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: Non-solicitation clauses are a type of restrictive covenant (meaning legally that they forbid a party from doing something). Can I take a copy of my patients records with me, in case they need care from me in the future. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. http://www.nmms.org/wp-content/uploads/2018/08/closing_your_practice_2016_revised_-_pcs_0.pdf. 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. 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. 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. . By contrast, a non-solicitation provision prohibits the employee from soliciting the employers clients and personnel for other business or work opportunities.
Florida Board of Medicine Can a health care practitioner terminate a The notice should be in the form of a letter sent to the patient, preferably certified with a return receipt requested. Your contract may require that you give your practice advance written notice of your departure. Develop a plan for patient notification. Voice mail systems can also be modified to provide new contact information after the physician has departed. Some require an extraordinarily long notice period (such as one year) before the physician can qualify for deferred compensation payments. Some employment agreements indicate that the practices general policies and procedures may be applicable even if they are contrary to the physicians employment agreement. A critical criterion for patient abandonment claims is the need for further treatment. This blog is made for educational purposes and is not intended to be specific legal advice to any particular person. The answer is yes. 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. The health care entity, which is the party responsible for maintaining custody of the medical record, should send the notice. Your contract may contain provisions against your soliciting the employment of existing employees of the practice. Such clauses generally cover a specific geographic area and period of time. Clearly, a provider is not susceptible to an allegation of patient abandonment each time arelationship with a patient terminates. . 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 . They are often related to, but distinct from, non-competition clauses, or non-competesanother type of restrictive covenant common in employment agreements. 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.
A Must-Do List for the Departing Physician | AAFP 1. Common questions include: Navigating the line between non-solicitation and patient abandonment poses a challenge.
How to Ensure Continuity of Care If a Physician Leaves Your Practice Thus, their specialty naturally limits their exposure to allegations of patient abandonment when they leave their jobs. No. In our experience at Jackson LLP, rarely are any two non-solicitation clauses alike. 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." Ultimately, a patient always has the right to seek out a provider of their choosing. The first example letter for notifying patients of a physician leaving their practice comes from Medical Center Clinic. This will ensure that your departure date does not result in unnecessary forfeitures. Likewise, physicians often agree to pay for tail coverage if they terminate their employment without cause. 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. 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. 7. 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. 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. Laura Hale Brockway is the Vice President of Marketing at TMLT. 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. (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. All Rights Reserved. In these cases, patients do not expect the same provider to perform related services in the future. The practice should also provide a script for receptionists on what to say. A Coda to the Covid Pandemic: Do Local and State Closure Laws Provide Cover for Tenant Nonpayment of Rent? If you are planning to make such a move, or to ask one of your partners to leave, follow these steps to avoid getting burned. (2). It is, however, not uncommon for employees to solicit the departing physician prior to departure. An example letter . 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. 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. If a non-solicitation attempted to forbid any treatment whatsoever of patients from the employers practice, then it would likely be unenforceable in Illinois.
2) The state offers guidelines, but without any statutory requirements or law enforcing notification practices.
You Can't Take It with You - Davis Wright Tremaine Leaving a practice can be a stressful time in any physicians career. 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. Keep the phone number of the closed practice active for a minimum of 90 days and include key information on the voicemail after the practice has closed.
5 Ways to Cover a Physician's Departure from Your Practice For TMB rules on notification requirements and more, refer to Chap 165.5 - Transfer and Disposal of Medical Records. 8. A non-solicitation restriction may prevent the provider from issuing such notice directly. 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. How long must a healthcare practitioner maintain a patients records? The health care entity has the dual role of safeguarding the medical record while facilitating continuity of care. 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. For this reason, you should review the covenant as though it is entirely enforceable in accordance with its terms. 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. Jennifer Bendokas, PA-C. Otolaryngology (ENT) 1110 Hospital Road Fort Walton Beach, Florida 32547 850.863.8275 Education Doctor of Medicine Science University of Lynchburg 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. In this situation, the provider might not be precluded from soliciting that practices patients for services at the medical spa. Physicians are generally required to notify patients directly through one or more channels . 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. If you would like to learn how Lexology can drive your content marketing strategy forward, please email [emailprotected]. (B) Placing written notice in the physician's office; AND The KBHA serves as a great resource to physicians. Yes. You and the practice have an obligation to provide proper care for your patients. 2. 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. http://164.64.110.134/parts/title16/16.010.0017.html, Additional Resources: The New Mexico Medical Society offers, Closing Your Practice Guide: 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. For instance, general advertisements, mailings to certain zip codes, and routine marketing activities normally would not meet this standard. established, continuing care patients who have been seen within the last year and/or patients who have future appointments scheduled) written notification of the office closure with instructions on how they may obtain access to their medical records; Place a notice on the door or near the reception desk of your practice at least 30 days in advance of the closure., https://wvbom.wv.gov/Closingordepartingpractice.asp. Make sure that if there are legal guidelines in you state, that you review them. Physicians are under a tremendous amount of pressure in todays health care environment as costs escalate, reimbursement declines and the malpractice crisis continues. 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. The FMA also recommends that the practitioner terminating the relationship should provide assistance in locating another practitioner for the patient. In addition to sending letters, think carefully about how you will address this topic when you speak with patients. The Florida Medical Association is not affiliated with the Board of Medicine. A threshold requirement for a malpractice claim premised on patient abandonment is that there is a patient-provider relationship. 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. 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. Notify other patients who won't be receiving a letter by placing a notice in the local newspaper with the largest circulation, putting a sign up in the lobby and preparing a patient handout. leaving a practice Within 90 days after a death . A provider who has not solicited a patient cannot, and should not, encounter barriers to providing treatment to that patient. (i) Sending a letter to each patient; OR 3. Apply Renew Maintain Practice Information A physician must give notice to patients of his or her leaving or closing a practice, otherwise face a possible claim of patient abandonment. Its an important aspect of [], At Cariend, we understand the challenges faced by healthcare facilities in transition. Provide notice to those active patients which explains that the licensee is no longer available to them, b. Each patient should receive a letter and notices should appear in local newspapers at least three times over a few months or more.
Can I notify my patients that I'm leaving a practice and can I tell Retiring members can reference our Retirement Checklist for additional guidelines and to find information about Tribute Plan award payments. A physician in a multi-physician practice is retiring or leaving the geographic practice area. 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 may be a requirement in your state, but make sure your plan also includes more effective notification methods that contain modern avenues of communicating that will more likely reach your patients. Notifying Patients of Physician Leaving Practice In all the steps we discussed above, you may have noticed that informing your patients about your departure is crucial. Weve compiled a resource to compare guidelines for every US state. Save my name, email, and website in this browser for the next time I comment. Harris County Medical Society. Notify Third Parties Dependent upon the provisions of contracts and state law, the insured physician and practice may need to notify various third parties. 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). In that circumstance, the list of names may be PHI. The case of Bloomington Urological Associates, SC v. Scaglia, 686 N.E.2d 389 (Ill. App. 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 . There is a range of activities and provider-patient communications that can continue after an exit without breaching the non-solicitation restriction. 1) The state has enacted law regarding patient notification. All rights reserved. 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.
What should be in the notice? 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.
The Intersection Between Non-Solicitation and Patient Abandonment There may also be different rules for different types of medical facilities or practice types, such as hospital vs. private practice, or psychiatry vs. dentistry. Having undertaken the care of a patient, the physician may not neglect the patient. This comparative map shows the patient notification guidelines for all 50 states. 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 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. We are looking for outstanding providers with leadership experience, who are committed to delivering high quality and compassionate patient care, to join our team. 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. 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. When possible, the outgoing provider should try to time their exit so that patients can arrange continuity in care. If you are asking your partner to leave, you need to know the practices rights and obligations to him or her. Dont hesitate to contact an attorney if you have any questions. Keep a copy of the notification letter in the patient's record. 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. 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. 10. Review noncompetition covenants. The settlement arose from events in the spring of 2015. The penalty was the result of a settlement with New York Attorney General Eric Schneiderman. Hiring for Your Healthcare 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. Texas Medical Board Rules Chapter 165.5(a)(1-3) Transfer and Disposal of Medical Records. 2) The state offers guidelines, but without any statutory requirements or law enforcing notification practices. Should patients be notified of the physicians departure? 3) The state offers no guidance, but another state association (i.e. However, the provider can arrange for the employer to give the notice on the providers behalf. 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. 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. Each state treats notification guidance differently, but their approach generally falls within four distinct categories. You should review the details of your plan so that you do not unwittingly forfeit significant amounts of retirement money. The physician will have the opportunity to mentor new physicians.
4 Compliant Examples of Letters for Notifying Patients of Physician Questions? Employment contracts usually reinforce this notion. How does the estate of a deceased or incapacitated physician provide 30-day notice? If you are responsible for tail coverage, you may be able to negotiate with your new practice to provide you with sufficient funds to purchase it. Practice Information Physicians and Surgeons A Physician or Surgeon (M.D.) Dont risk falling short on your notification message which can result in charges of abandonment. It is not just a piece of advice; several state and federal regulations make it a mandate. The FMA also . (ii) Sending an email to each patient, in a manner that is compliant with state and federal law. Which patients should be notified? For example, you would never want to be in a situation where you felt compelled to lie to a patient. This notice shall be no less than two columns wide and no less than two inches in height. Itshould not be used as a substitute for competent legal advice from a licensed attorney in your jurisdiction. It is critical that you understand what you have promised to do and what has been promised to you via these documents. 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. 2023 Jackson LLP Healthcare Lawyers. After all, employers typically exclude information that might prompt patients to seek the outgoing providers services at a new practice. California health care entities should review CMA guidance before sending the notice. 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.
Medicine's great resignation? 1 in 5 doctors plan exit in 2 years