Close Your Medical Practice

Articles and Resources for Canadian Retiring, Relocating Physicians and Physician Estates

The Doctor Shortage is No Laughing Matter

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Laughter is always the best medicine but the doctor shortage is no laughing matter in some areas.

Laughter is always the best medicine but the doctor shortage is no laughing matter in some areas.

A dancing doctor wearing a wig and cape? Facing a severe doctor shortage, the Ontario municipality of Chatham-Kent has produced a zany music video as a tool to recruit emergency room physicians.

Riffing hilariously on the hit song Sexy and I Know It, by U.S. electronic dance music duo LMFAO, the video, titled I’m an Emerg Doc and I Know It, features Chatham-Kent medical staff to drive home its recruitment message.

Sample lyric: “I’ve got passion in my scope and I’m not afraid to show it,” intoned by the wigged-out dancing doc.

In the video, patients communicate their ailments by way of signs held up for benefit of the mincing medic. To a driving dance beat, nurses pull back the curtain at each emerg-room bed and exclaim, “Doc look at that patient!”

Although the video effectively uses humor to deliver its message, Chatham-Kent’s doctor shortage is no laughing matter.

Just as the physician shortage in Chatham-Kent leaves area patients scrambling to find a new doctor, so, too, can closing a practice significantly affect your patients.  But there are ways to mitigate the impact that your closure has on your patients.  Proper advance notification, creative attempts at finding someone to assume the practice (or some of your more acute patients), and providing your patients with record information necessary for continuity of care, are just some of the steps you can take to help.

Since 1997, RSRS has assisted hundreds of physicians with their medical-practice closures, record storage obligations and a variety of other issues that come into play as a physician winds down. Whether you’re retiring, relocating or enquiring on behalf of a doctor’s estate, RSRS can help.

RSRS is the only physician-managed, fully compliant storage facility in Canada and follows the guidelines for each Canadian province with respect to medical practice closure and patient record retention.

RSRS can often offer many or all of its services at no charge to a primary care doctor, where RSRS is appointed custodian for the records, and facilitates all patient record transfer requests. RSRS also offers excellent rates for specialists and services doctors across Canada.

Call us today at 1-888-563-3732 to learn more, or visit our website.

After Medical Practice Closure – A New Chapter

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retired doctor playing golfafter Medical Practice closure… a new chapter begins

So you’ve decided to hang up your stethoscope and close your medical practice.

Now what?

Far from being an end point, retirement marks a new beginning, a gateway to the exciting next chapter of your life.

If you want to indulge in a life of leisure — golf galore; exotic travel; pursuing your favorite hobby or taking up a new one — then go for it. You’ve worked damn hard to get to this point. Let the good times roll!

For some, nothing brings more pleasure at this stage than more time with extended family.

Or maybe you want to keep your hand in medicine, but on a more relaxed schedule — say, two to three days a week.

In that case, you could become a “locum tenens” doctor, essentially a fill-in or temporary physician hired as-needed (you’ll have some freedom to make your own schedule and the pay is pretty darn good!). Another option is part-time work at one of many walk-in clinics opening practically everywhere.  Name your hours and take no headaches home.  A Google search will turn up staffing agencies specializing in these sorts of placements.  You may also want to check the classifieds section of publications like The Medical Post, Ontario Medical Review, BC Medical Journal, and many more.

Or maybe consulting is more your thing. If so, you could act as a consulting doctor to a healthcare facility, freeing up their roster of practicing doctors to concentrate on patient care.

Law firms often seek doctors to provide expert testimony in legal cases, especially those involving contentious malpractice suits. Companies that specialize in making medical devices often need consultants to advise on new products. Medical industry publications will hire doctors to fact-check articles. And government organizations often call on doctors to consult on disability claims, to assess their legitimacy.

Or you could become a scribe-for-hire and contribute freelance articles to medical magazines and websites.

You could go the community service route and volunteer your medical services at free clinics. Thinking bigger still, you could volunteer your services to developing countries — a quick Google search and you’ll be abroad in no time.

You’re in the driver’s seat and you have options aplenty.  The main thing is that you do what brings you happiness and satisfaction.  As we all know, those words represent many different things to different people.

Since 1997, RSRS has assisted hundreds of physicians with their medical practice closures and record-storage obligations.  We also can assist with recommending locums and part-time placements.  RSRS is the only physician-managed, fully compliant storage facility in Canada and follows the guidelines for each province with respect to medical practice closure and patient record retention.

Our medical practice closure services include Patient Notification; Packing Assistance (where available); Scanning of Records; and Patient Record Transfers & Retrievals.

Call us today at 1-888-563-3732 or visit our website, and get started on life’s next chapter.

 

5 Essential Tips on Closing Your Medical Practice

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5-tips5 essential tips regarding medical practice closure

Closing a medical practice is a complex undertaking and requires a carefully planned strategy. While there are many lists of things to remember for such an event, here are what we believe are 5 essential tips to ensure that you’ll cover all the bases when closing your practice.

1. Inform your staff three months in advance of the anticipated closing date.  Remember, they have lives too and while you may fear their premature departure, your honesty usually pays off and is appreciated.

2. Make sure to outline a staff severance policy and take care to meet your obligations to pay any unused benefits such as sick time and vacation.  If you’re at all unsure, check with employment standards for your province as well as with your accountant.

3. Your high-risk patients who have chronic or complex medical conditions should be informed early so that they can secure a new doctor and ensure continuity of care without interruption.  Even better would be to call in some favours from colleagues who might be able to take them on.   Make referrals, where appropriate.

4. Most of the provincial Colleges of Physicians and Surgeons suggest that notification of intent to close your practice should go out to patients 3 months before the date.  You can mail (to active patients who were last seen within the last 2-3 years), post a notice in your office, leave a recording on your voicemail and notify by way of automated dialler to patients.

5. Secure and protect the confidentiality of the records you retain. Keep in mind that each province has its own retention requirements.  This applies to both paper and to EMR.  Storage options include archiving records, contracting with a storage firm, or scanning into a read-only digital media.  You’ll want to use a professional records company for this last option as well.

Since 1997, RSRS has assisted over hundreds of Canadian physicians with their medical practice closures and record-storage obligations. For storage and scanning, whether you’re retiring, relocating or enquiring on behalf of a doctor’s estate, RSRS can help. RSRS is the only physician-managed, fully compliant storage facility in Canada and follows the guidelines for each Canadian province with respect to medical practice closure and patient record retention.

Call us today at 1-888-563-3732 or visit our website.

The Proactive Patient

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According to a recent CBC news article, in the weeks after delivering a child in July, 2008, a Toronto-area woman noticed a dead-fish smell emanating from her body. Isn’t that a disgusting scenario? Turns out the source of the smell was a gauze sponge that the obstetrician had inadvertently left inside her after performing an episiotomy.

Significantly, the patient only discovered the sponge following a self-examination after the antibiotics her family doctor –thinking the wound-closing stitches had become infected – had prescribed failed to eradicate the smell or the discomfort.

A doctor’s worst nightmare, this incident underlines how proactive patients have become with respect to their healthcare.

Patients have learned to speak up.

No question, with the Internet, and its mountain of online medical information, just a click away, it’s much easier than ever for patients to take an active, proactive and informed role in their healthcare. Gone are the days of patients’ blind acceptance of a physician’s diagnosis. In this age of enlightenment, patients are asking questions; conducting research; and accessing their medical records to get an accurate picture of their health history before seeking a professional opinion(s).

With this in mind, reliable medical-record storage is critical, especially for doctors who are retiring or moving. These records, depending on the province, must be retained for anywhere from 2 to 34 years (in the case of pediatric charts in BC come June 1, 2013). Patients have a right to access their medical records, regardless of circumstance. It’s the law.

A leader in records management, RSRS is one of Canada’s largest repositories of medical records and specializes in medical records management and practice closure assistance. RSRS also services several other vertical markets, with experience and expertise in record scanning, storage, workflow and secure backup solutions.

RSRS also manages the secure transfer of records to patients, new physicians and authorized third parties in every province in Canada.

 

Unattached Patient Programs – How Health Care Connect Helps Your Patients Locate New Physicians

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Connect Patients With Doctors

Connect Patients With Doctors with Health Care Connect

As you prepare to close your medical practice, you may feel concern over your patients’
ability to find a new health care practitioner. Of course, posting a notice in your office, mailing a letter to active patients or running a small ad in your local paper (all
services that RSRS can provide on your behalf
) are some of the key ways to ensure that you get the message out and comply with provincial CPSO requirements.

Even with sufficient notice, ending the physician-patient relationship will usually have significant consequences for the patient, as he or she will need to find another health care provider.  Long-term care patients, seniors, and acute/chronic care patients need to find a new primary care physician as quickly as possible.  The current shortage of primary care physicians in Ontario may make this especially difficult.

Health Care Connect (HCC)  was launched in the province of Ontario in 2009;
the service does not provide health care advice or treatment for patients, but strives to connect patients with new primary care physicians. At the time of its launch,  approximately 780,000 Ontarians were without  the services of a primary care physician. About 8% of these patients are considered to be high-needs.

The program takes registration information provided by the patient and prioritizes them
through a scoring methodology (i.e. high vs. low need).  Registering with HCC doesn’t guarantee that a family health practitioner can be found for all patients, so each patient is encouraged to conduct their own search.

If you are a closing physician in Ontario,  RSRS will include details and contact information for Health Care Connect to all your  patients if we are notifying them on your behalf.  Patients receiving this notification letter can then expedite their search for a new physician.  You can further assist your high-needs patients by reminding them of
their status so that they can be fast-tracked through Health Care Connect and more
quickly rostered with a new physician.  Additionally,  HCC services are available in French and 120 other languages, as needed,  for your patients whose first language is not English.

Patients do not need permission from any physician in order to be de-rostered when they contact Health Care Connect.  Health Care Connect de-rosters them automatically, and transfers them to a new physician, usually within 2 weeks.  Patients are free to
obtain care from any physician they choose, even if they are not officially rostered with that physician.  However,  keeping accurate lists of rostered patients is important in order that the Ministry of Health properly allocate services such as nurse practitioners, therapists, dieticians, and diabetes education, etc. to physicians and health teams.  Some of these services may only be available to rostered patients.

Since 1997, RSRS has assisted hundreds of physicians with their medical practice closures and record storage obligations. RSRS is the only physician-managed, fully compliant storage facility in Canada,  and we follow the guidelines for each Canadian province with respect to medical practice closure and patient record retention.

We offer a complete medical practice closure consulting service, and in most cases for
Ontario Primary Care Doctors, we can offer full record scanning and storage services and more, at NO CHARGE*.

 

EMR or Retirement?… The Physician Dilemma

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Planning to take a trip down Retirement Lane?

Planning to take a trip down Retirement Lane?

The decision to use an EMR when you’re close to retirement can be problematic for a physician. There is little doubt that the leap from paper to EMR is a quantum one. It may take many months to implement an EMR when you consider the training and integration involved, along with the time required to learn to use the system efficiently.  When deciding which path to take, the most important questions a physician must ask him/herself are:

  • How long will I remain in practice? And…
  • Am I willing to invest in my practice in
    hopes that another physician will take it over.

If you plan to remain in practice for 10 or more years, you’re probably going to have little choice but to move to an EMR.  The good news is that you should see dramatic changes in the efficiencies once you get the hang of it which ultimately is positive all around.  What’s more, you’re continuing to fund your retirement in the interim.

On the other hand, if retirement is around the corner (say, less than 3 years away), you may or may not want to make the leap.  While funding may be available for the transition, there is a learning curve that may create more stress than necessary for a soon-to-be retiring doctor.

There may be a happy medium though.

One alternative approach often overlooked is the Document Management System (DMS).  A Document Management System not only rids the medical practice of all new paper, it also affords the physician additional achievements in efficiency without a huge investment in infrastructure.

In its simplest form, a Document Management System is a software application which tracks, stores nd allows for immediate retrieval of electronic documents or images. It is not specific to medical offices, but lends itself beautifully to one.

In the case of a medical practice, the DMS will store each patient record digitally and allow for instantaneous retrieval of that record through its search capabilities.
Once retrieved, the record is similar to the paper record in that you can flip through the record one page at a time by using the arrow button or “next page” button, just as you would use your finger to flip through a paper record. Any paper coming into the office, be it through fax, mail or even handwritten notes, can be scanned in to the DMS at the end of the day, with each new page appended to the top of the existing digital record for that patient. Plain and simple.

Document Management Systems vary greatly and usually offer additional functionality such as: annotation tools (highlight, circle, redact, etc.), ability to zoom in and out; rotate an image, print, share, etc. When set up for it, the DMS can be accessed via any secure internet connection (ie. the home, or hospital). It can be fully secured, and there’s an audit log showing the date and time and username for each activity that takes place within the record. Compared to an EMR, the DMS eliminates all paper going
forward. It prepares everyone for a paperless office environment. A physician
opting for a DMS can also ensure that new paper documents received are appended
into the existing files using RSRS’ Day Forward Scanning service.

For a solid DMS with a great track record in the medical sector, RSRS recommends Digitech’s PaperVision Enterprise, which can accommodate small to very robust
requirements, without significant capital expenditure. In subsequent blog posts,
we’ll publish case studies where PaperVision was implemented in a single
physician practice,  a large clinic, and a hospital.

Saying Farewell to Patients

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Retiring from your medical practice?

When you're ready to close your medical practice, how do you say good-bye to your patients?

Since its start in 1997, RSRS has worked with hundreds of Canadian doctors who have closed their medical practices.  Whether retiring or relocating, saying farewell to your patients is never a simple task.  In many cases we see doctors who consistently delay the closure because they can’t bring themselves to the day that they’llno longer go into that office that has served their career for 20, 30 or even 40 years.  For others, it is also the
sense of leaving their patients in the lurch.

This blog will deal with the some of the things that doctors can do to ease the issue for the patients.  It’s all about expectation management.

While the CMPA and the provincial Colleges of Physicians offer their own guidelines to closing practices, RSRS offers the following pointers based on our years of dealing with both physicians and patients:

1. Provide Proper Notification

Posting a notice in your office, mailing a letter to active patients or running a small ad in your local paper (for smaller communities), are some of the key ways to ensure that you get the message out.  We’ve found that doing this approximately 60 days in advance is appropriate.  In a mailer, you have the opportunity to personalize an opening and closing
paragraph to your patients, but the emphasis should be on “continuity of care”.

2. Encourage Transfer of the Medical Record

While you may have been the sole custodian of your patient’s record to date, things are changing quickly.  Patients should be encouraged to get a copy of their records, both for
themselves as well as for their new care provider.  Patients need to be included because their new doctor (if/when they find one) often doesn’t want a stack of paper and
often will make do with a verbal summary from the patient.  Today’s patients are also more involved than ever in their own healthcare management.

3. Canvass Your Colleagues to Take on Patients

It’s possible that a couple of physicians you know in the area might be able to squeeze in a few of your “special needs” patients.  While not always possible, we’ve found that with a little effort most doctors can take on a select, few more patients.

4. Give Special Consideration to Long-Term Care, Acute Care Patients, and Seniors’ Needs

Ensure that your long-term care or acute-care patients have sufficient prescriptions and that their vaccinations are brought up-to-date.  Provide them with the location of nearby
Walk-In Clinics,  Nurse Practitioners,  or Public Health Clinics while they are transitioning to a new physician.

5. A Personal Note

While a personal phone call to each patient is simply not realistic, a note of a more personal nature in the form of some heartfelt sentiment in the opening and closing paragraph of a Letter to Patients (or Posting) is in order and will go a long way to close the circle for your patients.

6. Health Care Connect

Finding a new doctor for each of your patients is not realistic.  Pointing your patients to
resources like Health Care Connect is.  This government sponsored service (for Ontario patients) will help your patients find a new health care provider.

7. Use RSRS to Help with All of the Above

RSRS has assisted doctors with practice closure for 15 years and will work with you to set out timelines leading right up to your closure date.  We will assist you each step of the way to make the transition so much easier for you, your patients and your staff.

Contact RSRS today for more information.  1-888-563-3732.

 

 

Proper Drug Disposal Protocol for Closing Medical Practices

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Proper drug disposal for closing medical practices

Closing your medical practice? Need assistance with the proper disposal of pharmaceuticals?

Now that you’ve decided retire and close your medical practice, have you given any thought to the disposal of medicines you have on hand? Whether expired or not, you will want to follow established protocols for disposing of FDA regulated medicines, such as opiates, NSAIDS, injectables, natural health products, lozenges, and biologics.

Improper disposal of drugs can end up in the sewer system and become a threat to the environment, ending up in streams and rivers, and eventually in our drinking water. Children and animals can also be poisoned if they discover them.

Environmentalists have been aware of pharmaceutical traces in the environment. There is increasing concern that chemicals from pharmaceuticals and personal care products may be affecting aquatic species, such as fish, mussels, and algae, and may possibly increase antibiotic resistance. Water treatment facilities aren’t equipped to deal with this type of contamination. Health Canada’s Environmental Impact Initiative was established as part of a response to the Canadian Environmental Protection Act, and requires that all substances in Canada must be assessed for impacts on human health and the environment. The Canadian Medical Association reports that the world’s doctors are concerned about the shoddy disposal of drugs.

Accountability is on the rise. Doctors don’t have to overprescribe drugs in order to receive a lot of negative attention. When you’re ready to retire, you may wish to take a complete inventory of all unused drugs etc. prior to disposing of them. Keep the medicines in the original container. You then have two options – contact your regular medical disposal company, or take the drugs to a Pharmacy that participates in a disposal program. The Post Consumer Pharmaceutical Stewardship Association has listed regional initiatives/take-back programs for each province/territory in Canada. Contact your local College of Physicians and Surgeons for additional guidance.

Need additional assistance disposing of your pharmaceuticals or in closing your practice? In addition to storage, we can provide assistant with equipment sale/donation, patient notification assistance, and patient placement assistance. Call RSRS at 1-888-563-3732 for further info.

Can You Re-Imagine Yourself After Retirement?

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Wrestling with Retirement Issues?

Doctors’ perspective on retiring has aligned with the rest of North America in recent years; a Sun Life survey reported that one in five working Americans says that they will never retire! Many doctors find that, upon nearing retirement age, they just can’t stop being a doctor – many feel, and rightly so, that medicine is a calling. Their career starts later than most, due to the degree of training involved, and they often must work longer to pay off educational loans. And since medicine is a field where one tends to be highly engaged with their community, many baby-boomer doctors are simply not ready to hang up the stethoscope and stop giving back to their community. Many doctors who are no longer classified as working full-time still carried, on average, 40 per cent of a full workload.

If you’re a doctor who is looking to retire from your practice, but not ready to give up medicine entirely, what options are available? And how can you stay current in your profession if you choose to continue practicing? Golf and relaxing may not be fulfilling enough, or perhaps that’s exactly what you’re looking for, but just not on a full-time basis. If you have a real sense of adventure, perhaps you’d like to relocate to an exotic locale? A quick review of the Doctor Jobs Portal on Linkedin reveals that there are many opportunities for doctors to work as hospital or specialty consultants in private health care groups in (warmer) climes.

But if your interest lies in continuing to work in your community, one of the biggest post-career opportunities lies in home health care and palliative care. If part-time is the way to go, consider that many larger companies hire doctors on a part-time basis in occupational health positions – check out Apple Tree Medical Group or Jack Nathan Health. Retirement communities need continual care for seniors and other vulnerable populations. Or you could elect to work with one of several firms that supply locum tenens services to other clinics.

If you’ve no intention returning to any kind of “grind” (yes – 6 AM IS overrated!) why not start to write a blog on medical conditions – perhaps in your career you specialized in treating certain disorders, special diets, or diseases. Why not participate in the writing of a protocol, evaluation tool, or toolkit that can be used by other professionals. If you’ve got that classic “bedside manner,” consider mentoring or tutoring medical students.

People are living longer, and living healthier – 75 is the new 65. Whatever you choose to do in your post-work “career,” remember that in retirement, every day is Boss Day and every day is Employee Appreciation Day! Call us to help you close your office – 1-888-563-3732.

How To Notify Your Staff When Closing Your Medical Practice

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Casting off after closing your medical practice

There’s an old saying that goes “It’s better to retire too soon than too late.” Leaving your practice can take some adjustment.

Are you planning to scale back over a period of months?… Sell your practice? (not easy these days, especially if it’s paper-based), or outright discontinue your practice as of a certain date? If you’re a sole medical practitioner who is planning to shut down, you face the prospect of telling your staff that their employment will cease as of the date of your retirement. So when it finally comes time to throw off the bowlines and sail away, you’ll need to have a plan in place to let your staff know of your intentions.

When you’re ready to communicate your plans to your staff, try to anticipate their uncertainty – will everyone have to look for new jobs, or do you have colleagues who would be happy to hire your trained, tenured team?

Where possible, it shows consideration to give your employees notice of your planned retirement or closure at least 90 days in advance. This allows them to start thinking about employment elsewhere. Naturally, when you give notice a few months in advance, there is a slight risk that your staff may leave prior to the actual closure of your practice, leaving you without the assistance you require to continue practicing to the end. One way to prevent this is to offer a bonus for each week that they continue on with you until the date of your retirement so that they will be more likely to stay and help you move forward with your office closure. Alternatively, you can make your offer of a bonus contingent upon them remaining with your office until the retirement date, payable after fulfilling their last week of employment.

Don’t forget that you must abide by the Employment Standards Act for the minimum notice periods in your province or territory – you will either have to provide sufficient notice for your tenured staff, or payment in lieu of notice. Remember that the Employment Standards Act provides for the minimum notice period only. You may also wish to obtain legal advice. Check the resources below for guidelines on notice periods for terminations:

Alberta Employment Standards
British Columbia Employment Standards
Manitoba Employment Standards
New Brunswick Employment Standards
Newfoundland Labour Standards
Nova Scotia Employment Rights
Ontario Employment Standards
The Government of Prince Edward Island
Quebec Labour Standards
Saskatchewan Labour Standards

Retirement can’t come soon enough for some doctors, but it often comes at a cost to your staff members. While you adjust to retiring from a profession that has engaged you intellectually and emotionally for many years, focus on helping your staff transition to a new career without you. Remain upbeat about your plans so that your enthusiasm becomes “infectious.” (pun intended). Involve your staff in the process – encourage them to plan a party or special event that they will also enjoy attending. We’ve seen some of our physician clients decide to engage the community and patients in the plans. Remove or minimize uncertainty wherever possible. Write letters of reference, and offer to network with other physicians who may be looking for skilled staff. Be reasonable in allowing them some time to interview for other positions. Above all, be sure to let your staff know how important their loyalty, service and friendship has been to you over the years.

For additional guidance with respect to practice closure issues, please refer to the College of Physicians and Surgeons for your province as well as the Canadian Medical Protective Association. RSRS – Record Storage and Retrieval Services also offers a FAQ that will assist you with other medical practice closure issues such as Patient Notification, assistance with Equipment Sale/Donation, organizing and packing the patient records, and secure record scanning and storage. For assistance with closing your medical practice, contact RSRS at 1-888-563-3732.