franklinBT Posted October 29, 2012 Share Posted October 29, 2012 I practice in a very autonomous setting with a good group of MD's in the northeast. Over the years I have treated many patients without any involvement from the MD's. Now that I am leaving for a better paying position in a newly formed practice, is it legal to take the address information of my patients so that I could send them notification of my new practice? I would not be taking their medical record. I do not have a contract with my current practice, so there is no 'non compete' clause. Any legal insight would be appreciated. Thanks! Link to comment Share on other sites More sharing options...
jmj11 Posted October 29, 2012 Share Posted October 29, 2012 This is a tricky question that I had to spend some time studying as I was leaving a practice to start my own. Your state may have specific rules. However I met with my lawyers and they said that here it is unclear. The paramount issue is the avoidance of patient abandonment. So, if you can prove (hopefully you will never have to) that it was in the best interest in the continuity of care to take the addresses, I think you are safe by the law. However, with that said, I would assume you don't have a no-compete clause in your contract that would forbid you from taking patients with you. I would suggest then, if it isn't clear in your contract that you can't take patients, and you can prove that you are doing this in the interest of your patients, I would quietly take the addresses. Even if you are in the right, your prior practice could block you (physically) from taking addresses and be very angry about it because they may see the situation differently. But check with your own lawyer. Link to comment Share on other sites More sharing options...
TWR Posted October 29, 2012 Share Posted October 29, 2012 I am not sure about legally but ethically or morally, I would have a hard time justifying taking patient addresses. The office should let patients know where you went. You never want to burn any bridges. Link to comment Share on other sites More sharing options...
jmj11 Posted October 29, 2012 Share Posted October 29, 2012 Ethically and morally has to do with what is best for the patient. If the physicians have never met the patient, and you have given them care for years, you were the one who marketed your services and brought them in, and the patient readily identifies you as their provider, it would immoral to abandon them in a practice that they don't want to be in nor have any connection to. An honest physician or practice should see it that way as well, but some will not, but that is not your problem. Patient care comes first. If the patient is better off in the old practice, leave them alone. If you do take them, at most you will just have contact information (by taking their addresses) so you can send them information where you are now so that they can make a choice where they are seen. Many unethical practices (speaking of ethics) will try to force the patient to see one of their physicians by refusing to let them know how find you. In our review of abandonment cases, some were simply where the leaving physician (there were no PA cases to review) didn't make a hard enough effort to communicate with his old patients where he was going. I didn't take address with me, but I personally paid for postage to send out 800 letters to my old patients telling them where I was going. I did it while I was at my old practice. My old SPs didn't feel great about it but I convinced them it was in the best interest of the patient. I wished that I had taken my old addresses, all of them,because my old practice put up barriers to those patients trying to find me after I left, even though they could not offer the service that I did. The old practice and I have locked horns over this a bit. But that is business. We are still friends and indeed have entered talks about creating a new relationship between us. But good ethics and morals is doing what is in the best interest of the patient not what is in the best interest of the providers. Link to comment Share on other sites More sharing options...
Moderator ventana Posted October 29, 2012 Moderator Share Posted October 29, 2012 every practice that I have worked it sent a letter out when a Doc left - provided contact info and how to remain their patient..... should be the same for you if not - DO NOT TAKE A PATIENT list - that would be bad juju.... If your current practice does not want to do a mailing and provide your new address and contact info - and believe me should check that they are doing this even if they say they are going to by having people call in and ask after you have left...... just get your new practice to take out advertisements ie a big old billboard next to your old place of business or weekly ad in the sunday paper...... Link to comment Share on other sites More sharing options...
surgblumm Posted October 29, 2012 Share Posted October 29, 2012 I would think this to be a conflict of interest, a breach of confidentiality between both you and your SP as well as your patients. Morally it is more than questionable and legally you may find yourself as having to defend this departure from normal activities. If this guy is a smart big mouth he could even write this up in the AMA journal and make every PA suspect to this type of manuver. I would vote a thumbs down. bob blumm Link to comment Share on other sites More sharing options...
primadonna22274 Posted October 29, 2012 Share Posted October 29, 2012 I concur with Bob...understandable to want to let your patients know where you are going, and standard for physicians but still not kosher for PAs. I think this is one of those many intangible barriers we face as PAs, but we are not completely autonomous (with the rare exceptions of those who own their practice). Link to comment Share on other sites More sharing options...
franklinBT Posted October 29, 2012 Author Share Posted October 29, 2012 Thanks for your insight and thoughts. I didn't know if anyone else had come across the same situation in their careers. My current practice is a good group and I would like to think they would relay my new information to patients when they call to make an appointment with me, even though it means turning away business for them. If not then we'll need to be ready with a great marketing campaign in the new practice. Keeping transparency is important. I would like to avoid legal/ethical shadows and not burn bridges. Link to comment Share on other sites More sharing options...
jmj11 Posted October 30, 2012 Share Posted October 30, 2012 Here is a good legal summary, again the continuity of care is paramount. Again, there is no similar document I know of pertaining to PAs. Of course PA's practice various widely and in many cases it makes no sense that the PA would be seen as the primary provider (eg. patients are shared every other visit with the SP). But in your case you were working autonomously. This is the point I was trying to make. The way I read the standard is that the patient must be notified of their provider's whereabouts for continuity of care. I've seen several practices in our area (with personal disputes between providers) and one doctor vanishes and totally abandons the patients (including my own PCP did this). The practice refuses to give any information about the provider's whereabouts. But according to ethical standards that is wrong. In my previous practice I created a subspeciality clinic within the main clinic. The two SPs told me, when I came out the first time, that they didn't want me there because they don't like the sub-specialty. I didn't take no for an answer. I created the whole thing from scratch and they never helped nor ever met (except for a rare occasion when one of my patients had a comorbidity that they treated) any of my patients. When I told them I was leaving, they were mad (big loss of money for them). But mad among friends. They were not going to do anything with my patients but just hope they all went away. I then took it on myself to comply with the law and to communicate with them on my own dime. In that case, I should have taken the charts and addresses because the other providers didn't want them nor did they want to help me at the time to communicate with them. So, I was reading into your situation the same. Someone has to communicate with your patients. If your old practice will not, then you have the responsibility to do so. If they want to hide your leaving, then I say you have an obligation to your patients to send out letters to the entire group telling them where you are going, or get their addresses, even if you have to write them down by hand in a log book, so that you can communicate with them for continuity of care. The worst situation is for your first practice, as many around here have done, to say that when they arrive for their next appointment that they say, "Sorry he is no longer here. Don't know where he is." Paramount is patient care and continuity, secondary is offending our colleagues. If they don't follow the law, then you must. This cannot be allowed to happen as this is a violation of patient continuity laws. Okay, it is 2 AM in Morocco and after a long hard day, I'm going to bed. Link to comment Share on other sites More sharing options...
healthconnect Posted November 1, 2012 Share Posted November 1, 2012 I agree with TWR, you don't want to burn any bridges. The medical community is small and everyone knows each other. You also don't want to jeopardize a future job opportunity because someone spoke negatively about you. I would be surprise if the practice/hospital doesn't have something in place to protect itself. Nelson http://www.healthconnectstaffing.com Link to comment Share on other sites More sharing options...
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