What can I tell my patients when Im leaving my employer? Be aware that patient lists, patient charts and other patient demographic information are property of the practice, not the departing physician. Notify the regulatory and business agencies impacted by your closure, including Centers for Medicare & Medicaid Services (CMS), Drug Enforcement Administration (DEA), health insurers, state medical or business associations, and state medical boards. A 24-year-old pregnant woman came to her ob-gyn with a headache and high blood pressure. Your contract may contain provisions against your soliciting the employment of existing employees of the practice. 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 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. The usage and disclosure of patient information, including patients medical records, are often limited by another form of restrictive covenant in employment agreements: confidentiality clauses. This example is conceptual. Apply Renew Maintain Practice Information For sound guidance on regulations and requirements, retiring physicians can call the KBHA at (785) 296-7413. 1, 2. 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. 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. Texas Medical Board Rules Chapter 165.5(a)(1-3) Transfer and Disposal of Medical Records. You and the practice have an obligation to provide proper care for your patients. 8. The sign or notice shall advise the physicians patients of their opportunity and right to transfer or receive copies of their records. 3. All patients of record who have not requested their records 30 days before the person discontinues the medical-practice business or leaves the State must be notified by first class mail by the person to permit that persons patients to procure their records., http://delcode.delaware.gov/title24/c017/sc05/index.html, Florida Statute Title 32 Ch. This may vary from practice to practice. A practice may opt to send a letter to patients about the departure of a physician, but is generally not legally required to do so, and a physician also generally has no legal right to send such letter independently in violation of their contract (and using a practice patient list). Doing so could subject the provider to claims of abandonment by the patient. 6. 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. 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. However, the provider can arrange for the employer to give the notice on the providers behalf. 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.. Connecticut Code of Medical Records Regulations Number 19a-14-44 states, Upon the death or retirement of a practitioner, it shall be the responsibility of the practitioner or surviving responsible relative or executor to inform patients. Many states require that patients be notified when a physician is departing a practice. How to text patients and colleagues without violating the Health Insurance Portability and Accountability Act. A physician in a multi-physician practice is retiring or leaving the geographic practice area. For example, you would not want to plan your departure during a week in which you are anticipating five deliveries. In this way, the provider might avoid claims of patient abandonment. This creates a quandary because although you may need new employees, you do not want to appear to be soliciting from the existing practice. 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. 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. In March 2015, the NP was preparing to leave URMC for a position at Greater Rochester Neurology (GRN). Or, in limited circumstances, the new practice may provide coverage through a new policy with a retroactive endorsement date. 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. 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. Placing a sign on the door of the closed practice only works if the space will not have future tenants. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. A number of patients called the Medical Center and complained about the letter they received. The health care entity has the dual role of safeguarding the medical record while facilitating continuity of care. During your review, pay careful attention to information about advance notice provisions, retirement plan details and noncompete covenants, to name a few key elements. In addition to sending letters, think carefully about how you will address this topic when you speak with patients. Contact information that enables the patient to obtaininformation on the patient's medical records. In this situation, the provider might not be precluded from soliciting that practices patients for services at the medical spa. 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. (I) Posting such notice on the physician's or practice website; OR Examples include social media pages, website banners, email, or even utilizing the practices existing patientportal. 1 Required notification of discontinuation of practice 2. That case involved a dispute over a non-compete in a urologists employment agreement. 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. The health care entity has the dual role of safeguarding the medical record while facilitating continuity of care. Many practices obtain claims made malpractice insurance policies that insure you for claims made during your term of employment. (i) Sending a letter to each patient; OR 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 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. State advises providers follow (1) AMA and (2) Louisiana State Medical Society Guidelines. The Florida Medical Association is not affiliated with the Board of Medicine. In our experience at Jackson LLP, rarely are any two non-solicitation clauses alike. https://www.texmed.org/Template.aspx?id=6676, The Vermont Guide to Healthcare Law by the Vermont Medical Society advises, In order to avoid a claim of abandonment, the physician should take several steps to terminate the physician-patient relationship. When you compare any random series of practice types for example, psychiatry, dental, OB/GYN, or pain management you quickly realize a one-size-fits-all approach does not work for notifying patients of your closing practice. If you had signed a non-compete, you would refer them to the other providers in your practice. Leaving a group practice. They worry that it will force them to abandon their established patients in violation of their legal and ethical obligations. This will ensure that your departure date does not result in unnecessary forfeitures. Thus, their specialty naturally limits their exposure to allegations of patient abandonment when they leave their jobs. . The office should notify patients as soon as possible to support continuity of care for the deceased physicians patients.2 As a first priority, the office staff should call patients with scheduled appointments so patients with immediate needs for a physician can find another healthcare provider. The FMA also recommends that the practitioner terminating the relationship should provide assistance in locating another practitioner for the patient. 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. In healthcare, this tug of war can implicate another stakeholder: the patient. 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. If youre in one of the states where we practice, schedule a complimentary phone consultation with one of Jackson LLPs healthcare attorneys. Water's Edge Dermatology, an AQUA Dermatology portfolio practice, is Florida's largest and mostSee this and similar jobs on LinkedIn. According to the urologists former employer, such activities violated the non-compete. 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. What determines a critical or high-risk patient? It is not just a piece of advice; several state and federal regulations make it a mandate. The content of the notice will depend upon state law. 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. Yes. 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. It may, if it chooses, permit the physician to have input as to the text of the notice. Some practices display placards in the waiting room informing patients of a physicians departure. URMC also obtained an attestation from GRN that all PHI transmitted by URMC had been returned or deleted. Hiring for Your Healthcare Practice? The legal guidelines regarding patient notification vary for each state. 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. Keep a copy of the notification letter in the patient's record. 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. 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. 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. If you would like to learn how Lexology can drive your content marketing strategy forward, please email [emailprotected]. 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. 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. An example letter . The case of Bloomington Urological Associates, SC v. Scaglia, 686 N.E.2d 389 (Ill. App.
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