What Otolaryngologists Should Know Before Leaving a Medical Practice

by Steven M. Harris, Esq. •

 The date the employment will be terminated as you transition to a new practice;

  • Any payment terms or buy-out requirements for the physician-employee;
  • Any post-termination compensation owed to you, including unused vacation days, bonuses or expense reimbursements;
  • Employer obligations, including those associated with retirement plan contributions, health insurance, life insurance, and other fringe benefits;
  • A statement of obligations surrounding noncompetition, solicitation of patients and/or practice employees, if any, and obligations surrounding retention of medical records;
  • A nondisparagement provision, which states that both the practice and the physician will refrain from making false or disparaging statements about each other;
  • Obligations to pay premiums associated with malpractice tail coverage; and
  • Direction as to who will handle the patient notifications described below.

Physician–Patient Relationship

The physician–patient relationship is an ongoing responsibility, and patients will need to be notified of your departure from the practice. If you signed an agreement with noncompete or nonsolicitation provisions with your current practice or employer, it should be evaluated by an attorney to determine if the terms are enforceable and any potential impact on your patient relationships. Depending on the terms of your employment, the patients may be considered patients of the practice rather than you personally, which could impact how notification is provided. Further, there are some states that specify the manner and content of this type of patient notification.

If you will be providing the notification personally, consider sending letters by certified mail to any higher risk patients who may be significantly affected by the change and notification to all active patients by regular mail. If you include an authorization for the release of medical records, it can expedite the process for record transfer either to your new practice or to any other provider that the patient may see in the future. Again, your employment or separation agreement may dictate the manner of providing notification to patients and should be reviewed carefully.

Medical Records

States have different requirements regarding the length of time that medical records are retained, and some HMO or managed care agreements also include retention requirements. You will want to include who will maintain the records, as well as how you will obtain access, if needed.

Other Notifications

The physician practice may have to notify third parties pursuant to certain contractual notice requirements, including managed care contracts. You should also make sure the medical staff committee of any hospitals where you have privileges and the state medical board are notified. If you are a provider enrolled in Medicare, you will need to notify the Centers for Medicare and Medicaid Services (CMS) of any information that changes your provider agreement.