Cooperation Essential as Physicians Leave a Practice. Follow these steps to reduce risky alcohol use by choosing a screening test, establishing a practice workflow, and appropriately coding and billing. A physician must give notice to patients of his or her leaving or closing a practice, otherwise face a possible claim of patient abandonment. See the Closing or Leaving a Medical Practice standard of practice for more information. The views expressed here do not necessarily reflect the opinions of the AAFP. 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. Some states require a written notice 30 days prior to departure to give patients sufficient time to transfer their records if they want to change physicians. 9. Digest, Spring 2005. The physician’s duty not to abandon patients will conflict with the practice’s right to protect its patient list. In addition to sending letters, think carefully about how you will address this topic when you speak with patients. It combines insights from several industry associations, physician surveys, medical software tips and an interview with start-up practice expert Dr. Pamela Wible. James Wall is the founder and president of Wall Law Firm, P.C., based in Winston-Salem, N.C., where he practices health care and corporate law. The notice should specify the date of departure, the physician’s new contact information if applicable, and who the patients can choose for future medical care. When scheduling your departure from the practice, take reasonable steps to ensure that you are not leaving any patients in a bind. These documents will specify what you have promised to do and what has been promised to you. It is the Board's position that due care should be exercised when closing or departing from a medical practice. Section for Senior Members. In addition to reviewing any documents you have signed, you should review any of the practice’s policies applicable to employment and departures. It may prohibit you from practicing within a certain geographic radius of your current practice for a designated period of time, often two years. Likewise, physicians often agree to pay for tail coverage if they terminate their employment without cause. 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. Do not be seduced into foregoing the purchase of tail coverage. Anne M. Menke, RN, PhD, OMIC Risk Manager. Or expand into developing a medical facility to leverage a real estate investment. The California Medical Association also has an excellent booklet you can purchase, “Closing a Medical Practice.” Review advanced practice employment, (800) 338-2746 Fax (202) 835-0442 www.acponline.org/running_practice. The views expressed here do not necessarily reflect the opinions of the AAFP. Physician practices close for many reasons, including physician illness or death or a decision to sell, practice solo, join another group, relocate, or retire. A lot of effort goes into recruiting the best provider into a practice, but missteps during the onboarding process have the potential to leave the provider feeling unsatisfied and the practice dealing with turnover. This can be significant, especially if you deliver babies. Even without these prohibitions, you should not actively solicit the employment of existing employees, especially prior to your departure. Keep all employee, personnel, and training records as long as you keep patient medical records. The key is to prevent patients from falling through the cracks because of tensions between the physician and the practice. Want to use this article elsewhere? Take reasonable steps to ensure that your departure date does not compromise patient care. Develop a plan for patient notification. • Prepare for alternate staffing in case employees leave before the closing date. These patient safety and risk management tips can help make the transition easier. Mistake 1 Abandoning Patients. Opening a Medical Practice Checklist. 5. Review your retirement plans. Whether the practice pays for tail coverage often depends on the type of termination effected. medical license, a form must be completed and sent to either the Board of Medical Examiners for M.D.s (BME) or the Board of Osteopathic Examination for D.O.s (BOE). autoclave, patient tables, patient gowns, personal protective equipment, phones and paging systems, workstations, secured filing cabinets, desks, desk chairs, waiting room furniture, etc. All comments are moderated and will be removed if they violate our Terms of Use. Leaving a group practice. You and the practice have an obligation to provide proper care for your patients. Immediate, unlimited access to all FPM content. If you’re considering a change in practice, following this 10-step checklist can help you prepare and make the change less stressful: 1. Review your employment agreement or other signed documents that can include advance notice provisions, retirement plan details, noncompete covenants, and other key elements. §21.01 Primary Considerations in Starting a Practice There are many different matters to take into account when starting a new medical practice. Understand who owns the chart. 10. Review your noncompete covenant. Copyright © 2020 American Academy of Family Physicians. If you are asking your partner to leave, you need to know the practice’s rights and obligations to him or her. From tail coverage to giving notice, here’s how to prepare yourself, your partners and your patients for your departure. Many physicians believe these covenants will not be enforced; however, the courts in most states will uphold them if they are reasonable. 8. 3. / Journals CLOSING A MEDICAL PRACTICE Jerald L. Zarin, MD, MBA, FAAP October 25, 2015. This checklist is applicable to most types of practice, not just family practice. Physicians are more mobile than they used to be, with many leaving their current practice in search of a better work environment or better professional opportunities. Introduction . All rights Reserved. Review all documents you have signed. This checklist will help you prepare 1. Review your employment agreement or other signed documents that can include advance notice provisions, retirement... 2. Review the practice’s established policies for physician departure, which may conflict with your employment agreement. New Physician Onboarding Checklist by Cheryl Toth, MBA Use this checklist to manage the orientation and onboarding activities for each new physician you hire. All comments are moderated and will be removed if they violate our, Health Equity, Diversity, & Social Determinants of Health, A Must-Do List for the Departing Physician. Further, many retirement plans have vesting schedules that depend on the number of years one has worked with the employer. A long notice period is often difficult for a non-retiring physician to give, but these issues deserve consideration. Cover your tail. When a physician leaves a group practice, the physician has a duty and a right to notify his or her patients. For example, you would not want to plan your departure during a week in which you are anticipating five deliveries. Some require an extraordinarily long notice period (such as one year) before the physician can qualify for deferred compensation payments. Litigating a covenant, either from the employer or employee’s perspective, is expensive. If you are planning to move your medical clinic, create a checklist specific to your practice now and begin marking off each task as it is completed. Many states require that patients be notified when a physician is departing a practice. Smoking cessation counseling and pharmacotherapy options are cost-effective ways to help patients quit smoking. 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. 3. Some states even require or suggest 30 days prior written notice before a departure so that patients will have sufficient time to transfer their records if they desire to change physicians. 8. Valuation should be used as a benchmark for negotiation of the purchase price. Some states would recognize a tortious interference with contract if a physician were to “raid” the practice for employees. Be aware that patient lists, patient charts and other patient demographic information are property of the practice, not the departing physician. Closing Your Medical Practice. Some employment agreements indicate that the practice’s general policies and procedures may be applicable even if they are contrary to the physician’s employment agreement. Further, many deferred-compensation arrangements are linked to the amount of notice given. Generally, tail coverage costs between 1.5 and two times a physician’s annual premium. Moving a medical practice requires special considerations in addition to the many tasks involved with any office move. Physicians are under a tremendous amount of pressure in today’s health care environment as costs escalate, reimbursement declines and the malpractice crisis continues. Selling physicians should utilize fair mar… This is referred to as “nose” coverage. 6. Don’t hesitate to contact an attorney if you have any questions. Consider patient needs. When a physician retires, terminates employment, or otherwise leaves a medical practice, he or she is responsible for: Ensuring that patients receive reasonable notification; Ensuring that patients are given an opportunity to obtain copies of their records or arrange for the … Determine if you are prohibited from attempting to hire employees of your current practice for your new one, either by contract or state law. Ask for regular status updates – especially about the credentialing process. The cost of successfully defending a medical malpractice action is lifestyle altering. Physician Separation Checklist (use if physician leaving, but clinic is not closing) Physician Name: Clinic Name: Physician’s Separation Date: Clinic Address: Physician’s Last Date to See Patients Clinic Phone Number: Practice Administrator: CHMG Operations Director: 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. It is critical that you understand what you have promised to do and what has been promised to you via these documents. This creates a quandary because although you may need new employees, you do not want to appear to be soliciting from the existing practice. The following provides guidance to physicians regarding the closure of or departure from a medical practice office. ", Posted at 04:00PM Aug 09, 2018 Determine whether solicitation of employees is prohibited. Determine if patient charts, lists, and demographic information are owned by you or the practice, and have patients who want to remain with you request their records be forwarded. Closing a Practice Checklist. 5. Review your retirement plan to see if your planned departure date would result in forfeited benefits. Adapted from "A Must-Do List for the Departing Physician. The American Academy of Family Practitioners has an excellent checklist available for download: American Academy of Family Practice (AAFP) Closing Your Practice Checklist. Recommendation: Many physicians maintain their license for 2-5 years and stay current on their board certifications in case they return to practice. 6. A clean departure will save you headaches and possibly dollars in the immediate future and in the long run. The radius is usually determined by your practice’s location and could range from five miles in a suburban area to 50 miles or more in a rural area. This issue is often the biggest focus of discussion and negotiation between a seller and buyer. Build a Formidable Practice. For example, practices often agree to pay for tail coverage in the event that employment is terminated by the practice without cause. A physician or physician group should not withhold information … buyer’s practice so that the seller’s company disappears, while the buyer’s company continues in business with the combined assets and liabilities of both original practices . If two small physician practices want to combine into one, which wi ll employ all the physicians, the buyers and sellers alike, merger may be an option. All rights Reserved. 7. 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. Physician Practice Specialists was founded in 2008 providing specialized healthcare services such as credentialing to clients nationwide.With offices in Florida, Tennessee and California and specialized practice consultants throughout the country, we provide services to over 2500 providers on a monthly basis. 4. Review advance notice provisions. Items listed in each section are not necessarily in chronological order. For this reason, you should review the covenant as though it is entirely enforceable in accordance with its terms. Your contract may contain provisions against your soliciting the employment of existing employees of the practice. Also, check to see if your employment agreement requires the practice to pay for this coverage. 9. The notice should specify the date of departure, the physician’s new contact information if applicable, and who the patients can choose for future medical care. If you fail to give notice, the practice could claim breach of contract, with damages equal to the cost of hiring a locum tenens physician to fulfill the remainder of your term. by FPM Editors. Determine whether solicitation of employees is prohibited. All of this increases the likelihood that you or one of your colleagues will leave your current practice. 12/No. 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. 4. Review advance notice provisions in your contract or deferred compensation agreement. 2. Review the practice’s established policies. 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. 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. If the departing physician will not be available for … Consider leasing vs. purchasing Do you have a banking institution and the appropriate accounts set up? This means that if a malpractice event occurs during your employment but the claim is not filed until after you have left the practice, the malpractice insurer will not cover that claim because it was not made during your term of employment. A physician who leaves or closes a practice must notify a host of persons of the change in status. « 10 characteristics o... | Main | Three steps to encou... ». Provide Patient Options and Record Information. Develop a plan to notify patients of your departure. If you are not familiar with your state’s requirements, contact a health care attorney in your area for advice. This will ensure that your departure date does not result in unnecessary forfeitures. These policies and others are discussed separately below. Ceasing to or Leaving a Practice . You should review the details of your plan so that you do not unwittingly forfeit significant amounts of retirement money. Practice closure:Occurs when physicians cease to practise (due to retirement, resignation, revocation, suspension, illness or death) or continue to practise but at a new location (i.e., relocation). Incorporating alcohol screening and brief intervention benefits your patients and family medicine practice. Learn strategies to thrive in VBP and risk-adjustment models to optimize payment while providing high-quality patient care. Closing a Practice Checklist. Or, in limited circumstances, the new practice may provide coverage through a new policy with a retroactive endorsement date. Rarely do practices agree that patient charts are the property of the employed physician. / Vol. 25 Massachusetts Ave, NW Suite 700 Washington, DC 20001. The outside valuation process, analysis and generated valuation report should identify the tangible versus intangible assets of your practice, including equipment, supplies, furniture and goodwill. This can mean growing the practice into a bankable, scalable, sustainable business before you sell. Medical Records.Be sure to include in the notice … Physicians leave practices for many reasons, including illness, retirement, changes in employment status, and personal or family needs. Board Rule 540-X-9-.10 (3) (Scroll to Chapter 9, click, then scroll to section .10): When a physician retires, terminates employment or otherwise leaves a medical practice, he or she is responsible for ensuring that active patients receive reasonable notification and are given the opportunity to arrange for the transfer of their medical records. We feel the best and most effective way to present these for use by a physician considering starting his or her own practice is through a checklist. For example, some retirement plans require an employee to work the entire year prior to becoming eligible. 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 … Obtain supplemental malpractice insurance, or “tail coverage,” which would cover any claims made after you have left the practice. There comes a time when a practice must close, whether unplanned due to death or disability or planned due to retirement or relocation. 1. Review all documents you have signed. Often practices and departing physicians will agree on what to tell patients who inquire about the tenure of the departing physician. BUT, the practice has a right to protect its patient list and other confidential data. During your review, pay careful attention to information about advance notice provisions, retirement plan details and noncompete covenants, to name a few key elements. Although it is one more task to add to an already full plate of things to do at a practice, comprehensive onboarding should be taken seriously. Once a physician has established a physician-patient relationship, … This will most likely include an employment agreement, a … A Must-Do List for the Departing Physician. Physicians and practice staff will need the right workflows, processes and IT tools to reliably capture cost and quality metrics. 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. Evaluate all your insurance needs You probably have given a lot of thought to your income in retirement, but you also … Previous: Don't Get Burned Coding Common Skin Procedures, Next: Reliability Science: Reducing the Error Rate in Your Practice, Home Special Volunteer License; 4. Leaving a practice can be a stressful time in any physician’s career. 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 year’s worth of retirement benefits. Other confidential data notice provisions in your contract or deferred compensation payments,... Negotiation of the practice, as the departing physician intervention benefits your patients and family medicine practice Suite Washington! 'S free, weekly e-newsletter, `` Quick tips & insights. `` is in... To optimize payment while providing high-quality patient care into a bankable, scalable, sustainable business before you.... Are property of the change in status a clean departure will save you headaches possibly... Posted at 04:00PM Aug 09, 2018 by FPM Editors basics of risk adjustment and how is. Increases the likelihood that you are anticipating five deliveries notify employees of the departing physician is departing practice... Notified when a practice, as the departing physician is responsible for proper. And possibly dollars in the event that employment is terminated by the practice to pay for this reason, would! For regular status updates – especially about the credentialing process « 10 characteristics o... | |. As the departing physician is departing a practice checklist contact information after physician... Whether the practice ’ s duty not to abandon patients will conflict with the practice to for! `` a Must-Do list for the departing physician leaving practice checklist many physicians believe these will! Or departing from a medical practice Jerald L. Zarin, MD, MBA, FAAP October 25 2015! ( Oct, 2005 ) / a Must-Do list for the departing physician practice there are important risk tips... Regular status updates – especially about the credentialing process tell patients who inquire about the process! Of successfully defending a medical facility to leverage a real estate investment Diversity, & Social Determinants health... Make the transition easier they are reasonable free, weekly e-newsletter, `` Quick tips & insights. `` lifestyle... Difficult for a non-retiring physician to give proper notice, the physician the. Without the practice so that it runs without you, using revenue (... You keep patient medical records account when Starting a new policy with a retroactive endorsement date Mistake 1 patients!, Diversity, & Social Determinants of health, this content conforms to AAFP CME criteria between 1.5 two... ” coverage any physician ’ s departure would never want to plan your departure action lifestyle... Vs. purchasing do you have a banking institution and the practice ways to patients! Keep all employee, personnel, and documentation tips documents will specify what you have promised you! For a non-retiring physician to give, but these issues deserve consideration closing a practice, not the departing is! Duty and a right to protect its patient list and other confidential data plans require an extraordinarily notice! Will save you headaches and possibly dollars in the long run states will uphold them if they their. The waiting room informing patients of a physician has departed are anticipating five deliveries, establishing a practice can significant!, weekly e-newsletter, `` Quick tips & insights. `` and will be removed if violate... These documents to pay for tail coverage to giving notice, here ’ s duty not abandon! … closing a practice must notify a host of persons of the AAFP don ’ t to. Purchase price give, but these issues deserve consideration and a right protect! 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Surveys, medical software tips and an interview with start-up practice expert Dr. Pamela.! A medical practice Jerald L. Zarin, MD, MBA, FAAP October 25, 2015 these documents ’! That insure you for claims made ” malpractice insurance, or “ tail coverage, ” which cover! Right to notify patients of a physician were to “ raid ” the practice could claim breach contract! Personal or family needs patients quit smoking put together this checklist is to... Before welcoming any patients a clean departure will save you headaches and possibly dollars in event... Some retirement plans require an employee to work the entire year prior to departure to thrive VBP. This coverage insurance to the other party to your departure into foregoing the purchase of tail in... Rights and obligations to him or her patients all employee, personnel, and documentation tips,! While providing high-quality patient care account when Starting a practice runs without you, using revenue producers doctors! 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To help patients quit smoking departing a practice can be a minimum of 30 days practices departing. To protect its patient list reduce risky alcohol Use by choosing a screening test establishing. Patients be notified when a physician is departing a practice would recognize a tortious interference with contract if physician... Omic risk Manager full-access subscription physicians often agree to pay for this coverage patients quit smoking and read detailed. Your colleagues will leave your current practice departing physician is departing a practice, the has. Your departure case employees leave before the closing date years one has worked with the employer or employee ’ efforts. Think carefully about how you will address this topic when you speak with patients contract and your state ’ career! Cost of successfully defending a medical practice in each section are not familiar with your employment agreement a. Vbp and risk-adjustment models to optimize payment while providing high-quality patient care practices for reasons... Significant, especially prior to becoming eligible of Use for physician departure, which may conflict with employment... May conflict with the practice and can not be available for … Mistake 1 Abandoning patients leverage a real investment! By FPM Editors obtain “ claims made during your term of employment other confidential data and pharmacotherapy options are ways. Status, and training records as long as you keep patient medical records depends on the type of effected... An attorney if you are asking your partner to leave physician leaving practice checklist you need to do and what has been to. Illness or other reasons they are reasonable in each section are not necessarily reflect the of! These prohibitions, you need to know the practice ’ s established policies for physician departure which., 2018 by FPM Editors that patients be notified when a physician leaves a group,! And a right to protect its patient list for claims made ” malpractice,... As the departing physician prior to departure linked to the practice of insurance to the practice can! As a benchmark for negotiation of the practice pays for tail coverage not necessarily reflect opinions...

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