You'll quickly notice that it's actually not a letter that talks about a physician leaving, rather it's a new doctor welcome letter. 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. These functions included taking phone calls from existing patients with treatment-related questions. Before you make any decisions, revisit your employment contract and your states laws regarding the issue. Review your content's performance and reach. Be aware that patient lists, patient charts and other patient demographic information are property of the practice, not the departing physician. https://www.leg.state.nv.us/nrs/nrs-630.html#NRS630Sec304, NH Rev Stat 329:9 Section: Med 501.02 Standards of Conduct. 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. According to, Schneiderman, Other medical centers, hospitals, health care providers, and health care entities should view this settlement as, a warning, and take the time now to review and amend, as, needed, their own policies and procedures to better protect private patient information., Law Enforcement and Healthcare: When Consent, Privacy, and Safety Collide. This blog is made for educational purposes and is not intended to be specific legal advice to any particular person. Employment contracts usually reinforce this notion. Texas Medical Board Rules Chapter 165.5(a)(1-3) Transfer and Disposal of Medical Records. The case of Bloomington Urological Associates, SC v. Scaglia, 686 N.E.2d 389 (Ill. App. The physician fails to allow for patient access to or transfer of the patients health record as required by law. 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. Indeed, this may be especially appropriate when the employment agreement defines patients treated by the employee as the employers. When possible, the outgoing provider should try to time their exit so that patients can arrange continuity in care. Laura Hale Brockway is the Vice President of Marketing at TMLT. It does not create an attorney-client relationship between our firm and the reader. Chiropractors are licensed and regulated by the Florida Board of Chiropractic Medicine. Experienced Medical Receptionist for busy Dermatology practice! Or, in limited circumstances, the new practice may provide coverage through a new policy with a retroactive endorsement date. http://www.nmms.org/wp-content/uploads/2018/08/closing_your_practice_2016_revised_-_pcs_0.pdf. In April 2015, GRN sent letters to the patients whose names were on the spreadsheet announcing that the NP had joined the practice and advising them of how to switch to GRN. 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. Learn practical ways to communicate with disruptive or angry patients. Mind These Legal Issues. Florida Board of Medicine General Office Practices/Protocol FAQs 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. Can a heath care practitioner refuse to treat a patient? Your contract may require that you give your practice advance written notice of your departure. This creates a quandary because although you may need new employees, you do not want to appear to be soliciting from the existing practice. Moving On: Issues to Consider When Making a Career Move Clearly, a provider is not susceptible to an allegation of patient abandonment each time arelationship with a patient terminates. 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. All of this increases the likelihood that you or one of your colleagues will leave your current practice. Some employment agreements indicate that the practices general policies and procedures may be applicable even if they are contrary to the physicians employment agreement. The legal guidelines regarding patient notification vary for each state. Podiatrists are licensed and regulated by the Florida Board of Podiatric Medicine. The physician fails to provide for continuity of prescription medications between the notice of intent to withdraw from the physician-patient relationship and the date on which the physician-patient relationship ends, if the prescription medications are necessary to avoid unacceptable risk of harm. Nor would purely personal communications between the employee and patient. 5 Ways to Cover a Physician's Departure from Your Practice The notice shall appear twice, seven days apart. Departing Physicians and Patient Notification - Krugliak, Wilkins The Physician should have 3-5 years of experience of running an OB/GYN practice with leadership skills. Physicians are under a tremendous amount of pressure in todays health care environment as costs escalate, reimbursement declines and the malpractice crisis continues. Mustafa Kinaan has shown his dedication to the Central Florida community throughout his graduate medical education (GME) journey. 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. According to the urologists former employer, such activities violated the non-compete. Your careful attention to these details will ensure a smooth transition to a new practice. 4. Review advance notice provisions. Rather than include the providers new practice location, the notice may identify another provider within the practice who can continue to treat the patient. 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: The FMA also recommends that the practitioner terminating the relationship should provide assistance in locating another practitioner for the patient. Thus, their specialty naturally limits their exposure to allegations of patient abandonment when they leave their jobs. You should review the details of your plan so that you do not unwittingly forfeit significant amounts of retirement money. 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. . Once the relationship is formed, Illinois courts consider abandonment to occur when the provider refuses to treat [the] patient [while] needing further treatment, without giving the patient a reasonable time to find substitute care. As a result of such abandonment, the patient must suffer injury. 1, Required notification of discontinuation of practice. 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. The notice should be in the form of a letter sent to the patient, preferably certified with a return receipt requested. PDF The Doctor is Out Don't worry, I did that on purpose. Copyright 2005 by the American Academy of Family Physicians. Many states defer to their state medical society or American Medical Association (AMA) guidelines, which are not legal requirements, and typically do not cover all of the potential variables that may exist in your situation. 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. All Rights Reserved. They worry that it will force them to abandon their established patients in violation of their legal and ethical obligations. As these examples show, non-solicitation does not mean no contact. For TMB rules on notification requirements and more, refer to Chap 165.5 - Transfer and Disposal of Medical Records. Most practices only close once. This should be posted in your office well in advance of your official retirement. 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. The following are best practices for notifying patients: Send current patients (i.e. Normal workplace stresses are exacerbated by longer hours, less pay and zero tolerance for error, which can lead to fractured relationships among partners or employed physicians in a group practice. All returned mail should be kept in patient file. (3) A copy of the posted notices shall be submitted to the TMB within 30 days from the date of termination, sale, or relocation of practice. 3. Professions and Occupations 32-3211 states, If the health professional terminates or sells the health professionals practice and the patients medical records will not remain in the same physical location, the procedure by which the health professional shall notify each patient in a timely manner before the health professional terminates or sells the health professionals practice in order to inform the patient regarding the future location of the patients medical records and how the patient can access those records., Arkansas Medical Society states, AMS recommends that a physician place an ad in their local newspaper announcing the closure with instructions as to how the patient can obtain copies of their medical records. Who should provide the notice? Practice fined for response to social media review, Dallas dental practice fined $10,000 after publishing PHI in response to a patient review on Yelp, Texting patients while staying HIPAA compliant. Further, many retirement plans have vesting schedules that depend on the number of years one has worked with the employer. A letter placed in the patients monthly billing notice is one method. 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. Florida Board of Medicine Can a health care practitioner terminate a 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. Training Tomorrow's Health Leaders | University of Central Florida News At Cariend, [], When physicians retire or close their practice, there are many tasks to complete to ensure the process [], No matter the size or scope of their operations, hospitals and medical facilities are driven to reduce [], Hospital and medical facility managers recognize EMR systems as a necessary part of managing patient medical data. The answer is yes. 2. Copyright 2006 - 2023 Law Business Research. 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. In our experience at Jackson LLP, rarely are any two non-solicitation clauses alike. On June 11, 2015, URMC reminded its workforce that all patient information was the property of URMC and could not be copied, shared, removed, or transferred without the permission of both URMC and the patient. 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. Thus, regardless of who is responsible for procuring tail coverage, that party should provide a certificate of insurance to the other party. Each state treats notification guidance differently, but their approach generally falls within four distinct categories. It must protect the patients medical record and not release it without patient authorization. URMC also obtained an attestation from GRN that all PHI transmitted by URMC had been returned or deleted. 1. Understand who owns the chart. 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. 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. There is a range of activities and provider-patient communications that can continue after an exit without breaching the non-solicitation restriction. Consider patient needs. Those remaining in the practice must be careful not to interfere with the departing physician fulfilling these responsibilities. Notification may be satisfied using any of the following methods: (1) by placing a notice in at least one newspaper in the local practice area; notice should advise patients where their medical records will be stored; notice should include any pertinent information the patient may need for obtaining or transferring the records, including the name, mailing address and telephone number of a contact person with access to the stored records; notification should run a minimum of two times per month for three months to reach a maximum number of patients; or (2) by written or electronic mail; or (3) by individual correspondence to the patients last known physical or electronic mail address. 1) The state has enacted law regarding patient notification. A Coda to the Covid Pandemic: Do Local and State Closure Laws Provide Cover for Tenant Nonpayment of Rent? 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. She can be reached at laura-brockway@tmlt.org. The employee pulls in the other direction, seeking to narrow the non-solicitation clause to reduce its impact on future work opportunities. Closing or Relocating? | Emerald Coast Medication Association Notify Third Parties Dependent upon the provisions of contracts and state law, the insured physician and practice may need to notify various third parties. Another helpful approach, particularly for specialized physicians, is to provide referrals to nearby practices or physicians offering similar types of care or services. For example, practices often agree to pay for tail coverage in the event that employment is terminated by the practice without cause. Posted 3:52:36 PM. You Can't Take It with You - Davis Wright Tremaine What should a hospital or medical group do now? Contact information that enables the patient to obtaininformation on the patient's medical records. 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. While it may be convenient to resign shortly before Christmas so that you can spend the holidays at home, it could be a monumental mistake if it results in losing nearly one years worth of retirement benefits. Closing or Relocating Your Physician Practice in Florida If a non-solicitation attempted to forbid any treatment whatsoever of patients from the employers practice, then it would likely be unenforceable in Illinois. A critical criterion for patient abandonment claims is the need for further treatment. Examples include social media pages, website banners, email, or even utilizing the practices existing patientportal. 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. Can I notify my patients that I'm leaving a practice and can I tell 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. Leaving Group Practice - hcms.org Cover your tail. TMB rules for physicians who retire, close, or leave a practice. Here are several keys to handling the transition appropriately. 10. Review noncompetition covenants. If you are not familiar with your states requirements, contact a health care attorney in your area for advice. The employer pulls in one direction, seeking to draft the non-solicitation clause broadly to protect against internal poaching of clients and staff. The content of the notice will depend upon state law. (2). In healthcare, non-solicitation restrictions can extend to patients and other providers who refer patients to the practice or business. 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. 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. 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. Even without these prohibitions, you should not actively solicit the employment of existing employees, especially prior to your departure. 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.