Closing a Practice

February 1, 2008

I am a solo physician. I need to leave the practice - and the country - to care for my ill parents. How can I disengage from this practice?

Question: I am a solo physician. I need to leave the practice - and the country - to care for my ill parents. How can I disengage from this practice?

Answer: If you can safely assume your trip abroad will end at a certain date, you can look into hiring a locum tenens to run the place while you are gone. If you expect a very long stay, you might also want someone else to back you up on the business side of things. The other alternative, of course, is to close the practice.

To do that, you need to consider all the logistics based on your practice situation. For example, what will you do with your building? Do you rent or own? If you rent, you’ll need to notify your landlord of your intentions. If you own, do you plan to sell? Find a real estate agent and start your preparations.

Also, determine what you need to do to move your equipment, files, and furniture - and where you will put them. If you lease your equipment, notify your lessor. If you want to sell the equipment you own, find a seller, have a yard sale, put your equipment up for sale on eBay, or find another way to locate a buyer.

Give your staff adequate notice, but retain at least one staff member for 30 to 60 days after the close to follow up on your final outstanding accounts. Most physicians find a part-timer for 60 days to be adequate, but it depends on the volume and how many of your accounts still await collection.

Remember that a physician has an ethical obligation to notify her patients when she moves or closes her practice to allow them to obtain copies of their medical records or to have their records transferred to another practice. Ideally, a physician should notify each patient by letter at least 60 days in advance of closing. You'll find a sample letter in the Tools section of www.PhysiciansPractice.com. Often a physician supplements these written notices with a published notice in the local newspaper scheduled to appear on three or more occasions.

The American Medical Association's Ethics Opinion 7.03, Records of Physicians Upon Retirement or Departure From a Group, states in part: “A patient's records may be necessary to the patient in the future not only for medical care but also for employment, insurance, litigation, or other reasons. When a physician retires or dies, patients should be notified and urged to find a new physician and should be informed that upon authorization, records will be sent to the new physician. Records which may be of value to a patient and which are not forwarded to a new physician should be retained, either by the treating physician, another physician, or such other person lawfully permitted to act as a custodian of the records.”

Finally, if you have privileges at a hospital - and especially if you take emergency call - you'll want to give that hospital at least 90 days notice, if not more.

Of course, you can also talk to the physicians you now share call with about buying your practice. I strongly suggest you use an experienced appraiser to set the price, which is usually based largely on accounts receivable.