Considerations on closing or leaving a practice

Information Packet-Recommended Procedure in Closing/Discontinuing a Medical Practice

Rules and opinions

Frequently asked questions

Rules and opinions

Board Rule 540-X-9-.10(3) (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.
  • A physician or physician group should not withhold information from a departing physician which is necessary for notification of patients.
  • A physician or the estate of a deceased physician transferring medical records in connection with the sale of a medical practice should notify the physician’s active patients that the records are being transferred and should provide the patient with information sufficient to secure the transfer of the medical record.

Medical Licensure Commission Rule 545-X-4-.06 (Scroll to section .06):

  • Example of unprofessional conduct: "The refusal by a physician to comply, within a reasonable time, with a request from another physician for medical records or medical information when such request is accompanied by a properly executed authorization of the patient."

AMA Ethical Opinion E-7.01 (Link to Chapter 7, sign up required):

  • The interest of the patient is paramount in the practice of medicine, and everything that can reasonably and lawfully be done to serve that interest must be done by all physicians who have served or are serving the patient.
  • A physician who formerly treated a patient should not refuse for any reason to make records of that patient promptly available on request to another physician presently treating the patient.
  • Proper authorization for the use of records must be granted by the patient. Medical reports should not be withheld because of an unpaid bill for medical services.

AMA Ethical Opinion E-7.03 (Link to Chapter 7, sign up required):

  • When a physician retires or dies, patients should be notified and urged to find a new physician and should be informed that upon authorization, records will be sent to the new physician.
  • Records which may be of value to a patient and which are not forwarded to a new physician should be retained, either by the treating physician, another physician, or such other person lawfully permitted to act as a custodian of the records.
  • The patients of a physician who leaves a group practice should be notified that the physician is leaving the group.
  • Patients of the physician should also be informed of the physician’s new address and offered the opportunity to have their medical records forwarded to the departing physician at his or her new practice location.
  • It is unethical to withhold such information upon request of a patient.
  • If the responsibility for notifying patients falls to the departing physician rather than to the group, the group should not interfere with the discharge of these duties by withholding patient lists or other necessary information.

AMA Ethical Opinion E-8.115 (Link to Chapter 8, sign up required):

  • Physicians have an obligation to support continuity of care for their patients.
  • While physicians have the option of withdrawing from a case, they cannot do so without giving notice to the patient, the relatives, or responsible friends sufficiently long in advance of withdrawal to permit another medical attendant to be secured.

Section 34-24-338 of the Code of Alabama:

  • If any registrant shall change his address during the year for which any certificate of registration shall have been issued by the commission, such registrant shall, within 15 days thereafter, notify the commission of such change, whereupon the commission shall issue to such registrant without additional fee, a duplicate registration certificate for such new location."

Frequently asked questions

Q: How much notice do I have to give patients that I'm leaving a practice/retiring?
A: There is no specific time period required.  Board Rule 540-X-9-.10 states "reasonable notification" must be provided. This may vary from practice to practice. If you are uncertain, check with your malpractice insurance carrier.

Q: Do I have to send patients a letter or can I just take an ad out in the paper?
A: While the Board rule does not specify the mode of notification, it would be difficult to ensure patients received notification by a newspaper ad. If you use certified, return receipt mail, you can place a copy of the letter and return receipt in the patient's file in case there is ever an issue of notification.

Q: What does "active patient" mean?
A: Again, the Board rule does not specify the meaning of "active," because this may vary from practice to practice. If you are unsure, check with your malpractice insurance carrier.

Q: Is the departing physician or the remaining group responsible for notifying patients?
A: It does not matter which party sends the notifications. If the departing physician is responsible, the remaining group may not withhold patient names and addresses required for the notification.

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