FAQs for doctors leaving a practice

FAQs for doctors leaving a practice

Summary:

Leaving a medical practice can be a daunting experience. It may be your decision to leave or the practice may require you to leave with little or no notice. With the support of Avant, you can make the transition as comfortable as possible.

SegmentsFactsheetsEmployment matters
27 / 04 / 2017

How much notice should I give?

If you have a written contract, you should give the notice period required by your contract. You should give notice in writing.

If you do not have a written contract, you should give ‘reasonable notice’. This will vary depending on factors such as the length of time you have worked at the practice and how easy it will be for the practice to replace you. At least four weeks’ notice will generally be expected. You should give notice in writing.

You can agree with the practice that you will finish earlier. If such an agreement is reached, it should be put in writing.

What happens to the practice records, prescription pads and other property of the practice?

You should not take any property belonging to the practice (including any of the practice’s confidential information) when you go. This includes patient records, patient lists, patient contact details and financial information about the practice.

You should return all practice property you have in your possession that is not physically located at the practice (for example, any records or equipment you may have at your home).

It may be prudent to ask the practice manager or owner to give you a note confirming the practice has received the equipment and records. Prescription pads remain the property of the practice. It is recommended you destroy all old prescription pads with your name and the practice address on them before you leave the practice.

What should I tell my patients?

You should ensure you comply with any obligations in your contract about leaving the practice (including any restraint of trade obligations). You should not breach any privacy obligations in dealing with patient contact details (for example, you should not use patient contact details to contact patients to let them know you are starting at a new practice).

If there are no restrictions in your contract:

  • we suggest that before any announcements of your leaving, you agree with the practice about the messaging you will give your patients.
  • You should not encourage or ask patients to leave the practice and become patients of your new practice.
  • if a patient wants to see you at your new practice, you can ask the patient to sign a consent form to transfer their medical records. See below for further information about the transfer of patient records.
  • you can advertise in the local press once you are established at your new practice. See below for further information about advertising.

You should seek Avant’s advice if you are unsure about your obligations.

What happens with my patients’ records?

The question of ownership of medical records where doctors practise together or in shared premises can become complicated without an express agreement. It is useful to clarify these matters when you start work in your practice.

Can I get access to the records later if I have a claim, complaint or other legal case?

It can be helpful to have a written agreement with the practice that if any dispute arises about a patient you have treated at the practice, the practice will provide you with a full copy of the records relating to that patient so you can complete statements and reports, instruct lawyers and respond to legal matters.

Are there any restrictions on what I can do at the new practice?

You should ensure you comply with any obligations in your contract about leaving the practice, including any restraint of trade obligations. A restraint of trade clause seeks to prevent you from poaching staff or patients and/or from working at another practice that is within a specified distance from your current practice for a specified period of time.

You should also ensure you are not breaching any obligations in your FAQs for doctors leaving a practice contract when you advertise your new practice.

What should I do with my personal property?

You should take your personal property when you go. You may wish to consider taking important personal property before you resign. In some cases, a practice owner may ask you to leave immediately and you may not have an opportunity to gather all of your personal belongings.

Who has responsibility for the care of my patients when I leave the practice?

Once you have left the practice, the practice will assume responsibility for the care of your patients as it holds the patient’s medical records. There are a number of things you should do in the lead-up to your departure to ensure patient care is maintained.

  1. Patient recalls
    You should bring to the attention of the practice the need to follow up urgent and non-urgent patient recalls after you have left and ensure the practice has a way of identifying the patients requiring follow-up. If you are not confident that the usual practice follow-up system will be sufficient, the simplest way is to provide a list of patients who have outstanding investigations or otherwise need follow-up together with a note about the urgency of the investigation/need for a further consultation. All urgent recalls should be generated by you in the first instance while you are still at the practice. It may be wise for you to make a list of your urgent recalls and provide a separate urgent recall list – incomplete actions/responses – as part of your clinical handover, before you leave the practice. You should also keep a list of the high-risk patients you want to ensure are followed up or handed over when you leave. Futhermore, you may wish to prepare a spreadsheet for this purpose. Lastly, you should provide a copy to the practice when you leave.

  2. Referral tracking
    You should develop a list of patients you have referred to a specialist who have clinically significant issues and would be at medium to high risk of a delayed diagnosis or a failure to diagnose if they do not attend the specialist appointment, or if you do not receive feedback from the specialist. You should provide a copy to the practice when you leave.

  3. Test tracking
    There is a computer system facility that can be used to manage an outstanding audit trail. You can go into your outstanding audit trail and print a list of all tests (pathology and radiology) you have requested where you have not received results (or not reviewed those results).

  4. Inbox
    Many computer programs have an inbox or task system for doctors to receive results, messages etc. Where possible, you should ensure these are completed before you leave the practice. You should provide a list of incomplete tasks to the practice owner before you leave.

  5. Hospitals
    You should download relevant patient communications/discharge summaries from the local public hospitals. A copy will probably be sent to the practice and to you at your new practice. You should review any correspondence and identify the patients who require follow-up. You should contact those patients to advise that follow-up is required. You should make a written request for future communications relating to your patients to be directed to you at your new practice, if those patients are going to follow you to the new practice.

  6. Letter about clinical handover
    It may be worthwhile writing a letter to the practice owner stating that clinical handover has been completed and the remaining follow-up processes are the responsibility of the practice.

You should keep copies of all handover documents provided to the practice when you leave, including detailed records of how you have managed the patient’s continuity of care.

The practice has directed me to leave immediately. What should I do?

If you are directed to leave the practice premises, you should do so as soon as you can. If you are distressed or upset, you should not drive yourself home. Call a taxi or family member to collect you.

If possible, you should collect your important personal belongings before you leave.

As soon as possible after you leave, you should write to the practice:

  • confirming that you were directed to leave the practice immediately (and perhaps setting out the circumstances)
  • advising that you are unable to attend to patient care matters as a result
  • advising that the continuity of care of your patients is now the practice’s responsibility
  • asking for your computer password to be deactivated
  • asking that your Medicare provider number not be used.

Should I contact Medicare?

Yes. You should ask Medicare to close down your Medicare provider number for the practice. You can request details of the Medicare billings for patients treated under your provider number if you wish. This information can be helpful if there is a later dispute about amounts that are owing to you from the practice.

A new provider number for your new practice will be required for future Medicare item numbers billed to Medicare. This may take some time to organise so it can be a good idea to apply as early as possible.

Can I advertise my new practice?

Yes, but you should ensure you comply with any obligations you have to your former practice.

You should consider the AHPRA (Australian Health Practitioner Regulation Agency) advertising guidelines which can be obtained from the AHPRA website.

Some options to advertise your new practice include:

  • letterbox drops
  • local press
  • internet – you may wish to include your name on the practice’s website or other websites used to locate doctors. If possible, website references to your former practice should be removed
  • social media – you should have regard to AMA (Australian Medical Association) and AHPRA guidelines
  • posters in nearby pharmacies and other relevant businesses.

Who should I notify of my change of address?

You should change your postal address from your former practice to your new practice or your home. In particular, you should notify the following organisations:

  • AHPRA (even if your mailing address is your home address, as AHPRA needs an address for your principal place of practice)
  • Medicare
  • The Department of Immigration (if there are sponsorship issues)
  • Your College (if any)
  • The publishers of publications you receive at the practice.

You should leave a forwarding address for any personal mail that still gets through.

What should I do about any outstanding fees?

If possible, you should reach an agreement with the practice about when and how outstanding fees will be paid and what documentation will be provided to you.

Most doctors are engaged as contractors and are not entitled to annual leave or long service leave. If you are an employed doctor, you may be entitled to a payment in lieu of accrued leave when you leave the practice.

Is there anything I need to do with my computer?

You should disable your computer passwords.

You may wish to put an auto reply message on your former practice email account indicating you no longer work at the practice.

If possible, you should arrange for all emails to that account to be forwarded to another person so any urgent follow-ups can be attended to.

You should remove your personal information from the practice’s computer system (for example, email addresses, personal documents) when you go.

I have received a letter from my former practice’s lawyer alleging that I stole confidential information. What should I do?

You should contact Avant for assistance.

This publication is not comprehensive and does not constitute legal or medical advice. You should seek legal or other professional advice before relying on any content, and practise proper clinical decision-making with regard to the individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgment or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. © Avant Mutual Group Limited 2015. 1219 04/17 (0804)