• Leaving a Group Practice

    When leaving a group practice, the departing physician is responsible for notifying the Texas Medical Board and his/her patients, as well as advising who has custodianship of the medical records and how a copy may be obtained.



    Texas Medical Board Rules 

    The Texas Medical Board (TMB) Rules Chap 165.5(a)(1-3) state 

    When a physician retires, terminates employment or otherwise leaves a medical practice, he or she is responsible for
    (1) ensuring that patients receive reasonable notification and are given the opportunity to obtain copies of their records or arrange for the transfer of their medical records to another physician; and
    (2) notifying the Texas Medical Board when they are terminating practice, retiring, or relocating, and therefore no longer available to patients, specifying who has custodianship of the records, and how the medical records may be obtained;
    (3) Employers of the departing physician...are not required to provide notification...the departing physician remains responsible for providing notification...

    Notification 165.5(b)(2)(A-C) shall be accomplished by
    (A) publishing notice in the newspaper of greatest general circulation in each county in which the physician practices or practiced and in a local newspaper that serves the immediate practice area;
    (B) placing written notice in the physician's office; and
    (C) sending letters to patients seen in the last two years notifying them of discontinuance of practice.

    Note: As the Harris County Medical Society (HCMS) frequently receives calls from patients who are looking for their medical records, please also notify our office so we may let these patients know who has custodianship. Call 713-524-4267, ext. 219, or send a letter to Harris County Medical Society, John P. McGovern Building, 1515 Hermann Dr, Houston, TX 77004-7126.

     

    The TMB also has rules prohibiting a practice from interfering.

    Prohibition Against Interference 165.5(c)(1-2) state that

    (1) other licensed physicians remaining in the practice may not prevent the departing physician from posting notice or the sign;
    (2) a physician, physician group, or organization may not withhold information from a departing physician that is necessary for notification of patients.

    When requested, the practice should provide the departing physician with the contact information of his/her patients to ensure the departing physician is allowed to fulfill patient notification responsibilities, and to avoid TMB disciplinary sanctions for the remaining physicians and possible legal risk to the practice.

    Opinion of the Texas Medical Association Board of Councilors:
    If requested by a patient of that physician, the group practice must inform that physician's patient of the departing physician's new address, and that copies of the patient's medical records may be forwarded to the departing physician's new practice. It is unethical for any remaining physicians in the group to withhold such info upon request of a patient.

     

    For TMB rules on transferring medical records, refer to Chap 165.5 - Transfer and Disposal of Medical Records.

    For TMB rules regarding maintaining, retaining, transferring ownership, and who owns the medical records, etc., see Chap 165.1(b) - Maintenance of Medical Records.

     

     

    Guidance and Resources

    The Texas Medical Association (TMA) whitepaper Notice to patients on the departure of a physician discusses the TMB regulations and the practice-employer and physician legal risks.

    Texas Medical Liability Trust (TMLT) also provides guidance Terminating the patient-physician relationship - navigating appropriate notice, difficult patients, closing a practice and more in The Reporter 2017 Quarter 4.

    TMA Board of Councilors Current Opinion - Patient's Rights upon Physician's Departure from a Group

    AMA Code of Medical Ethics - Privacy, Confidentiality & Medical Records Opinion 3.3.1 Management of Medical Records

     

    Notifying patients

    Notifying your patients when you leave a practice - TMA discusses how to notify and who is responsible.

    Leaving a practice? Notice to patients has gray areas - TMA provides guidance on who is responsible for notifying patients and how they should be notified.

     

    Sample Letters and Medical Records Resources

    TMLT has sample Leaving a Practice letters.

    TMA has other practice change sample forms.

    Records Management, Storage & Retrieval Resources in the Houston area. (This list is provided for reference only; it is not an endorsement of any of these companies.)

    Also, refer to the HCMS Buyers Guide page under "Custodian of Records," "Document Destruction," and "Document Scanning & Imaging."

     

    Who owns the medical records?

    Who owns the medical record? - Physicians should agree about ownership up front before entering into the group arrangement to avoid any ambiguity over medical records ownership.

    Access to medical records - Be aware of clauses in your employment or managed care contracts.

     

    For more info on medical records, please refer to our Medical Records page.

    For info on closing a practice, visit our Closing or Selling Your Practice page.