If the restrictive covenant specifically prohibits the physician from treating patients he saw while employed with his former employer, there is case law that indicates a physician may not be able to treat the patient regardless of who establishes first contact. Make sure that if there are legal guidelines in you state, that you review them. 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. Understand who owns the chart. (C) Notifying patients seen in the last two years of the physician's discontinuance of practice BY EITHER: All of this increases the likelihood that you or one of your colleagues will leave your current practice. 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. State advises, Complaints of patient abandonment or neglect can be avoided by giving patients sufficient notice of the practice closure. 2. Notifying Patients of Practice Closure When closing a practice, you should send a notification letter to the patients you have seen in your practice within the last three years. 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. University of Florida Levin College of Law UF Law Scholarship Repository Yes. 2) The state offers guidelines, but without any statutory requirements or law enforcing notification practices. 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. (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. 3. PDF Retention of medical records and patient information upon closure of a The notice shall appear twice, seven days apart. At the mediation, the single specialty practice initially took the position that: (1) if a patient contacted them asking for an appointment with one of the departing physicians, the practice would . 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. The TMB has rulesprohibiting the practice or physician group from interfering. Your contract may contain provisions against your soliciting the employment of existing employees of the practice. (Abandonment is defines as the termination of the physician patients relationship at an unreasonable time and without giving the patients the chance to find an appropriate replacement.) Some practices display placards in the waiting room informing patients of a physicians departure. 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." 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. 1 Required notification of discontinuation of practice Which patients should be notified? How does the estate of a deceased or incapacitated physician provide 30-day notice? 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. Rarely do practices agree that patient charts are the property of the employed physician. 1) The state has enacted law regarding patient notification. OB/GYN Physician - Brand New Offices with Well-Established Group Practice Breaking Up is Hard to Do: Notifying Patients When a Physician Leaves This blog is made for educational purposes and is not intended to be specific legal advice to any particular person. Some states even require or suggest 30 days prior written notice before a departure so that. In healthcare, non-solicitation restrictions can extend to patients and other providers who refer patients to the practice or business. Some require an extraordinarily long notice period (such as one year) before the physician can qualify for deferred compensation payments. The scope of practice of CNAs, as well as other nursing professions (RN, APRN, etc.) This creates a quandary because although you may need new employees, you do not want to appear to be soliciting from the existing practice. In addition to sending letters, think carefully about how you will address this topic when you speak with patients. It is not just a piece of advice; several state and federal regulations make it a mandate. Should patients be notified of the physicians departure? 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. Typically, a non-competition provision prohibits an employee from joining or starting a competitor business. Notifying Your Patients When You Leave a Practice The legal guidelines regarding patient notification vary for each state. [], Smart hospitals and medical facility managers already know how to capture savings in health information management by [], Hospitals and healthcare providers are aways looking for opportunities to increase savings. URMC began receiving calls from patients who were upset that their confidential medical information had been disclosed without their permission. 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. 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. 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. 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. Notice to Patients. 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. https://regulations.justia.com/states/wyoming/medicine-board-of/medicine-board-of/chapter-3/section-5/. They worry that it will force them to abandon their established patients in violation of their legal and ethical obligations. 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. A long notice period is often difficult for a non-retiring physician to give, but these issues deserve consideration. Chiropractors are licensed and regulated by the Florida Board of Chiropractic Medicine. Texas Medical Board Rules Chapter 165.5(a)(1-3) Transfer and Disposal of Medical Records. In these cases, patients do not expect the same provider to perform related services in the future. Copyright 2006 - 2023 Law Business Research. 4. Review advance notice provisions. 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. The American Medical Associations 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.. Many practices obtain claims made malpractice insurance policies that insure you for claims made during your term of employment. 10. Review noncompetition covenants. PDF The Doctor is Out The key is that the notice affords a reasonable time to find substitute care., See our related video, Patient Abandonment.. Hiring for Your Healthcare Practice? 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). What can I tell my patients when Im leaving my employer? 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. 1. 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. 115(4): 325327 advises, practices must notify patients as soon as possible to facilitate continued patient care. The analysis will always depend on the particular circumstances involved. the state Medical Association or Board) has guidelines available. Contact managed care companies with whom you have contracts. There is no specific time period required. Apply Renew Maintain Practice Information After all, employers typically exclude information that might prompt patients to seek the outgoing providers services at a new practice. 1, Required notification of discontinuation of practice. PDF Notice to Patients on the Departure of a Physician 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. Many states require that patients be notified when a physician is departing a practice. Are you a healthcare provider considering a new employment agreement with a non-solicitation clause? 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. The NP was interviewed, suspended, and subsequently terminated. 1. Review all documents you have signed. Sources While the Board rule does not specify the mode of notification, it would be difficult to ensure patients received notification by a newspaper ad. Moving On: Issues to Consider When Making a Career Move 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. 2. Review the practices established policies. Departing Physicians and Patient Notification - Krugliak, Wilkins According to the urologists former employer, such activities violated the non-compete. It does not create an attorney-client relationship between our firm and the reader. Medicine's great resignation? 1 in 5 doctors plan exit in 2 years Develop a plan for patient notification. URMC also obtained an attestation from GRN that all PHI transmitted by URMC had been returned or deleted. Such clauses generally cover a specific geographic area and period of time. 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. The case of Bloomington Urological Associates, SC v. Scaglia, 686 N.E.2d 389 (Ill. App. Each state treats notification guidance differently, but their approach generally falls within four distinct categories. Don't worry, I did that on purpose. Does a heath care practitioner have to accept new patients? The sign shall be placed at least 30 days prior to the termination, sale or relocation of the practice and shall remain until the date of termination, sale or relocation. 1. Leaving a Medical Practice / Closing a Medical Practice - HG.org The KBHA serves as a great resource to physicians. Another helpful approach, particularly for specialized physicians, is to provide referrals to nearby practices or physicians offering similar types of care or services. Such an approach may frustrate the provider who is leaving. As these examples show, non-solicitation does not mean no contact. A non-solicitation clause only prohibits solicitation. Common questions include: Navigating the line between non-solicitation and patient abandonment poses a challenge. Further, many deferred-compensation arrangements are linked to the amount of notice given. A physician who leaves or closes a practice must notify a host of persons of the change in status. 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. 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. Posted 3:52:36 PM. Notify patients in writing, through a letter carefully crafted with input from practice colleagues or the employing . Negotiations over non-solicitation restrictions can play out like a game of tug of war. 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. Courts have, however, held physicians liable for breach of non-solicitation agreements and misappropriation of trade secrets when The physician fails to allow for patient access to or transfer of the patients health record as required by law. Here are several keys to handling the transition appropriately. 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. The notice should be in the form of a letter sent to the patient, preferably certified with a return receipt requested. 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. For example, you would not want to plan your departure during a week in which you are anticipating five deliveries. This notice shall be no less than two columns wide and no less than two inches in height. The content of the notice will depend upon state law. 1) The state has enacted law regarding patient notification. 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. 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.