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Physician's Guide to Medicine - Closing/Relocating a Practice
Retirement
What is required when a physician decides to terminate or
relocate his or her practice?
What should be done with patient records when a
practice is terminated or relocated?
What should be done with patient records upon a physician´s
death?
How long should medical records be maintained after a
practice is terminated or relocated?
How should medical records be destroyed?
Retirement
Upon retirement, the physician must file with the State Board of Registration
for the Healing Arts an affidavit which states the date of retirement and such
other facts as required to verify the retirement. The State Board will furnish
the affidavit form. The physician will not thereafter be required to register
with the Board, unless he or she reengages in practice. Then he or she must
again register with the State Board of Registration for the Healing Arts.
What is required when a physician decides to terminate
or relocate his or her practice?
Notification
Although Missouri law has no specific notice requirements concerning terminating
or relocating a practice, the following guidelines will help to assure prompt
notification to patients:
(1) Send postcard notices to all patients;
(2) Publish in the newspaper of the greatest general circulation in each county
where the physician practices or practiced, a notice containing the date of
termination or relocation and an address where the records may be obtained from
the physician terminating practice or another licensed physician;
(3) At least thirty days prior to termination or relocation of the practice, the
physician should place in a conspicuous location or on the facade of the
physician's office a sign announcing termination or relocation of the practice;
and
(4) Both the notices and sign should advise the patients of their opportunity to
transfer or receive their records.
In addition, the State Board of Registration for the Healing Arts should be
notified, and all managed care contracts should be reviewed to determine with
what notification provisions, if any, the physician must comply.
What should be done with patient records when a
practice is terminated or relocated?
When a physician terminates a practice or relocates and is no longer available
to patients, the physician should notify his or her patients by direct mail and
by publication in the newspaper of greatest circulation in each county where the
physician practices or practiced. The notice should contain the date of
termination or relocation, and an address where the records can be obtained from
the physician or another physician. Also, the physician should place, in a
conspicuous location in the office or on the office sign, an announcement of the
termination or relocation of the practice. This announcement should advise
patients of the opportunity to transfer or receive copies of their records, and
should be posted at least thirty days prior to termination or relocation, and
remain until the practice is closed.
What should be done with patient records upon a
physician's death?
The executor, administrator, personal representative or survivor of the deceased
physician should retain all medical records for at least two years from the
physician's death. If the physician was in practice at the time of death, a
postcard notice should be mailed to each patient. Within one month of the
physician's death, the estate's representative should publish in the newspaper
of greatest general circulation in the county where the physician resided or
practiced, a notice indicating to the deceased physician's patients that the
physician's medical records are available from a specific person at a specific
location.
How long should medical records be maintained after a
practice is terminated or relocated?
In general terms, Missouri law does not provide specific guidance governing the
retention of medical records when a physician retires or closes an office. One
exception is that records relating to abortion must be kept for seven years. As
a practical matter, the entire record should be maintained for as long as the
physician remains in practice. There are many instances in which a patient is
treated for a condition and then is not treated again for many years, yet the
initial record would be very beneficial for subsequent treatment. Medical
records may also be needed to support a defense to a medical malpractice
lawsuit.
The Missouri State Medical Association recommends all medical records be kept
for at least as long as the applicable statute of limitations on medical
malpractice claims. Under Missouri´s medical tort laws, malpractice actions must
be filed within two years of the alleged occurrence. There are, however,
exceptions for foreign objects left in a patient´s body and those cases
involving minors. Actions involving foreign objects must be filed within two
years of the date of discovery (or the date on which the object should have been
discovered). Actions involving minors must be filed within two years of the date
on which the minor reaches the age of majority (which has been determined by the
courts to be twenty-one).
How should medical records be destroyed?
The method to be used for destroying medical records is not described in statute
or rule, but the method chosen should protect confidential information and
patient identity. The physician should consider, once notification requirements
have been complied with, shredding or burning the documents rather than simply
disposing of them in a garbage receptacle. See also "Medical Records" section
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