Leaving a Group Practice

When leaving a group practice, the departing physician is responsible for providing proper notification. 

The physician must notify the Texas Medical Board (TMB) and his/her patients and advise who has custodianship of the medical records and how a copy may be obtained. Those remaining in the practice must be careful not to interfere with the departing physician fulfilling these responsibilities.

Texas Medical Board (TMB) Rules and Requirements

The 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:
  • 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
  • Notifying the Texas Medical Board when he/she is 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.
  • Employers of the departing physician... are not required to provide notification... the departing physician remains responsible for providing notification...
The Method of Notification 165.5(b)(2)(A-C) when a physician terminates employment or leaves a practice is:
Notification shall be accomplished by:

     (A) EITHER:
           (i) Posting such notice on the physician's or practice website; OR
           (ii) 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; AND
    (B) Placing written notice in the physician's office; AND
    (C) Notifying patients seen in the last two years of the physician's discontinuance of practice BY EITHER:
          (I) Sending a letter to each patient; OR
          (ii) Sending an email to each patient, in a manner that is compliant with state and federal law.

Note: As 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 and how they may request a copy of their records. 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.

For TMB rules on notification requirements and more, refer to Chap 165.5 - Transfer and Disposal of Medical Records.

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

The TMB also has rules prohibiting the practice or physician group from interfering.
Prohibition Against Interference 165.5(c)(1-2) rules state that:
(1) Other licensed physicians remaining in the practice may not prevent the departing physician from posting notice and 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 (TMA) 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.

Guidance and Resources

The 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 in The Reporter Quarter 4 2017.

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 

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

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

TMLT has sample Leaving a Practice letters.

TMA has other practice change sample forms.

Medical Records Resources

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

Also, refer to the HCMS Buyers Guide under Custodian of Records, Document Management Solutions, and Document Scanning and Imaging.

For more information, including retention requirements, refer to our Medical Records page.

Who Owns the Medical Records?

Who owns the medical record? (TMA) - Physicians should agree about ownership up front before entering into a multiple-physician arrangement to avoid any ambiguity over medical records ownership.