Legal and Ethical Considerations when Leaving a Medical Practise

Whether leaving a practice or retiring:

– Continuity of patient care should be assured and patient records should be preserved!

– When records are transferred – doctors are advised that copies of the records be transferred and that originals be maintained in a secure location for the prescribed period of time. (Patients should be advised that a reasonable rate will be charged for this transference)

A. Recommended Period of Time

– At least 10 years after the date of the patient’s last attendance

– At least 10 years after a child has reached the age of majority ( or at least 10 years after the members ceases to practice medicine, whichever comes first)

This process is the responsibility of the member, or of the members staff – or in the event of the members death – the executor of his estate.

– Records no longer needing to be maintained (as in A above) should be destroyed by burning or shredding. It is prudent to keep a list of names of charts destroyed.

Continuity of Care

Doctors have a legal responsibility to patients for whom they have undertaken to provide care. This includes the responsibility to make reasonable arrangements for transfer of care when the doctor departs.

Consultants should notify primary care physicians who regularly refer to them and provide them with advise about transferring patients to appropriate specialists.

Primary care physicians should, before leaving a practice, make specific arrangements for patients being actively treated and let patients in the practice know of planned departure.

This would be 1: In the form of a letter to patients which could include information about who will be replacing the doctor or how to find a new doctor. Whether to stay with the replacement doctor or relocate to an alternate physician is a choice that is completely left up to the patient.

(No person should destroy records of family medicine or primary care except in accordance with A above. Members should be reminded of their own medico-legal vulnerability if they decide to destroy charts.)

2. A notice could be put in the local newspaper (but this is not considered adequate on its own)

3. If a member ceases practice suddenly (i.e. illness or death) a notice may be put in the newspaper, and/or in the office premises, and/or a message may be left on an office answering machine – as to where and when patient files (or better still copies) may be accessed. Notice as to a reasonable fee for this service may also be given.

Before leaving his/her practice a doctor should also:

1) Notify in writing the Provincial Medical Association

2) Notify in writing the Provincial College or Medical Board

3) Notify in writing the hospitals in which the doctor has privileges

4) Notify in writing the Canadian Medical Protective Association CMPA

Letters should also be sent to

5) Any regional centres which may be dealing with the doctors patients (i.e. convalescent homes for aged, disabled or palliation – external laboratories etc.)

These letters should include – date when the doctor will be stopping work – doctors forwarding address – and person and address to whom correspondence and reports about patient should be sent.

N.B. A physician involved in a group practice should have an agreement before joining the practice as to who has ownership or rights to charts on specific patients should partnership dissolve or one partner leave. In general, continuity of care of the patient should be assured, and patient records preserved. Even when the record is to remain with the group practice, there should be provision that the physician (or physicians) who has left the group be allowed to review the record as there is reasonable need to do so and obtain photocopies of certain parts of it.

June 21, 1995