How to hang up the stethoscope
Retirement can be a lot of work. The responsibilities as- sociated with closing or selling a medical practice make the process a complex transaction. To guide physicians in the right direction, TMA offers Clos- ing or Selling Your Medical Practice. The publication, available in hard copy for $99 or as a PDF for $89, features chapters on selling a medical practice, notifying patients and employ- ees, medical records management, and important decisions for retiring physicians. It also includes a helpful practice-closure checklist. To purchase Closing or Selling Your Medical Practice, visit
texmed.inreachce.com. Austin attorney Michael Stern, JD, CPA, has experience in business formation and representation, contracts, and health law. He says physicians closing or leaving a practice have a duty to notify their patients of their decision and to offer them a chance to get a copy of their medical records. He adds that it’s a good idea for physicians to seek advice from a lawyer and an accountant when selling or closing a medical practice. Under Texas law, physicians must give patients adequate notice and opportunity to seek another physician or face pa- tient abandonment charges. Texas Medical Board (TMB) spokesperson Leigh Hopper
says physicians whom the board determines have abandoned a patient face potential penalties ranging from a remedial plan with a $500 fee to sanctions that could include continuing medical education requirements and an administrative penalty.
She says some cases of patient abandonment, depending on the facts, could cause the board to revoke a physician’s medi- cal license.
TMB rules outline the procedures retiring physicians must follow when leaving a medical practice. It says physicians must:
• Publish notice in the newspaper of greatest general circula- tion in each county in which the physician practices and in a local newspaper serving the immediate practice area;
• Place written notice in the physician’s office at least 30 days before the date of termination, sale, or relocation of the practice;
• Send letters to patients seen in the previous two years, no- tifying them of discontinuance of practice; and
• Submit a copy of the notice to TMB within 30 days of the date of termination, sale, or relocation of the practice.
TMB rules also cover medical records management, release,
and charges; patient access to diagnostic imaging studies; and appointment of a custodian for a physician’s records. The rules say physicians must maintain adequate medical
records for at least seven years from the date of last treat- ment by the physician. For patients younger than 18 when last treated, the physician must maintain the medical records until the patient reaches 21 or for seven years from the date of last treatment, whichever is longer. Closing or Selling Your Medical
• Top 10 physician stressors •
The TMA Committee on Physician Health and Rehabilitation identified these top 10 physician stressors:
• Time constraints; • Problems with patients and their families; • Financial issues; • Overwork or too much work; • Fear of lawsuits and malpractice; • Insurance issues and third-party intrusions; • Problems with hospital administrators or hospital and office staff; • Family concerns; • Paperwork; and • Governmental regulations, including Medicare and Medicaid.
Source: TMA Coping With Stress in the Practice of Medicine, 2009 and 2010 course evaluations
20 TEXAS MEDICINE June 2012
Practice lists retention guidelines for medical records of deceased patients, drug records, hospital records, mammography images, managed care contracts, Medicaid and Medicare records, and more. The book also features a sample medical records release authoriza- tion form and sample letters for physicians who are discontinuing or closing their practices.
Lawsuits still possible Retirement doesn’t mean you can
stop worrying about getting sued. Patients can sue for alleged medi- cal malpractice after you leave practice.
John Alexander, senior vice
president of underwriting ser- vices for the Texas Medical Liabil- ity Trust (TMLT), says Texas law doesn’t require retiring physicians to purchase “tail coverage” but it’s
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