For this reason, you should review the covenant as though it is entirely enforceable in accordance with its terms. After all, employers typically exclude information that might prompt patients to seek the outgoing providers services at a new practice. 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. 1997) supports this understanding. They worry that it will force them to abandon their established patients in violation of their legal and ethical obligations. The University of Rochester Medical Center (URMC) recently agreed to pay a $15,000 penalty for providing patient names, addresses, and diagnoses to a departing nurse practitioner (NP) without first obtaining authorization from those patients. In that circumstance, the list of names may be PHI. It is not just a piece of advice but also a legal requirement by several state and federal laws. Texas Medical Board Rules Chapter 165.5(a)(1-3) Transfer and Disposal of Medical Records. This comparative map shows the patient notification guidelines for all 50 states. URMCs Privacy and Security Executive Committee formed a task force to review the hospitals privacy and security requirements and the protocol for disclosure of PHI with respect to departing and incoming workforce members. All returned mail should be kept in patient file. 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. A 68-year-old woman came to an orthopedic surgeon due to pain in both knees. 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 provider who has not solicited a patient cannot, and should not, encounter barriers to providing treatment to that patient. Copyright 2005 by the American Academy of Family Physicians. 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. 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. This is referred to as nose coverage. Do not be seduced into foregoing the purchase of tail coverage. 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. In fact, you must notify them- you can't just leave and let them find out you're no longer their provider. Alert your state medical board in case patients contact them for information. 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. 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. Can a heath care practitioner refuse to treat a patient? Can a medical doctor perform acupuncture? The requirements of this rule shall not apply to a physician who has retired from or sold his or her medical practice if: Such physician has notified his or her active patients of retirement from or sale of practice by mail. During your review, pay careful attention to information about advance notice provisions, retirement plan details and noncompete covenants, to name a few key elements. The first example letter for notifying patients of a physician leaving their practice comes from Medical Center Clinic. Even without these prohibitions, you should not actively solicit the employment of existing employees, especially prior to your departure. 219, or send a letter to Harris County Medical Society, John P. McGovern Building, 1515 Hermann Dr, Houston, TX 77004-7126. She can be reached at laura-brockway@tmlt.org. 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. A physician in a multi-physician practice is retiring or leaving the geographic practice area. The notice shall provide the patient with 30 days to request a copy of his or her record or to designate where he or she would like his or her medical records transferred and shall request from the patient within 30 days written authorization for the destruction of his or her medical records., http://www.legislature.mi.gov/(S(qm1p2yrrhuxenh2d4yfgk1dd))/mileg.aspx?page=GetObject&objectname=mcl-333-16213, Mississippi State Board of Medical Licensure Policy 3.17 advises, whether by relocation, retirement, disability or death, the patient should be advised of the right to have the medical records sent to the physician of their choice. For instance, general advertisements, mailings to certain zip codes, and routine marketing activities normally would not meet this standard. Dont risk falling short on your notification message which can result in charges of abandonment. In our experience at Jackson LLP, rarely are any two non-solicitation clauses alike. 1) The state has enacted law regarding patient notification. The notice must include an explanation of how copies of the facilitys records may be accessed by patients. 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. 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 provider might still face constraints in accessing patients addresses and other information. 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, 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. For assistance, members of The Doctors Company can contact a patient safety risk manager at (800) 421-2368 or by email. The case of Bloomington Urological Associates, SC v. Scaglia, 686 N.E.2d 389 (Ill. App. 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. All Rights Reserved. Texas Medical Board. At our healthcare law firm, our clients frequently voice concerns over the non-solicitation provision in their employment agreements. Texas Medical Board Rules Chapter 165.5(c)(1-2) Prohibition Against Interference. 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. This content is owned by the AAFP. Such clauses generally cover a specific geographic area and period of time. The key is to prevent patients from falling through the cracks because of tensions between the physician and the practice. Hiring for Your Healthcare Practice? The physician must notify the TMB and his/her patients, and advise who has custodianship of the medical records and how a copy may be obtained. Drafting the Notification Letter . The employee pulls in the other direction, seeking to narrow the non-solicitation clause to reduce its impact on future work opportunities. Contact managed care companies with whom you have contracts. The cost of successfully defending a medical malpractice action is lifestyle altering. The Physician should have 3-5 years of experience of running an OB/GYN practice with leadership skills. The legal guidelines regarding patient notification vary for each state. 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. This will ensure that your departure date does not result in unnecessary forfeitures. The Florida Medical Association is not affiliated with the Board of Medicine. 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. Cover your tail. 2) The state offers guidelines, but without any statutory requirements or law enforcing notification practices. The KBHA serves as a great resource to physicians. 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. 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. 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. Determine whether solicitation of employees is prohibited. 2. The notice to patients should be a minimum of 30 days. Should patients be notified of the physicians departure? Leaving a practice can be a stressful time in any physicians career. 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. 10. Review noncompetition covenants. We can help you assess your rights and responsibilities. Here are several keys to handling the transition appropriately. This can be significant, especially if you deliver babies. At the same time, physicians are in high demand and have tremendous professional opportunities, ranging from starting a new practice to joining an existing one. 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. This example is conceptual. These functions included taking phone calls from existing patients with treatment-related questions. 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. 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. The practice should also provide a script for receptionists on what to say. Itshould not be used as a substitute for competent legal advice from a licensed attorney in your jurisdiction. 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). 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). Its an important aspect of [], At Cariend, we understand the challenges faced by healthcare facilities in transition. This means that if a malpractice event occurs during your employment but the claim is not filed until after you have left the practice, the malpractice insurer will not cover that claim because it was not made during your term of employment. The answer is yes. 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 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. 1. For example, practices often agree to pay for tail coverage in the event that employment is terminated by the practice without cause. 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. Accessed January 18, 2023. However, there are several other elements that could be helpful to your patients as they are searching for their next provider, having their medications refilled, or other specific needs related to continuation of care. 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. 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. See permissionsforcopyrightquestions and/or permission requests. 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. 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, Additional Resources: Texas Medical Association advises, Texas Medical Board (TMB) regulations say a physician leaving a group must notify his or her patients by: Publishing a notice either: On the physicians or practices website or In the newspaper of greatest general circulation in each county in which the physician practices or practiced, and in a local newspaper that serves the immediate practice area; and Placing a written notice in the physicians office; and Sending patients the physician has seen in the last two years either: A notice in a letter or A notice in an email in a manner compliant with state and federal law. It may, if it chooses, permit the physician to have input as to the text of the notice. Your contract may contain provisions against your soliciting the employment of existing employees of the practice. 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." 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. 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 . 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. This is done so patients cannot sue for abandonment. To avoid charges of abandonment, youll need to send a letter to active patients., https://www.llr.sc.gov/med/Policies/ClosingOffice.pdf, South Dakota Codified Law (SDCL) 44:04:09:11 states, At least 30 days before closure, the health care facility must notify the department in writing indicating the provisions for the safe preservation of medical or care records and their location and publish in a local newspaper the location and disposition arrangements of the medical or care records., https://sdlegislature.gov/api/Rules/Archived/1540.pdf, Texas Administrative Code Rule 190.8 22:9:190: b states, Practice Inconsistent with Public Health and Welfare. 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. That case involved a dispute over a non-compete in a urologists employment agreement. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); What kind of notification should or do I have to give to patients if I am retiring, Hospitals are often growing, acquiring new facilities and systems to expand their reach and services.