If the employment agreements for your staff do not address some of the terms discussed above, you may want to consider drafting a separation agreement with each employee to be entered into after notification to the employee of your decision to retire. A separation agreement can help provide clarity and avoid unnecessary issues and disputes, and will typically include the following:
- The date that the employment will be terminated as you transition into retirement;
- Any post-termination compensation owed to each employee, including unused vacation days, bonuses or expense reimbursements; and
- Employer obligations, including those associated with retirement plan contributions, health insurance, life insurance and other fringe benefits.
Patient Notification
Timeframe: At least 30 days in advance
The physician–patient relationship is an ongoing responsibility. To avoid claims of patient abandonment and to assure continuity of care, patients should be notified of your decision to retire at least 30 days in advance of the practice closing; however, some states specify the manner and content of this type of patient notification. Further, the timeframe for providing notice depends on the type of practice, the health status of the patients, the availability of other physicians within your specialty to accept new patients and the number of patients involved. The notification letter should clearly state that the practice is closing, along with the effective date of its closure, and that the patient will need to seek medical care from another physician; it should also delineate where medical records will be stored, how copies of medical records can be obtained and how to have medical records transferred to another physician. If you are allowing another physician to assume your practice, but you are not selling, be sure to state this in the notification letter and inform patients that they are not obligated to use the new physician. A copy of this written notice should be placed in each patient’s medical record.
Consider sending letters by certified mail to any higher-risk patients who may be significantly affected by the change and by regular mail to all active patients. Include an authorization for the release of medical records to expedite the process for record transfer to any other provider the patient may see in the future. In addition, consider placing an advertisement in the local newspaper regarding your retirement, and include the same information provided in the notification letter sent to patients.
No new patients should be seen at your practice once your existing patients are notified of your retirement. In addition, you should start referring patients who require continuous care to other providers at least 60 days before closing. You should also start limiting non-emergent visits at this time.
Insurance Notification
Timeframe: In accordance with applicable contractual terms
Even if you completely retire from the practice of medicine, you could be named in a malpractice action resulting from services provided while you were engaged in active practice; therefore, you must notify your insurance carrier that you will be retiring. Under an occurrence policy, you likely only need to notify the carrier of your retirement in writing and request a refund of any unearned premium. If you carry a claims-made policy, you may need to obtain tail coverage. Claims-made policies require that both the incident and the resulting claim occur during the coverage period. Tail coverage provides insurance for claims that are made after you retire for events that occurred while you were engaged in active practice.
Other Notifications
Timeframe: In accordance with applicable contractual terms
You should inform all necessary third parties of your retirement, including but not limited to Medicare/Medicaid and other payers, hospitals at which you have privileges, referral sources, and your state and local medical boards. Review your contracts with each of the above parties to ensure that notice of termination is provided in accordance with the terms of the applicable contract. You should also notify the medical staff committee of any hospitals where you have privileges and the state medical board.
Medical Record Arrangements
Timeframe: At least 30 days in advance
Each state has its own record-retention guidelines that regulate the preservation and maintenance of medical records, including the length of time that medical records must be retained. In addition, some HMO or managed care agreements also include retention requirements. Be sure to provide copies of these agreements to your legal advisor for review.
