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. 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. It is imperative patients are notified well in advance of closure to ensure they have access to their medical records for continuation of care. 2023 Jackson LLP Healthcare Lawyers. Rather than include the providers new practice location, the notice may identify another provider within the practice who can continue to treat 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. Many states require that patients be notified when a physician is departing a practice. Even without these prohibitions, you should not actively solicit the employment of existing employees, especially prior to your departure. What should be in the notice? Patient Notification Requirements for a Closing Medical Practice - Cariend 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. 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). At our healthcare law firm, our clients frequently voice concerns over the non-solicitation provision in their employment agreements. 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. Notification may be satisfied using any of the following methods: (1) by placing a notice in at least one newspaper in the local practice area; notice should advise patients where their medical records will be stored; notice should include any pertinent information the patient may need for obtaining or transferring the records, including the name, mailing address and telephone number of a contact person with access to the stored records; notification should run a minimum of two times per month for three months to reach a maximum number of patients; or (2) by written or electronic mail; or (3) by individual correspondence to the patients last known physical or electronic mail address. The scope of practice of CNAs, as well as other nursing professions (RN, APRN, etc.) However, the provider can arrange for the employer to give the notice on the providers behalf. First, ensure proper notice is provided to patients as well as all interested governmental entities and other organizations. Readers should consult their healthcare attorney to obtain advice with respect to any legal matter. This blog is made for educational purposes and is not intended to be specific legal advice to any particular person. Medicine's great resignation? 1 in 5 doctors plan exit in 2 years https://regulations.justia.com/states/wyoming/medicine-board-of/medicine-board-of/chapter-3/section-5/. In healthcare, non-solicitation restrictions can extend to patients and other providers who refer patients to the practice or business. The notice must include an explanation of how copies of the facilitys records may be accessed by patients. This comparative map shows the patient notification guidelines for all 50 states. An official letter to your patients is highly recommended. State advises, the following requirements regarding closures must be met: each patient, resident, next of kin, physician and sponsor must be notified immediately upon receipt of the Department of Healths approval. 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. As these examples show, non-solicitation does not mean no contact. Hear from top leaders in medicine Many states require that patients be notified when a physician is departing a practice. If you would like to learn how Lexology can drive your content marketing strategy forward, please email [emailprotected]. The court, however, disagreed. Yes. Florida Board of Medicine General Office Practices/Protocol FAQs Make sure that if there are legal guidelines in you state, that you review them. Drafting the Notification Letter . It does not create an attorney-client relationship between our firm and the reader. When scheduling your departure from the practice, take reasonable steps to ensure that you are not leaving any patients in a bind. is regulated by the Florida Board of Nursing. 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. The notice to patients should be a minimum of 30 days. Approximately ninety days is suggested whenever possible. Your contract may contain provisions against your soliciting the employment of existing employees of the practice. Accessed January 18, 2023. Before you make any decisions, revisit your employment contract and your states laws regarding the issue. While the Board rule does not specify the mode of notification, it would be difficult to ensure patients received notification by a newspaper ad. 7. Hiring for Your Healthcare Practice? 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. 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. https://www.ilga.gov/legislation/publicacts/fulltext.asp?Name=093-0087, Indiana Administrative Code 844 IAC 5-2-16 states, A practitioner, upon his/her retirement, or upon discontinuation of the practice of medicine or osteopathic medicine, or upon leaving or moving from a community, shall notify all of his/her active patients in writing, or by publication once a week for three (3) consecutive weeks in a newspaper of general circulation in the community, that he/she intends to discontinue his/her practice of medicine or osteopathic medicine in the community, and shall encourage his/her patients to seek the services of another practitioner., https://www.in.gov/pla/professions/medical-licensing-board-of-indiana/public-notices/practice-related-faqs/, Iowa Administrative Code 13.7(1) states, Termination of the physician-patient relationship. Leaving a group practice. For example, practices often agree to pay for tail coverage in the event that employment is terminated by the practice without cause. Placing a sign on the door of the closed practice only works if the space will not have future tenants. http://164.64.110.134/parts/title16/16.010.0017.html, Additional Resources: The New Mexico Medical Society offers, Closing Your Practice Guide: 9. (i) Sending a letter to each patient; OR This may vary from practice to practice. 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. Determine whether solicitation of employees is prohibited. 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. TMB rules for physicians who retire, close, or leave a practice - TMLT Dont risk falling short on your notification message which can result in charges of abandonment. We are looking for outstanding providers with leadership experience, who are committed to delivering high quality and compassionate patient care, to join our team. For determining your best course of action on notification, rely on an experienced custodial records provider that can share examples of what others have done, participate in a dialog with your malpractice insurer or healthcare attorney, and determine what is best for your specific practice type and patients in order to balance cost, patient care, and reasonability. And 4) The state is completely silent on patient notification without any guidance available. 115(4): 325327 advises, practices must notify patients as soon as possible to facilitate continued patient care. 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. If the restrictive covenant specifically prohibits the physician from treating patients he saw while employed with his former employer, there is case law that indicates a physician may not be able to treat the patient regardless of who establishes first contact. However, here are a few baseline recommendations: For example, a common suggestion is to place repeating local newspaper ads to notify the public of a closing practice. A non-solicitation clause only prohibits solicitation. For instance, general advertisements, mailings to certain zip codes, and routine marketing activities normally would not meet this standard. You'll quickly notice that it's actually not a letter that talks about a physician leaving, rather it's a new doctor welcome letter. The FMA also recommends that the practitioner terminating the relationship should provide assistance in locating another practitioner for the patient. No. 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. Can a heath care practitioner refuse to treat a patient? Mustafa Kinaan has shown his dedication to the Central Florida community throughout his graduate medical education (GME) journey. 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. These rule changes also apply when leaving a group practice, as the departing physician is responsible for providing proper notification. Departing Physicians and Patient Notification - Krugliak, Wilkins Yes. Those remaining in the practice must be careful not to interfere with the departing physician fulfilling these responsibilities. 2. 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. Learn practical ways to communicate with disruptive or angry patients. How to text patients and colleagues without violating the Health Insurance Portability and Accountability Act. It may, if it chooses, permit the physician to have input as to the text of the notice. 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. Further, many deferred-compensation arrangements are linked to the amount of notice given. Its an important aspect of [], At Cariend, we understand the challenges faced by healthcare facilities in transition. 5 Ways to Cover a Physician's Departure from Your Practice 3. Why? Proactive [], American Medical Association (AMA) guidelines, https://www.cms.org/uploads/BME_Policy_40-8.pdf, https://drive.google.com/file/d/0B-K5DhxXxJZbZGZUdllNbUFvdDg/view, https://www.ama-assn.org/delivering-care/ethics#Chapter%201:%20Opinions%20on%20Patient-Physician%20Relationships, https://cdn.ymaws.com/lsms.site-ym.com/resource/resmgr/resources/lsms_resource_closingamedica.pdf, http://www.lsbme.la.gov/content/health-care-resources-practitioner, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140270/, https://www.msma.org/guide-to-closing-a-medical-practice.html, https://www.njconsumeraffairs.gov/bme/Pages/FAQ.aspx, http://164.64.110.134/parts/title16/16.010.0017.html, http://www.nmms.org/wp-content/uploads/2018/08/closing_your_practice_2016_revised_-_pcs_0.pdf, 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, https://www.texmed.org/Template.aspx?id=6676, State offers no guidance, but association guidelines available. 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. In Illinois, as in many other states, patient abandonment is not only a form of malpractice; for physicians, it is also grounds for disciplinary action against ones license. Most practices only close once. 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. 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. That case involved a dispute over a non-compete in a urologists employment agreement. For this reason, you should review the covenant as though it is entirely enforceable in accordance with its terms. What is the health care entitys responsibility when a physician departs? 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 . University of Florida Levin College of Law UF Law Scholarship Repository Understand who owns the chart. 5. Review your retirement plans. 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. All rights reserved, Prohibition Against Interference 165.5(c)(1-2). Though every clients situation is unique, a good place to start when planning for your practices records after retirement or closure is reviewing the legal guidelines for your state regarding patient notification. The TMB has rulesprohibiting the practice or physician group from interfering. (B) Placing written notice in the physician's office; AND Notifying patients should be done within three months in advance; thirty (30) days at minimum. The employee pulls in the other direction, seeking to narrow the non-solicitation clause to reduce its impact on future work opportunities. It may also resolve the issue in advance by including a provision in the physicians written employment or other affiliation agreement that specifies the details of the notice that the health care entity will send in the event of the physicians departure. 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. A provider who has not solicited a patient cannot, and should not, encounter barriers to providing treatment to that patient. 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. Supreme Court Decision Impacts FLSAs Overtime Rules, Update on San Franciscos Treatment of Vacant Properties, 2023 Filing Requirements and Contribution Limits for California Major Donors, Checklist: Processor due diligence (data protection and cybersecurity) (UK), Checklist: Obtaining and managing consent under the GDPR (UK), Checklist: Assessing whether an organisation is a controller or processor under the GDPR (UK), Notice to the patient that the physician will no longer be practicing medicine at the health care entity, The date the physician ceased or will cease to provide medicine services at the health care entity, If the physician will be practicing medicine in another location,contact information for the physician subsequent to leaving the health care entity, Contact information for an alternative physician or physiciansemployed by the health care entity or contact information for a group practice that can provide care for the patient. 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. 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). 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. It must protect the patients medical record and not release it without patient authorization. Can Physician Assistants Own Independent Medical Practices? 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. Notify Third Parties Dependent upon the provisions of contracts and state law, the insured physician and practice may need to notify various third parties. 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. 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. The analysis will always depend on the particular circumstances involved. It is not just a piece of advice but also a legal requirement by several state and federal laws. Notifying Your Patients When You Leave a Practice Notices to Patients When a Physician Leaves a Group Practice Colorado provides a combination of guidelines and state laws, and while their categorization in terms of whether its a law or mere guidance isnt completely clear, when considering the information as a whole it compels Colorado physicians to make provisions to ensure the physician (or estate) isnt liable for abandoning patients or their records. Starting, Closing, or Selling a Practice | AAFP [], Smart hospitals and medical facility managers already know how to capture savings in health information management by [], Hospitals and healthcare providers are aways looking for opportunities to increase savings. 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. 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. Save my name, email, and website in this browser for the next time I comment. Apply Renew Maintain Practice Information 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. Say, for example, a provider leaves a dermatology practice to join a medical spa that performs cosmetic procedures not available at the dermatology practice. A notice in an email in a manner compliant with state . 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. Some employment agreements indicate that the practices general policies and procedures may be applicable even if they are contrary to the physicians employment agreement. Is a list of patient names without information about the patients medical condition considered PHI? 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. Be aware that patient lists, patient charts and other patient demographic information are property of the practice, not the departing physician. 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. 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. State advises providers follow (1) AMA and (2) Louisiana State Medical Society Guidelines. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140270/, Additional Resources: The Missouri State Medical Association offers, Be sure to notify your patients regarding your retirement. Cover your tail. For TMB rules on notification requirements and more, refer to Chap 165.5 - Transfer and Disposal of Medical Records. 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. The case of Bloomington Urological Associates, SC v. Scaglia, 686 N.E.2d 389 (Ill. App. 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. 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. Such clauses generally cover a specific geographic area and period of time. The Medical Center suspended and ultimately terminated the nurse practitioner and treated the incident as a reportable breach. Rarely do practices agree that patient charts are the property of the employed physician. 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.