatric Medicine. 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. https://www.leg.state.nv.us/nrs/nrs-630.html#NRS630Sec304, NH Rev Stat 329:9 Section: Med 501.02 Standards of Conduct. 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. 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. According to the urologists former employer, such activities violated the non-compete. No. Which patients should be notified? For instance, providers who staff emergency departments, hospitalist programs, and urgent care centers render care that is episodic in nature. In healthcare, this tug of war can implicate another stakeholder: the patient. Posted 3:52:36 PM. Your careful attention to these details will ensure a smooth transition to a new practice. Contact information that enables the patient to obtaininformation on the patient's medical records. While the Board rule does not specify the mode of notification, it would be difficult to ensure patients received notification by a newspaper ad. Copyright 2005 by the American Academy of Family Physicians. 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. The answer is yes. Say, for example, a provider leaves a dermatology practice to join a medical spa that performs cosmetic procedures not available at the dermatology practice. Starting, Closing, or Selling a Practice | AAFP The key is that the notice affords a reasonable time to find substitute care., See our related video, Patient Abandonment.. Patient Notification Requirements for a Closing Medical Practice - Cariend 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. Texas Medical Board Rules Chapter 165.5(a)(1-3) Transfer and Disposal of Medical Records. Physicians are under a tremendous amount of pressure in todays health care environment as costs escalate, reimbursement declines and the malpractice crisis continues. It must protect the patients medical record and not release it without patient authorization. For example, the Ohio Medical Board has adopted specific rules about the content of the notice, which must include the following (Rule 4731-27-03): The Ohio rules require the health care entity to send the notice to patients, but it may satisfy its statutory obligation by providing patient contact information to the departing physician and requiring the physician to send the notice to patients. The practice should also provide a script for receptionists on what to say. Before leaving, she asked for a list of patients she treated while employed at URMC, and URMC provided her with a spreadsheet containing the protected health information (PHI) of 3,403 patients. 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. 3. Can a heath care practitioner refuse to treat a patient? As we were assembling the resources for this document, we were amazed at the level of vague, incomplete, and even inaccurate material on the internet regarding notification requirements for closing medical practices. (C) Notifying patients seen in the last two years of the physician's discontinuance of practice BY EITHER: Many physicians believe these covenants will not be enforced; however, the courts in most states will uphold them if they are reasonable. PDF The Doctor is Out Mustafa Kinaan has shown his dedication to the Central Florida community throughout his graduate medical education (GME) journey. Texas Medical Liability Trust Resource Hub, 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). Nevada Revised Statues (NRS) 630.304 states, The following acts, among others, constitute grounds for initiating disciplinary action or denying licensure: (7) Terminating the medical care of a patient without adequate notice or without making other arrangements for the continued care of the patient. . 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. Should patients be notified of the physicians departure? As these examples show, non-solicitation does not mean no contact. Further, many retirement plans have vesting schedules that depend on the number of years one has worked with the employer. Yes. Some employment agreements indicate that the practices general policies and procedures may be applicable even if they are contrary to the physicians employment agreement. Many states defer to their state medical society or American Medical Association (AMA) guidelines, which are not legal requirements, and typically do not cover all of the potential variables that may exist in your situation. A physician can perform acupuncture under his/her medical license as long as he/she is properly trained and educated in the field of acupuncture. 10. Review noncompetition covenants. Further, many deferred-compensation arrangements are linked to the amount of notice given. It also informed URMCs workforce of its policy that information regarding continuity of care was to be communicated to patients by URMC, not the individual health care providers. 5. Review your retirement plans. Having undertaken the care of a patient, the physician may not neglect the patient. Every state has a long list of requirements to obtain and maintain a license to practice medicine, but when it comes to closing a practice, most states only offer (at best) guidelines for what to do when ending a practice, and some states offer no guidance at all. Leaving a practice can be a stressful time in any physicians career. This notice shall be no less than two columns wide and no less than two inches in height. A physician in a multi-physician practice is retiring or leaving the geographic practice area. This must be done by placing a notice in a daily local newspaper published in the community which is the prime locus of the practice. 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. 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: An official letter to your patients is highly recommended. If you are asking your partner to leave, you need to know the practices rights and obligations to him or her. Below we share both guidance from the State Board of Medical Examiners and information available from the Department of Regulatory Agencies (DORA) indicating regulatory penalties that could be assigned for not ensuring patient access to records. After all, employers typically exclude information that might prompt patients to seek the outgoing providers services at a new practice. The physician fails to give the patient at least 30 days notice in advance of the date on which the physicians withdrawal becomes effective. The notice must include at least the following information: (1) a notice to the patient that the physician will no longer be practicing medicine as an employee of the health care entity and the date on which the physician ceased or will cease to practice as an employee of the health care entity; (2) except where the health care entity has a . We understand the process can feel daunting. 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. 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. A 24-year-old pregnant woman came to her ob-gyn with a headache and high blood pressure. This will ensure that your departure date does not result in unnecessary forfeitures. Can I take a copy of my patients records with me, in case they need care from me in the future. Some states even require or suggest 30 days prior written notice before a departure so that patients will have sufficient time to transfer their records if they desire to change physicians. Leaving Group Practice - hcms.org A clean departure will save you headaches and possibly dollars in the immediate future and in the long run. Some states dont specifically list steps for closing a practice, but simply note the requirements for terminating a physicians relationship to patients. A provider who has not solicited a patient cannot, and should not, encounter barriers to providing treatment to that patient. 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. On the other hand, a notice directed to specific patients that informs them that the provider is leaving the employer's practice and identifies a new practice where the patient can receive the same or similar services is much closer to the line of solicitation. The Texas Medical Board (TMB), in an attempt to address this issue, adopted regulations that must be followed whenever a physician leaves a group. (i) Sending a letter to each patient; OR The sign shall be placed at least 30 days prior to the termination, sale or relocation of the practice and shall remain until the date of termination, sale or relocation. 1. In Ontario and Alberta, for example, at least 90 days notice is required, unless the closure is unexpected or due to circumstances beyond the physician's control, in which case the notice must be communicated as soon as reasonably possible. You may start by searching for your state requirements, but quickly end up at a third-part source that has paraphrased or misinterpreted the laws. What determines a critical or high-risk patient? 2. Review the practices established policies. The following are best practices for notifying patients: Send current patients (i.e. 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. Call 713-524-4267, ext. TMB rules for physicians who retire, close, or leave a practice - TMLT What if a given non-solicitation provision does not restrict a providers right to notify patients of his or her departure? Prohibition Against Interference 165.5(c)(1-2)rules state that: Practice Information Physicians and Surgeons A Physician or Surgeon (M.D.) In this way, the provider might avoid claims of patient abandonment. 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. However, it at least informs the patients that the provider is not responsible for their further care. These guidelines tend to put a heavy burden on the physician, leaving them to decide on their own, items such as: In all cases, even if a particular state offers no specific requirements or guidelines for closing practice notifications, every state is clear about seeking to penalize physicians for complaints of abandonment or untimely records access if the steps chosen by the physician fail to meet an unpublished standard. 7. Often practices and departing physicians will agree on what to tell patients who inquire about the tenure of the departing physician. A physician may choose whom to serve. But it is highly recommend for the protection of the physician and the patient.