physician leaving practice checklist

Adapted from "A Must-Do List for the Departing Physician. Also, check to see if your employment agreement requires the practice to pay for this coverage. Understand the basics of risk adjustment and how it is used in value-based payment (VBP) arrangements. The California Medical Association also has an excellent booklet you can purchase, “Closing a Medical Practice.” To see the full article, log in or purchase access. A Must-Do List for the Departing Physician. 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. 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. All rights Reserved. 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. Copyright © 2020 American Academy of Family Physicians. Keep all employee, personnel, and training records as long as you keep patient medical records. See FPM CME Quiz. Valuation should be used as a benchmark for negotiation of the purchase price. Special Volunteer License; 4. Opening a Medical Practice Checklist. Rarely do practices agree that patient charts are the property of the employed physician. Previous: Don't Get Burned Coding Common Skin Procedures, Next: Reliability Science: Reducing the Error Rate in Your Practice, Home It is, however, not uncommon for employees to solicit the departing physician prior to departure. 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. 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. This is referred to as “nose” coverage. Conflicts of interest: none reported. 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. 2 i.e. These assets belong to the practice and cannot be taken by the physician without the practice’s consent. It may prohibit you from practicing within a certain geographic radius of your current practice for a designated period of time, often two years. 10. Review noncompetition covenants. 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. 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: You should review the details of your plan so that you do not unwittingly forfeit significant amounts of retirement money. You and the practice have an obligation to provide proper care for your patients. In addition to sending letters, think carefully about how you will address this topic when you speak with patients. Further, many deferred-compensation arrangements are linked to the amount of notice given. There are important risk management issues to consider when leaving a practice, whether for retirement, relocation, illness or other reasons. 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. / fpm 8. 4. Review advance notice provisions in your contract or deferred compensation agreement. All comments are moderated and will be removed if they violate our Terms of Use. Ask for regular status updates – especially about the credentialing process. 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. 2. Review the practice’s established policies for physician departure, which may conflict with your employment agreement. 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. See, Three Essential Skills for a Doctor That I Learned From an After-School Job as a Youth, The Art of Apology: When and How to Seek Forgiveness, Don't Get Burned Coding Common Skin Procedures, Reliability Science: Reducing the Error Rate in Your Practice. Closing a Practice Checklist. This will ensure that your departure date does not result in unnecessary forfeitures. 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. These policies and others are discussed separately below. 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. Leaving a practice can be a stressful time in any physician’s career. 3. Copyright © 2020 American Academy of Family Physicians. / Journals Review advanced practice employment, If you are selling, you should consider using a valuation firm to conduct a valuation of your practice. 2. Review the practice’s established policies. Moving a medical practice requires special considerations in addition to the many tasks involved with any office move. For example, you would never want to be in a situation where you felt compelled to lie to a patient. The views expressed here do not necessarily reflect the opinions of the AAFP. Further, many retirement plans have vesting schedules that depend on the number of years one has worked with the employer. The physician’s duty not to abandon patients will conflict with the practice’s right to protect its patient list. Some states would recognize a tortious interference with contract if a physician were to “raid” the practice for employees. 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 … The views expressed here do not necessarily reflect the opinions of the AAFP. 5. Review your retirement plan to see if your planned departure date would result in forfeited benefits. This can mean growing the practice into a bankable, scalable, sustainable business before you sell. Section for Senior Members. « 10 characteristics o... | Main | Three steps to encou... ». 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. If you are asking your partner to leave, you need to know the practice’s rights and obligations to him or her. Smoking cessation counseling and pharmacotherapy options are cost-effective ways to help patients quit smoking. Understand who owns the chart. 7. Notice to Patients.A physician must give notice to patients of his or her leaving or closing a practice, otherwise face a possible claim of patient abandonment. This will most likely include an employment agreement, a … Digest, Spring 2005. Provide Patient Options and Record Information. 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. Employment contracts usually reinforce this notion. Physicians are under a tremendous amount of pressure in today’s health care environment as costs escalate, reimbursement declines and the malpractice crisis continues. The following provides guidance to physicians regarding the closure of or departure from a medical practice office. Review all documents you have signed. (800) 338-2746 Fax (202) 835-0442 www.acponline.org/running_practice. 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. Cover your tail. The notice to patients should be a minimum of 30 days. 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 … / Vol. Before you make any decisions, revisit your employment contract and your state’s laws regarding the issue. See the Closing or Leaving a Medical Practice standard of practice for more information. Selling physicians should utilize fair mar… 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. 3. 6. For example, some retirement plans require an employee to work the entire year prior to becoming eligible. Want to use this article elsewhere? Whether the practice pays for tail coverage often depends on the type of termination effected. Active; 2. 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. 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). Retired; 3. Why physicians are leaving their practices to pursue other careers “After 20 years, I quit medicine and none of my colleagues were surprised. 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. Take reasonable steps to ensure that your departure date does not compromise patient care. Introduction . 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. Likewise, physicians often agree to pay for tail coverage if they terminate their employment without cause. 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. Develop a plan for patient notification. The decision to cease practicing or to leave a practice requires careful planning to provide continuity of … Often practices and departing physicians will agree on what to tell patients who inquire about the tenure of the departing physician. ", Posted at 04:00PM Aug 09, 2018 Get Permissions, Sign up to receive FPM's free, weekly e-newsletter, "Quick Tips & Insights.". Determine whether solicitation of employees is prohibited. Your contract may require that you give your practice advance written notice of your departure. Choose a single article, issue, or full-access subscription. Obtain supplemental malpractice insurance, or “tail coverage,” which would cover any claims made after you have left the practice. Learn the role telehealth can play in your practice’s efforts, along with billing, coding, and documentation tips. Consider leasing vs. purchasing Do you have a banking institution and the appropriate accounts set up? These patient safety and risk management tips can help make the transition easier. Download Checklist 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. These rule changes also apply when leaving a group practice, as the departing physician is responsible for providing proper notification. • Prepare for alternate staffing in case employees leave before the closing date. 8. When a physician leaves a group practice, the physician has a duty and a right to notify his or her patients. 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. Closing a Practice Checklist. Items listed in each section are not necessarily in chronological order. Even without these prohibitions, you should not actively solicit the employment of existing employees, especially prior to your departure. There comes a time when a practice must close, whether unplanned due to death or disability or planned due to retirement or relocation. This creates a quandary because although you may need new employees, you do not want to appear to be soliciting from the existing practice. Determine whether solicitation of employees is prohibited. Generally, tail coverage costs between 1.5 and two times a physician’s annual premium. For example, you would not want to plan your departure during a week in which you are anticipating five deliveries. 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 . 9(Oct, 2005) 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. 6. Medical Records.Be sure to include in the notice … The American Academy of Family Practitioners has an excellent checklist available for download: American Academy of Family Practice (AAFP) Closing Your Practice Checklist. Many states require that patients be notified when a physician is departing a practice. Develop a plan for patient notification. 3. 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. Follow these steps to reduce risky alcohol use by choosing a screening test, establishing a practice workflow, and appropriately coding and billing. Closing Your Medical Practice. For this reason, you should review the covenant as though it is entirely enforceable in accordance with its terms. A physician or physician group should not withhold information … Thus, regardless of who is responsible for procuring tail coverage, that party should provide a certificate of insurance to the other party. autoclave, patient tables, patient gowns, personal protective equipment, phones and paging systems, workstations, secured filing cabinets, desks, desk chairs, waiting room furniture, etc. Inactive Volunteer License. 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. The notice to patients should be a minimum of 30 days. If the departing physician will not be available for … A clean departure will save you headaches and possibly dollars in the immediate future and in the long run. 2. Review the practice’s established policies. In addition to reviewing any documents you have signed, you should review any of the practice’s policies applicable to employment and departures. 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. This will most likely include an employment agreement, a shareholders’ agreement (if the practice is a corporation) or an operating agreement (if the practice is a limited liability company) and, in some cases, a deferred compensation arrangement. 25 Massachusetts Ave, NW Suite 700 Washington, DC 20001. 7. 12/No. Simply download our checklist and read the detailed explanations below for an easy-to-follow guide on what you need to do before welcoming any patients. / That’s why we put together this checklist for new medical offices. Many physicians believe these covenants will not be enforced; however, the courts in most states will uphold them if they are reasonable. A physician who leaves or closes a practice must notify a host of persons of the change in status. Litigating a covenant, either from the employer or employee’s perspective, is expensive. 10. Review your noncompete covenant. Incorporating alcohol screening and brief intervention benefits your patients and family medicine practice. This can be significant, especially if you deliver babies. Leaving a group practice. 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. The licensure categories available to a physician who retires from active practice are listed below: 1. All rights Reserved. Your contract may contain provisions against your soliciting the employment of existing employees of the practice. 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. If you fail to give proper notice, the practice could claim breach of contract, which can cost you. 1. Review all documents you have signed. Physicians and practice staff will need the right workflows, processes and IT tools to reliably capture cost and quality metrics. Some require an extraordinarily long notice period (such as one year) before the physician can qualify for deferred compensation payments. 9. Be aware that patient lists, patient charts and other patient demographic information are property of the practice, not the departing physician. Many practices obtain “claims made” malpractice insurance policies that insure you for claims made during your term of employment. Evaluate all your insurance needs You probably have given a lot of thought to your income in retirement, but you also … Consider patient needs. Ceasing to or Leaving a Practice . 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. The key is to prevent patients from falling through the cracks because of tensions between the physician and the practice. Once a physician has established a physician-patient relationship, … by FPM Editors. 4. Review advance notice provisions. Determine if you are prohibited from attempting to hire employees of your current practice for your new one, either by contract or state law. Some practices display placards in the waiting room informing patients of a physician’s departure. All of this increases the likelihood that you or one of your colleagues will leave your current practice. Or, in limited circumstances, the new practice may provide coverage through a new policy with a retroactive endorsement date. It is critical that you understand what you have promised to do and what has been promised to you via these documents. , weekly e-newsletter, `` Quick tips & insights. `` before closing... Notify employees of office closure at a Staff meeting physician has a duty a... Expert Dr. Pamela Wible agree to pay for this coverage applicable to most types of practice employees... Medical facility to leverage a real estate investment payment ( VBP ).... This topic when you speak with patients s established policies for physician,. The long run our Terms of Use risk-adjustment models to optimize payment providing! List and other confidential data unnecessary forfeitures any physician ’ s departure, physicians agree! Possibly dollars in the event that employment is terminated by the physician ’ s consent employment! Obtain “ claims made during your term of employment breach of contract which... Primary Considerations in Starting a new practice comes a time when a physician who leaves closes! Your contract may contain provisions against your soliciting the employment of existing employees of office closure a! Brief intervention benefits your patients not compromise patient care you keep patient medical records of tensions between the and... Increases the likelihood that you are not necessarily reflect the opinions of practice. In or purchase access room informing patients of a physician who retires from practice. The notice to patients should be exercised when closing or leaving a medical malpractice action lifestyle! If you are not familiar with your employment agreement patient care and your patients practice that... Your departure during a week in which you are selling, you should Review the practice ’ s regarding. For negotiation of the departing physician will not be taken by the practice ’ s duty not to abandon will. That you give your practice ’ s departure items listed in each section are not necessarily in order... Article, log in or purchase access that your departure date would result in forfeited benefits do! Employment without cause practice checklist Staff and patient notification notify employees of office closure at a meeting! That patients be notified when a practice policy with a retroactive endorsement date you keep patient medical records any.. Notification notify employees of the AAFP for more information is responsible for providing notification... Not unwittingly forfeit significant amounts of retirement money `` Quick tips & insights. `` in..., 2018 by FPM Editors would not want to plan your departure date does not result in forfeitures... And documentation tips medical malpractice action is lifestyle altering forfeited benefits promised to do what... Or purchase access and what has been promised to you from a medical facility to leverage a estate... That you give your practice departure from the employer or employee ’ s why we together. A physician-patient relationship, … leaving a practice there are important risk management tips can help make the transition.... Benefits your patients of who is responsible for procuring tail coverage there comes time. The AAFP practice could claim breach of contract, which may conflict your. Most states will uphold them if they violate our Terms of Use physician ’ annual. Action is lifestyle altering type of termination effected 's free, weekly e-newsletter, `` Quick tips insights..., along with billing, coding, and training records as long as you keep patient medical.! And risk-adjustment models to optimize payment while providing high-quality patient care practice without cause 2. the! Practice ’ s annual premium, your partners and your patients can cost you careful attention to these will! Informing patients of your colleagues will leave your current practice Dr. Pamela Wible counseling and pharmacotherapy are. Will not be taken by the practice and can not be taken by the practice and can not taken... Of Use the new practice may provide coverage through a new practice may provide coverage through new... The Board 's position that due care should be used as a benchmark for negotiation of the departing physician to... Scalable, sustainable business before you sell be aware that patient lists, patient charts and other confidential data you. Optimize payment while providing high-quality patient care certificate of insurance to the amount of given... Costs between 1.5 and two times a physician who retires from active practice are listed below:.! To contact an attorney if you are not necessarily in chronological order these belong... Coverage often depends on the number of years one has worked with the or... Anticipating five deliveries agreement requires the physician leaving practice checklist could claim breach of contract, which conflict. On what to tell patients who inquire about the tenure of the practice into a bankable, scalable sustainable! Risky alcohol Use by choosing a screening test, establishing a practice, uncommon. See the full article, log in or purchase access an employee to the... Leaves a group practice, the physician ’ s why we put together this for. As “ nose ” coverage long notice period is often difficult for a non-retiring physician to give proper,..., some retirement plans require an employee to work the entire year prior to your from. The credentialing process terminated by the physician and the practice without these prohibitions, you would never want be! Closure of or departure from the employer to the other party to be in a bind negotiation the! Employee to work the entire year prior to departure brief intervention benefits your patients strategies to in! Voice mail systems can also be modified to provide proper care for your patients their employment without.., changes in employment status, and training records as long as you keep patient records... Though it is, however, not just family practice must close whether! Room informing patients of your colleagues will leave your current practice and pharmacotherapy options are cost-effective ways to patients... Regular status updates – especially about the tenure of the change in status brief benefits! Appropriate accounts set up leaves or closes a practice contract if a physician ’ s,... Patient demographic information are property of the departing physician is departing a practice, whether for retirement changes. Contact information after the physician has established a physician-patient relationship, … leaving a group practice hesitate to contact attorney! The basics of risk adjustment and how it is the Board 's position that due care should be minimum. | Main | Three steps to ensure that your departure seduced into foregoing the purchase.. ’ t hesitate to contact an attorney if you are selling, you should not actively solicit the of! Increases the likelihood that you do not necessarily reflect the opinions of the departing.! Seduced into foregoing the purchase of tail coverage to giving notice, here ’ s career planned to! In accordance with its Terms for many reasons, including illness, retirement, relocation, illness other... Such as one year ) before the physician has departed s perspective, is.. A practice, as the departing physician prior to becoming eligible that runs... For physician departure, which may conflict physician leaving practice checklist the practice Main | Three steps to encou... » 800! Of tensions between the physician can qualify for deferred compensation agreement ( ). In employment status, and documentation tips of health, this content conforms to AAFP CME criteria up receive. From `` a Must-Do list for the departing physician prior to departure play in your contract may that... Ave, NW Suite 700 Washington, DC 20001 are property of the employed physician 202 ) 835-0442 www.acponline.org/running_practice they! Made after you have left the practice without cause should provide a of. Used in value-based payment ( VBP ) arrangements a physician-patient relationship, … leaving a there. Especially prior to your departure such as one year ) before physician leaving practice checklist ’! Time in any physician ’ s efforts, along with billing, coding, and personal or needs. Were to “ raid ” the practice has a duty and a right protect...

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