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Closing a Practice: Some Practical Suggestions

How much should you tell your patients about why you are retiring? It’s up to you; you can provide as much or as little personal detail as you judge to be appropriate. As is true in any clinical situation, you should be aware that some patients may not deal well with overly detailed disclosure about your personal life. You might want to plan additional sessions to help some patients deal with the transition.

Make records available to patients and subsequent treaters

If patients request it, offer to send a copy of their records to a new treater, although it’s more common for new clinicians to request records from you once they see your patients. Make sure to send copies only, and retain the original record in your files.

How long should you retain patient records? While regulations may vary by state, most boards of medicine require that you retain all patient records for at least 7 years from the date of the last patient encounter (if the patient is a minor, the rule is 7 years or up to age 18, whichever is longer).

In addition to storing records, you have to arrange a way for patients to access those records for the 7-year period. If you have an electronic medical record, this can be an easy process. But if you use paper records, you may have hundreds or even thousands of charts. How should you arrange for access in this situation? Here are three options for managing your records after retirement:

1. The best way is generally to keep your own records and to respond to requests for access the same way you always have. To keep things manageable, destroy records that are beyond the 7-year cutoff date, although you should maintain a list of destroyed records, along with a brief comment about the patient and the date of the last clinical encounter.

2. If you are unable or unwilling to be the keeper of your records, you can ask a colleague to maintain them for you. If you’re lucky, your colleague will do this for free, but otherwise you should agree on a fee in advance—both for the colleague’s trouble and for the costs of preparing and mailing records.

3. Finally, there are professional records management companies, such as Iron Mountain, that will do everything for you for a fee. Make sure any company you enlist is HIPAA-compliant.

Note that different states dictate different allowable charges for handling and copying of records; check with your board of medicine. If records are requested for a Social Security claim, you are usually not allowed to charge for them. It’s also a good idea to retain your business records, such as tax returns, office bills, etc, for a minimum of about 6 years.

Know rules for malpractice protection after retirement

If an alleged incident of malpractice occurred during active practice, retirement does not protect you against the claim. Accordingly, maintaining malpractice insurance for a period after retirement is an absolute necessity. How long depends on the statute of limitations in your state.

Insurance policies vary, and you should consult with your malpractice insurer as soon as you have decided to retire to discuss your options for post-retirement coverage. If you have a so-called “occurrence” policy, that policy will provide coverage for all claims based on acts that “occurred” when the insurance was in effect, regardless of when the claim is actually made. If you have this kind of policy, you wouldn’t have to continue active coverage after retirement. But if you have a “claims made” policy, you’re covered only if the insurance is in place at the time the claim is filed. In that case, you would need to pay for a “tail” insurance policy.

Unplanned retirement

An unplanned retirement generally occurs due to death or illness. While this is a topic most of us would prefer to avoid, setting up a detailed plan in the event of your untimely demise will help your grieving family and friends to deal with the logistics of closing your practice.

Helpful retirement resources

The American Psychiatric Association (APA) has developed a number of helpful practice resources for clinicians on the topic of retirement. Although these resources are generally available only to active members of the APA, the organization has graciously agreed to make them available to readers of The Carlat Psychiatry Report. Because these materials were originally written in 2007, we have updated their checklists and templates to make them more relevant to current practice environments. We have also added several new templates to make your transition to retirement even easier. For the planned and unplanned retirement toolkits, please see: http://thecarlatreport.com/RetirementToolkits

checklist for closing psychiatry practice

Closing a Practice: Some Practical Suggestions

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This article was published in print November 2017 in Volume:Issue 15:11.