This is the fourth and final in series of articles about changing or
terminating a practice. This article focuses on notifications to
patients when a doctor retires or goes to another practice.
What to do with patients' records when a physician leaves? Even if there is a provision with the physician in his employment contract, is it a legally valid agreement to provide the physician and the patient with continuing access to the records?
Custodianship
of Records
The departing physician and the practice need to
come to a written agreement about who is the custodian of the records and the
conditions under which the departing physician will be granted access to the
records of the patients he or she treated. Consult an attorney who is familiar
with health care, insurance and contract law for assistance in drafting the
agreement or contract.
The
custodianship agreement should state whether patient authorization is needed
for the departing physician to access his or her former records or to obtain a
copy of those records for his or her health care operations (such as a medical
malpractice allegation). If not specified in the agreement, state law may
determine whether patient authorization is needed for the departing physician
to access or copy these records. Generally, physicians should be allowed access
to the records of patients they treated. The records provided should reflect
care up to and including the day of the physician’s
departure.
The
custodianship agreement should specify the access process, contents of the
records to be copied and who pays for copies of the records provided.
Ensure
security. The custodian of the records has a legal duty to maintain the
security, integrity and confidentiality of the records, and to comply with
state law and HIPAA regulations about patient and third party access.
Provide
access to records. When the departing physician continues to treat patients from
his or her previous practice and needs access to their records, the priority
should always be patient safety and well-being in order to avoid delays in
diagnosis or treatment. Juries will not be sympathetic to physicians or
practices that impede access to health care information for business or
financial reasons. A list of the patients treated by the departing physician
should be given to each party, in order to simplify requests for access to and
copies of the records. The list should specify the date of the physician’s departure.
Get the
patient’s authorization. If the
patient will be transferring care to the departing physician, try to obtain a
written authorization from the patient before providing a copy of the medical
record. If you do not have a copy of an authorization, do not delay transfer of
the records as long as you can verify and document the purpose of the
disclosure and the identity of the party requesting it.