Letting patients know you're leaving the practice

[SCPA]

What is the normal protocol for an office to alert patients when a provider has left the practice? Is there any obligation to do this? 

 

I work in rural med and have no clue how they will handle this. 

 

Thanks. 

[jmj11]

It is customary to notify them as well as to give them a contingency plan for their care. The only legal requirement is to avoid a sense of abandonment. For example, if you offered the only care in an area or the only specific care within a practice and you left without notifying them, they could (unlikely though) sue you for abandonment. Usually, you send a letter say as of day X, you will be gone and you have arranged for Y to take your patients, If you have no such arrangement, you then say you recommend them going to Z practice for their care. If you are in a large practice that can easily accommodate your patients or you have a replacement, a courtesy letter is still standard to advise them that you will no longer be in that practice but  so and so will now assume your practice. 

 

I closed my practice last year. I had about a three-week notice and had my MA reach out to all 2,000 of my patients by letter, e-mail or phone call. Despite our attempts to notify them, some were not reached. Several, (handful) were very angry about that.

[sk732]

There are generally College/Medical Board guidelines/by-laws regarding how much notice, etc you're supposed to give and they vary by jurisdiction.  It's generally considered that you give as much notice as possible so that people can get updated Rx's to tide them over until someone takes over the practice or the patients can find someone new to look after them.

 

SK

[Reality Check 2]

Corporate medicine doesn't want you to tell the patients you are leaving so they don't try to follow you away from their income base. My corp job would NOT tell patients I was leaving and kept scheduling them under the assumption they would see me next visit. It was very uncomfortable. They also had me see NEW patients up until the very last day and then I would tell the patient I wouldn't be there next time and they were rather cheesed...... I was a cog in a machine and perceived as readily and easily replaceable. 

 

The CHC didn't want me to tell anyone either so the patients would still come to that clinic. They refused to send out letters, claiming no necessity and excess cost. I told every patient and some wanted to know where I was going and I would tell them - others I would not tell...... yep, dodged some bullets.

 

Most of the time there is a letter from you, the provider, stating that you are leaving the practice to "seek other opportunities" or "move to be closer to family", etc etc. The form letter goes on to say that you have the fullest confidence in your partners to continue patient care and continuity. The letters are usually sent out 60-90 days before departure. They are sent to your "panel" or patients who identify with you as their primary contact. 

 

Also a letter in posted at the front desk and in each exam room.

 

Interestingly, I worked with a simply AWFUL physician who was fired on the spot by the CHC and escorted from the building. No one told me what to say to patients, so I told them she was terminated. No details but I wasn't going to lie for that woman. 

 

A few weeks later she took out an ad in the local paper (reportedly advised by her lawyer) stating that due to circumstances beyond her control she was no longer available at that clinic to care for them and they should call the county medical society for a referral to a qualified provider and she apologized for any inconvenience. It was filled with sideways barbs and not so veiled animosity. 

 

Do right by the patient. Don't lie. Be professional and respectful. 

[SCPA]

If the office doesn't want to mail letters, and there's a good chance they won't, any advice on what I should do? I plan to leave in a 4-6 week period and as such won't be able to see all my patients to tell them. 

[Reality Check 2]

Depends on the "who" in the office.

If you feel strongly then check with the next Who above this one.

Ask about policy or capacity to meet patient appt needs.

 

If you have a replacement then the letter should introduce the replacement.

 

If no replacement then you could stress with the higher ups that the patients need to know sooner than later so you can fill meds and catch up on complex patients to keep them safe.

 

You are leaving - so keep asking - they can't fire you..........................