A long notice period is often difficult for a non-retiring physician to give, but these issues deserve consideration. Should patients be notified of the physicians departure? 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. 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. The content of the notice will depend upon state law. For example, practices often agree to pay for tail coverage in the event that employment is terminated by the practice without cause. Litigating a covenant, either from the employer or employees perspective, is expensive. (i) Sending a letter to each patient; OR 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. Doing so could subject the provider to claims of abandonment by the patient. http://164.64.110.134/parts/title16/16.010.0017.html, Additional Resources: The New Mexico Medical Society offers, Closing Your Practice Guide: (2). In healthcare, non-solicitation restrictions can extend to patients and other providers who refer patients to the practice or business. Sources Keep a step ahead of your key competitors and benchmark against them. 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. Practice Information Physicians and Surgeons A Physician or Surgeon (M.D.) 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. 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. Another helpful approach, particularly for specialized physicians, is to provide referrals to nearby practices or physicians offering similar types of care or services. These functions included taking phone calls from existing patients with treatment-related questions. Contact managed care companies with whom you have contracts. 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. Typically, a non-competition provision prohibits an employee from joining or starting a competitor business. It is, however, not uncommon for employees to solicit the departing physician prior to departure. 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. A clean departure will save you headaches and possibly dollars in the immediate future and in the long run. In that circumstance, the list of names may be PHI. 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. You and the practice have an obligation to provide proper care for your patients. All rights reserved. A non-solicitation clause only prohibits solicitation. Rather than include the providers new practice location, the notice may identify another provider within the practice who can continue to treat the patient. 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. 3. You should review the details of your plan so that you do not unwittingly forfeit significant amounts of retirement money. 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. 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. Notices to Patients When a Physician Leaves a Group Practice When a physician leaves a group practice, the physician has a duty and a right to notify his or her patients. 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. (4) Notices placed in the physician's office shall be placed in a conspicuous location in or on the facade of the physician's office as a sign announcing the termination, sale or relocation of the practice. Copyright 2006 - 2023 Law Business Research. 1) The state has enacted law regarding patient notification. 5. Review your retirement plans. Rarely do practices agree that patient charts are the property of the employed physician. How to text patients and colleagues without violating the Health Insurance Portability and Accountability Act. Can I take a copy of my patients records with me, in case they need care from me in the future. . 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. Your contract may require that you give your practice advance written notice of your departure. 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. While some employers will contractually agree to pay tail insurance in certain events, a thorough review of your employment agreement, and sometimes the shareholders or operating agreement, will determine who is responsible for procuring tail coverage. 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). 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. 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. In this way, the provider might avoid claims of patient abandonment. Approximately ninety days is suggested whenever possible. This growth [], Filling out patient records requests at Cariend just got a whole lot easier. As these examples show, non-solicitation does not mean no contact. In any case, some of the most effective notification arrangements you can make include: As you look for notification guidance on the internet, carefully assess the credibility of the source for information. Contact information that enables the patient to obtaininformation on the patient's medical records. The first example letter for notifying patients of a physician leaving their practice comes from Medical Center Clinic. See permissionsforcopyrightquestions and/or permission requests. URMC began receiving calls from patients who were upset that their confidential medical information had been disclosed without their permission. Notify Third Parties Dependent upon the provisions of contracts and state law, the insured physician and practice may need to notify various third parties. This creates a quandary because although you may need new employees, you do not want to appear to be soliciting from the existing practice. 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. 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. 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. 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. The health care entity, which is the party responsible for maintaining custody of the medical record, should send the notice. Physicians are generally required to notify patients directly through one or more channels . Also, we advise that a letter is sent to all patients seen within the last year with the same information and possible suggestions for other physicians., State advises, It is the Boards position that due care should be exercised when closing or departing from a medical practice. It must protect the patients medical record and not release it without patient authorization. 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). 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. 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). 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). The notice may be given by publication in a newspaper of general circulation in the area in which the health care facility is located. Texas Medical Board Rules Chapter 165.5(c)(1-2) Prohibition Against Interference. 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. Each state treats notification guidance differently, but their approach generally falls within four distinct categories. 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. When Would My Healthcare Practice Use a Promissory Note? 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. 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 . workforce on policies and procedures related to PHI and notify the Attorney General of future breaches. 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. Ensuring that patients receive reasonable notification; Ensuring that patients are given an opportunity to obtain copies of their records or arrange for the transfer of their medical records to another physician; Specifying who has custodianship of the records; and, Advising how copies of the medical records may be obtained.. (C) Notifying patients seen in the last two years of the physician's discontinuance of practice BY EITHER: Notify patients in writing, through a letter carefully crafted with input from practice colleagues or the employing . And 4) The state is completely silent on patient notification without any guidance available. The statute adopts the concept of a "records owner." A "records owner" may or may not be a physician. Here are several keys to handling the transition appropriately. Assuming the physician is leaving the practice on good terms and with ample time to prepare for the departure, the key consideration is ensuring that patients are properly notified in a timely and professional manner. Notifying Patients of a Doctor's Retirement You may have observed that communicating with your patients about your leaving is essential in each of the processes we covered above. Podiatrists are licensed and regulated by the Florida Board of Podiatric Medicine. 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. Placing a sign on the door of the closed practice only works if the space will not have future tenants. They are often related to, but distinct from, non-competition clauses, or non-competesanother type of restrictive covenant common in employment agreements. Can Physician Assistants Own Independent Medical Practices? If you use certified, return receipt mail, you can place a copy of the letter and return receipt in the patients file in case there is ever an issue of notification., https://www.albme.gov/resources/licensees/practice-issues, Alaska State Medical Board adopted AMA policy No. Can a health care practitioner terminate a patient relationship? (ii) Sending an email to each patient, in a manner that is compliant with state and federal law. In contrast, patient abandonment is more prone to arise from the failure to properly act. If you are asking your partner to leave, you need to know the practices rights and obligations to him or her. The analysis will always depend on the particular circumstances involved. However, weve found its always useful to clarify what exactly non-solicitation and patient abandonment mean and what they do not mean. When scheduling your departure from the practice, take reasonable steps to ensure that you are not leaving any patients in a bind. Call 713-524-4267, ext. Mustafa Kinaan has shown his dedication to the Central Florida community throughout his graduate medical education (GME) journey. 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. Laura Hale Brockway is the Vice President of Marketing at TMLT. Confidentiality clauses usually define patient information and records generated during the providers employment as the practices property. Courts have, however, held physicians liable for breach of non-solicitation agreements and misappropriation of trade secrets when Abandonment also occurs when a physician leaves the employment of a group practice, hospital, clinic or other health-care facility, without the physician giving reasonable notice and under circumstances which seriously impair the delivery of medical care to patients., https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/049/chapter16/chap16toc.html&d=, State advises, Publish a notice 90 days before closing a practice in a newspaper with statewide circulation, including information on how patients can get their medical records (when a physician is deceased, the heirs or the estate must give the same public notice within 90 days); Send a letter to patients that have been seen within the past year notifying them of the practice closure., https://health.ri.gov/healthcare/about/closingpractices/, State advises, Doctors should advertise in all papers, and notify all patients (no matter how long ago treated) the letter of closing. Keep a copy of the notification letter in the patient's record. 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. 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. If the practice has social media, post the notification message there as well. This letter must be sent by certified mail, return receipt requested. Texas Medical Board Rules Chapter 165.5(c)(1-2) Prohibition Against Interference. 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. Even without these prohibitions, you should not actively solicit the employment of existing employees, especially prior to your departure. Even if a communication is arguably solicitous, it might fall outside the scope of a non-solicitation clause if it pertains to services not offered by the employer. 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. This comparative map shows the patient notification guidelines for all 50 states. A 24-year-old pregnant woman came to her ob-gyn with a headache and high blood pressure. 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. Don't worry, I did that on purpose. leaving a practice Within 90 days after a death . Your careful attention to these details will ensure a smooth transition to a new practice. Cover your tail. An example letter . Or, in limited circumstances, the new practice may provide coverage through a new policy with a retroactive endorsement date. Texas Medical Board Rules Chapter 165.5(a)(1-3) Transfer and Disposal of Medical Records. This makes it very unfair to a physician closing their practice and illustrates why the steps outlined here are important to help closing practices avoid trouble, ensure continuity of patient care, and achieve peace of mind. 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. 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 office should also consider changing its answering message to alert patients If possible, consider posting your retirement in your local newspaper(s) as well as on your website and/or social media pages (if applicable). Indeed, this may be especially appropriate when the employment agreement defines patients treated by the employee as the employers. Leaving a group practice. This may vary from practice to 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. The physician fails to allow for patient access to or transfer of the patients health record as required by law. 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. Texas Medical Board. Are you a healthcare provider considering a new employment agreement with a non-solicitation clause? (I) Posting such notice on the physician's or practice website; OR 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. For TMB rules on notification requirements and more, refer to Chap 165.5 - Transfer and Disposal of Medical Records. Unless your employment agreement provides otherwise, you may be able to notify patients that you are leaving the practice . A Coda to the Covid Pandemic: Do Local and State Closure Laws Provide Cover for Tenant Nonpayment of Rent? What should be in the notice? Copyright 1997-2023 TMLT. For the states that do not offer specific guidance on closing a medical facility and simply defer to AMA or state medical society guidelines, understand these are third-party sources are merely providing general guidance, and not legal or practice-specific advice. For example, you would never want to be in a situation where you felt compelled to lie to a patient. 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 . Web Design Trundlemedia, Health Insurance Portability and Accountability Act(HIPAA). It must protect the patients medical record and not release it without patient authorization. Recent changes to Board rule 165.5 have expanded the exceptions to providing notice to patients.. A physician is not required to provide notice of his or her discontinuation of practice to patients if the physician: treated the patient while in a locum tenens position at a practice location for a period of no longer than six months at that location. Readers should consult their healthcare attorney to obtain advice with respect to any legal matter. Say, for example, a provider leaves a dermatology practice to join a medical spa that performs cosmetic procedures not available at the dermatology practice. According toSchneiderman, Other medical centers, hospitals, health care providers, and health care entities should view this settlement asa warning, and take the time now to review and amend, asneeded, their own policies and procedures to better protect private patient information.. Determine whether solicitation of employees is prohibited. The answer is yes. 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. 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.