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There are several critical issues to consider when retiring and/or closing a practice. From a professional liability perspective, the following areas are key.
Proper Notification
Physicians/providers closing their practices are responsible for notifying their active patients, defined as those who are currently being treated for disease or illness or those who have been seen within the past 18 months. Proper notification gives patients time to find another physician/provider without interrupting their care. Physicians/providers are also required to notify their state licensing boards and the Drug Enforcement Agency (DEA) about their pending change in status.
Referrals
If possible, physicians/providers should make referrals an option for patients. However, there are documented cases where insureds were sued for negligent referrals. If insureds refer patients, they should make sure the patients understand that it's their choice to see the recommended physicians/providers. SCPIE risk managers also suggest advising patients to contact their county medical societies or local hospital referral lines. Managed care patients should contact their health plan representatives.
Retaining Clinical Records
The possibility of a lawsuit after a physician/provider has left or closed his or her practice always exists. To help defend against any future claims, a policy of retaining clinical records indefinitely is strongly recommended. Another option is to keep records a minimum of 10 years from the date of the last visit, although 25 years is preferable. Under no circumstances should adult patients' clinical records be retained less than 10 years following their last visit. The records of minors should be kept 10 years or until their 21st birthday, whichever is longer.
It is in the physician/provider's best interest to retain clinical records as long as possible. They must be stored in a place and manner that maintains confidentiality. Insureds should also keep telephone and office visit logs in the event a lawsuit calls for a reconstruction of events.
Transferring Clinical Records
Physicians/providers turning their practices over to replacement doctors should have an agreement that stipulates how long their clinical records will be kept by the incoming physicians/providers. That allows them access to their records in case they are sued and need them for defense purposes. Also, patients should be informed as to where they can find their transferred records.
Destroying Clinical Records
If physicians/providers choose to destroy clinical records after a set period of time, confidentiality must not be compromised. There are record destruction services that guarantee records are properly destroyed without releasing any information.
Insureds should establish documented policies and procedures for logging which records will be destroyed as well as when and how. This can help quell any future allegations that records were destroyed deliberately and maliciously.
Professional Liability Insurance
SCPIE offers several liability coverage options for those retiring or closing a practice. Insureds should contact their insurance agent/broker, SCPIE Account Executive or Policyholder Services Representative several months before retiring and/or closing a practice. Early notification will ensure that insureds receive the correct benefits and coverages.
State or local medical associations or healthcare associations may have resources or references to assist in retiring and/or closing a practice. For help with any additional questions and concerns, contact SCPIE's Risk Management Department at
800/585-7799 or
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