According toRule 64B8-10.002(3), FAC : A licensed physician shall keep adequate written medical records, as required by Section458.331(1)(m), Florida Statutes, for a period of at least five years from the last patient contact; however, medical malpractice law requires records to be kept for at least seven years. When possible, the outgoing provider should try to time their exit so that patients can arrange continuity in care. 7.03. 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. 10. Review noncompetition covenants. The Physician should have 3-5 years of experience of running an OB/GYN practice with leadership skills. http://www.nmms.org/wp-content/uploads/2018/08/closing_your_practice_2016_revised_-_pcs_0.pdf. Many practices obtain claims made malpractice insurance policies that insure you for claims made during your term of employment. 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. 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. A threshold requirement for a malpractice claim premised on patient abandonment is that there is a patient-provider relationship. 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. (i) Sending a letter to each patient; OR Unprofessional conduct includes, but is not limited to, the following: (17) Abandoning a patient. When preparing your notifications: Looking at the closing medical practice notification guidelines of all 50 states, some are silent on providing guidance, while others provide a vague range of recommendations. With respect to patients, solicitation generally requires a targeted, affirmative act by the employee to convince a patient to obtain services from somewhere other than the employers practice. Texas Medical Board. 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. You should review the details of your plan so that you do not unwittingly forfeit significant amounts of retirement money. 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. 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. Board Rule 540-X-9-.10 states reasonable notification must be provided. Health care entities must be prepared for the departure of physicians and other health care professionals. Voice mail systems can also be modified to provide new contact information after the physician has departed. 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 physician can perform acupuncture under his/her medical license as long as he/she is properly trained and educated in the field of acupuncture. 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. A 24-year-old pregnant woman came to her ob-gyn with a headache and high blood pressure. Copyright 2006 - 2023 Law Business Research. The practice should also provide a script for receptionists on what to say. Texas Medical Board. The employer pulls in one direction, seeking to draft the non-solicitation clause broadly to protect against internal poaching of clients and staff. The FMA also . Except in cases of death or other incapacity of the practitioner, practitioners may not abandon a patient or abruptly withdraw from the care of a patient. 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. 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. 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. URMC responded by sending breach notification letters to the affected patients and notifying the media. Don't worry, I did that on purpose. Proactive [], American Medical Association (AMA) guidelines, https://www.cms.org/uploads/BME_Policy_40-8.pdf, https://drive.google.com/file/d/0B-K5DhxXxJZbZGZUdllNbUFvdDg/view, https://www.ama-assn.org/delivering-care/ethics#Chapter%201:%20Opinions%20on%20Patient-Physician%20Relationships, https://cdn.ymaws.com/lsms.site-ym.com/resource/resmgr/resources/lsms_resource_closingamedica.pdf, http://www.lsbme.la.gov/content/health-care-resources-practitioner, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140270/, https://www.msma.org/guide-to-closing-a-medical-practice.html, https://www.njconsumeraffairs.gov/bme/Pages/FAQ.aspx, http://164.64.110.134/parts/title16/16.010.0017.html, http://www.nmms.org/wp-content/uploads/2018/08/closing_your_practice_2016_revised_-_pcs_0.pdf, 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, https://www.texmed.org/Template.aspx?id=6676, State offers no guidance, but association guidelines available. Many states require that patients be notified when a physician is departing a practice. These rule changes also apply when leaving a group practice, as the departing physician is responsible for providing proper notification. Failure to comply with the time limit requirement of this Section shall subject the denying party to expenses and reasonable attorneys fees incurred in connection with any court ordered enforcement of the provisions of this Section. A physician must give notice to patients of his or her leaving or closing a practice, otherwise face a possible claim of patient abandonment. 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. Consider patient needs. 2. 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. Notify patients in writing, through a letter carefully crafted with input from practice colleagues or the employing . It is not just a piece of advice but also a legal requirement by several state and federal laws. Therefore, patients should be given reasonable advance notice to allow their securing other care. 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. 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 notice shall appear twice, seven days apart. 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). 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. Med 10.03.2 (o) states, Patient abandonment occurs when a physician without reasonable justification unilaterally withdraws from a physician-patient relationship by discontinuing a patients treatment regimen when further treatment is medically indicated and any of the following occur: 1. The provider might still face constraints in accessing patients addresses and other information. (2). How to text patients and colleagues without violating the Health Insurance Portability and Accountability Act. Become your target audiences go-to resource for todays hottest topics. 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. Clearly, a provider is not susceptible to an allegation of patient abandonment each time arelationship with a patient terminates. 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. Some practices display placards in the waiting room informing patients of a physicians departure. 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.ncbi.nlm.nih.gov/pmc/articles/PMC6140270/, Additional Resources: The Missouri State Medical Association offers, Be sure to notify your patients regarding your retirement. Practice Information Physicians and Surgeons A Physician or Surgeon (M.D.) 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. Develop a plan for patient notification. The analysis will always depend on the particular circumstances involved. If you are not familiar with your states requirements, contact a health care attorney in your area for advice. 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. 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. https://regulations.justia.com/states/wyoming/medicine-board-of/medicine-board-of/chapter-3/section-5/. Are physicians required to have a chaperone present in the room when examining patients. What is the health care entitys responsibility when a physician departs? Leaving a practice can be a stressful time in any physicians career. Common questions include: Navigating the line between non-solicitation and patient abandonment poses a challenge. If the practice has social media, post the notification message there as well. Leaving a group practice. The notice may be given by publication in a newspaper of general circulation in the area in which the health care facility is located. 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 Is a list of patient names without information about the patients medical condition considered PHI? In this situation, the provider might not be precluded from soliciting that practices patients for services at the medical spa. Thus, non-competition and non-solicitation clauses act together to prevent an employee from stealing the employers clients and staff and starting a new venture in the same industry or field. Having undertaken the care of a patient, the physician may not neglect the patient. the state Medical Association or Board) has guidelines available. Further, many retirement plans have vesting schedules that depend on the number of years one has worked with the employer. Should patients be notified of the physicians departure? 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. Just because a provider ends patient relationships following termination of employment and cannot, by contract, solicit the employers patients for further treatment, does not mean that the provider is necessarily at risk of liability for patient abandonment. 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. Weve compiled a resource to compare guidelines for every US state. Approximately ninety days is suggested whenever possible. This example is conceptual. is regulated by the Florida Board of Nursing. Those remaining in the practice must be careful not to interfere with the departing physician fulfilling these responsibilities. For some, challenges come from [], All businesses know that protecting vital operational data and records is paramount in the digital landscape. The health care entity, which is the party responsible for maintaining custody of the medical record, should send the notice. Copyright 1997-2023 TMLT. 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. Rarely do practices agree that patient charts are the property of the employed physician. Please contact [emailprotected]. 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. 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. The employee pulls in the other direction, seeking to narrow the non-solicitation clause to reduce its impact on future work opportunities. A Coda to the Covid Pandemic: Do Local and State Closure Laws Provide Cover for Tenant Nonpayment of Rent? Apply Renew Maintain Practice Information 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. In healthcare, this tug of war can implicate another stakeholder: the patient. 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. 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. All rights reserved, Prohibition Against Interference 165.5(c)(1-2). Nor would purely personal communications between the employee and patient. 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. Physicians and other healthcare providers have a duty not to expose their patients to undue harm by ending the treatment relationship in an abrupt, disruptive manner. 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. HIPAA protects information that relates to the past, present, or future physical or mental health or condition of an individual when there is a reasonable basis to believe the information can identify the individual. It must protect the patients medical record and not release it without patient authorization. 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. In Illinois, as in many other states, patient abandonment is not only a form of malpractice; for physicians, it is also grounds for disciplinary action against ones license. This comparative map shows the patient notification guidelines for all 50 states. 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. If you would like to learn how Lexology can drive your content marketing strategy forward, please email [emailprotected]. Whether the practice pays for tail coverage often depends on the type of termination effected. 8. 3. 6. Notification can be accomplished by a sign in the reception area, a note in the monthly billing statement, or an advertisement in a local newspaper. Continued, https://www.msbml.ms.gov/sites/default/files/Policies/3-22-19Policies.pdf, Missouri Med. This should be posted in your office well in advance of your official retirement. According to Rule 64B8-10.002(3), FAC : A licensed physician shall keep adequate written medical records, as required by Section 458.331(1)(m), Florida Statutes, for a period of at least five years from the last patient contact; however, medical malpractice law requires records to be kept for at least seven years. 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. (B) Placing written notice in the physician's office; AND Yes. If possible, consider posting your retirement in your local newspaper(s) as well as on your website and/or social media pages (if applicable). https://www.ilga.gov/legislation/publicacts/fulltext.asp?Name=093-0087, Indiana Administrative Code 844 IAC 5-2-16 states, A practitioner, upon his/her retirement, or upon discontinuation of the practice of medicine or osteopathic medicine, or upon leaving or moving from a community, shall notify all of his/her active patients in writing, or by publication once a week for three (3) consecutive weeks in a newspaper of general circulation in the community, that he/she intends to discontinue his/her practice of medicine or osteopathic medicine in the community, and shall encourage his/her patients to seek the services of another practitioner., https://www.in.gov/pla/professions/medical-licensing-board-of-indiana/public-notices/practice-related-faqs/, Iowa Administrative Code 13.7(1) states, Termination of the physician-patient relationship. Though every clients situation is unique, a good place to start when planning for your practices records after retirement or closure is reviewing the legal guidelines for your state regarding patient notification. Prohibition Against Interference 165.5(c)(1-2)rules state that: 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. Here are several keys to handling the transition appropriately. 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 notice should be in the form of a letter sent to the patient, preferably certified with a return receipt requested. 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. All rights reserved. The physician fails to give the patient at least 30 days notice in advance of the date on which the physicians withdrawal becomes effective. Each state treats notification guidance differently, but their approach generally falls within four distinct categories. The settlement arose from events in the spring of 2015. The case of Bloomington Urological Associates, SC v. Scaglia, 686 N.E.2d 389 (Ill. App. Do not be seduced into foregoing the purchase of tail coverage. 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. 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. 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. Such clauses generally cover a specific geographic area and period of time. 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 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." 1. Can a medical doctor perform acupuncture? If youre in one of the states where we practice, schedule a complimentary phone consultation with one of Jackson LLPs healthcare attorneys. We are looking for outstanding providers with leadership experience, who are committed to delivering high quality and compassionate patient care, to join our team. https://www.msma.org/guide-to-closing-a-medical-practice.html. 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. (I) Posting such notice on the physician's or practice website; OR Ultimately, a patient always has the right to seek out a provider of their choosing. 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. A non-solicitation provision is usually triggered only by an action. In this way, the provider might avoid claims of patient abandonment. A long notice period is often difficult for a non-retiring physician to give, but these issues deserve consideration. These functions included taking phone calls from existing patients with treatment-related questions. How does the estate of a deceased or incapacitated physician provide 30-day notice? 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. For instance, general advertisements, mailings to certain zip codes, and routine marketing activities normally would not meet this standard. 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 .
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