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. 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. 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. 10. Review noncompetition covenants. 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. What if a given non-solicitation provision does not restrict a providers right to notify patients of his or her departure? The provider might still face constraints in accessing patients addresses and other information. This comparative map shows the patient notification guidelines for all 50 states. The California Medical Board ("CMA") advises that patients should be notified of changes in the medical practice and recommends "that due care should be exercised when closing or departing from a medical practice." 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. For TMB rules on notification requirements and more, refer to Chap 165.5 - Transfer and Disposal of Medical Records. A non-solicitation provision is usually triggered only by an action. 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. In addition, an individual letter is to be sent to each patient seen within the three years preceding the date of discontinuance of the practice., https://portal.ct.gov/DPH/Public-Health-Hearing-Office/Regulations/Public-Health-Code-Medical-Records-Regulations, Delaware Code Title 24 1761 states physicians discontinuing business: shall notify that persons patients of record by publishing a notice to that effect in a newspaper of daily circulation in the area where the person practices. The American Medical Association's 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 . Generally, tail coverage costs between 1.5 and two times a physicians annual premium. 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. Abandonment occurs when a physician withdraws his services after a physician-patient relationship has been established, by failing to give notice to the patient of the physicians intention to withdraw in sufficient time to allow the patient to obtain necessary medical care. 8. All Rights Reserved. Voice mail systems can also be modified to provide new contact information after the physician has departed. Such property is confidential and, therefore, not to be used or disclosed following termination of the providers employment. URMC responded by sending breach notification letters to the affected patients and notifying the media. 4 Compliant Examples of Letters for Notifying Patients of Physician 5 Ways to Cover a Physician's Departure from Your Practice 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. That case involved a dispute over a non-compete in a urologists employment agreement. Save my name, email, and website in this browser for the next time I comment. Florida Board of Medicine General Office Practices/Protocol FAQs workforce on policies and procedures related to PHI and notify the Attorney General of future breaches. 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. Even without these prohibitions, you should not actively solicit the employment of existing employees, especially prior to your departure. If you had signed a non-compete, you would refer them to the other providers in your practice. 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). Some states dont specifically list steps for closing a practice, but simply note the requirements for terminating a physicians relationship to patients. The court, however, disagreed. Negotiations over non-solicitation restrictions can play out like a game of tug of war. Courts have, however, held physicians liable for breach of non-solicitation agreements and misappropriation of trade secrets when Don't worry, I did that on purpose. 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. Dont risk falling short on your notification message which can result in charges of abandonment. 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. Does a heath care practitioner have to accept new patients? They worry that it will force them to abandon their established patients in violation of their legal and ethical obligations. 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. 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. 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. 5. Review your retirement plans. Copyright 2006 - 2023 Law Business Research. (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. Readers should consult their healthcare attorney to obtain advice with respect to any legal matter. Unless your employment agreement provides otherwise, you may be able to notify patients that you are leaving the practice . Podiatrists are licensed and regulated by the Florida Board of Podiatric Medicine. Copyright 1997-2023 TMLT. PDF The Doctor is Out 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. Closing or leaving a practice: Tips for primary care physicians 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). Be aware that patient lists, patient charts and other patient demographic information are property of the practice, not the departing physician. The health care entity, which is the party responsible for maintaining custody of the medical record, should send the notice. 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. As the above discussion shows, solicitation and patient abandonment claims are not limitless. The KBHA serves as a great resource to physicians. It may, if it chooses, permit the physician to have input as to the text of the notice. 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. 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. 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: As these examples show, non-solicitation does not mean no contact. Each patient should receive a letter and notices should appear in local newspapers at least three times over a few months or more. It is not just a piece of advice; several state and federal regulations make it a mandate. A notice in an email in a manner compliant with state . 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. In addition to sending letters, think carefully about how you will address this topic when you speak with patients. Subsection: F9 states, If a licensee retires, moves from the area or decides to stop treating a patient or group of patients, the licensee shall: a. 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. 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.