This is the second 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
should the organization do when (1) a physician decides to leave and (2) the physician’s patients decide to stay with organization?
First, as stated in the prior posting on this subject, the
patient should be notified about the change in physician. The patient should be provided the
opportunity to make inquiries, and someone within the organization should be
tasked with taking those calls. If the care will be provided by another
practitioner with the same scope of practice as the departing physician, the
organization should make sure that physician is appropriate for the
patient. If the physician is in the same practice, notice should simply inform the
patient of the new physician’s name, and reference that the medical records
will be maintained.
Special care should be utilized when replacing a specialist, particularly if a different type of specialist will be the replacement. The organization should make sure that the replacement physician has the capability to service the patient. The notice to the patient should reflect the change in specialities.
Service
to the Departing Physician‘s Patient.
In
general, physicians are not liable for the care given by the previous provider,
unless they were part of the same medical group or otherwise participated in
the prior care. To promote continuity of care and avoid allegations of failure
to diagnose or failure to follow-up, however, the new provider assuming care of
the patient should obtain the patient’s medical record from previous providers
and review it. Once the review is complete, make an entry in the medical
record, noting pertinent history and current healthcare plan and needs. At the time
of the first visit, carefully evaluate and document the patient’s current
condition at the time of the first visit. Take special care to document the then-current condition of the patient and changes to the patient’s care plan.
A top cause of malpractice lawsuits is comments by physicians about their predecessors and their care or lack thereof. Lawsuits will often include both the new and the old physician. Physicians should be counseled to focus on the current condition of the client and appropriate treatment options.When discussing prior care, all physicians should use maximum caution. Physicians and nursing staff should restrict their comments to the known medical facts, and refrain from speculation or
blame. If asked by the patient to render an opinion about the prior physician’s
decision-making process or care, inform the patient that you were not present
during that aspect of the care and are therefore not able to comment upon it.
Refer the patient back to the prior physician.