What to Do When a Physician Departs

Steps to take when a Physician Departs

When a physician leaves, most group practices first check out their buy/sell documents regarding departure issues; what generally is not written how to handle the logistics. Here are some suggestions (not necessarily in any order) for a physician remaining in town and when a physician leaves and moves out of town:

1. The departing physician doesn't take the charts with him/her -  copy charts per patient written request.
2. Post notice in the lobby well in advance informing of the departure if the physician is moving out of state.
3. Have staff prepare patients to transfer to another doctor in the practice when the patients call for appointments. There have been the occasions when the practice didn't know where the departing physician was going (if staying in town) and patient were told such. Inform the patient that they do have the option of switching to another physician in the group.  Don't assume your departing doc will be so kind as to not solicit patients by telling them they have no option but to follow him/her --no matter how amicable the departure may seem.
4. Meet with the staff regarding the departure - let them hear it  from you first as they will be concerned about job retention.  Meet with and don't memo, if you are a small to midsize practice as your staff/physician relations may be more bonded. If the departure isn't amicable, pretend it is - your staff doesn't need the stress of being in the middle or forcing them to take sides. They will appreciate you taking the high road. Perfect the look of puzzlement as you may need it when a staff member comes to you and says "Doctor X told me that you ___  I don't think that's fair." You want to send the message of a sincere "Huh? Thanks for telling me."
5. File Form 855-R with Medicare and send a letter to all health plans notifying them (certified) of the departure date so the doc will be removed from your group ID & tax ID. Stress in the letter that payment for services rendered up to a determined date are expected to be paid in a timely manner to your medical practice entity. Also request removal of the physician's name in the provider directory and on line physician list. It will be up to the departing physician to reapply to all.
6. Notify the Hospitals of the termination date from your practice. It is up to the physician to resign from the medical staff or not, in writing.
7. In letter form, ask the departing physician to accept responsibility or decline responsibility for any designated hospital related duties such as ER call weeks, EKG reading weeks etc. He/She can check off what he wants to retain in his "new practice" and what he wants your practice to absorb. This is so important as you don't want any last minute surprises which could put your practice in bad form with the hospital. Be sure he/she has a copy of this letter, send one to the Hospitals (and call info over) and retain one in your files.
8. When he/she leaves, have him sign off on a check list of items he has turned in such as building key and anything else that is owned by the practice)
9. Notify group malpractice carrier, benefits administrator etc of departure date in writing - and any prepaid $$ are to be refunded to the practice, not the physician.
10. Don't prohibit your staff from passing around a good-bye card etc.  Sign it readily and cheerfully. If they need the closure, let them have it.

Breaking up is hard to do, even under the best of circumstances.  Don't assume anything, but don't make it adversarial on your part either. Remember that your words may come back to haunt you. What starts out amicably can end up adversarial once the departure details - especially financial - comes down to the nitty-gritty.