What notification is required when a physician moves?

If the patient records belong to the practice and not the physician there are some other options, depending on how the employment contract reads:

• Ethical and Statutory Requirements –  When moving, physicians are required to give Notice to DOH of relocation.  However if the records are going to be moving, then the Patient must also be given notice of where they can obtain patient records. 
• Build a social media presence – Facebook or LinkedIn, etc.
• Build an advisory website (i.e. “DrBen.com”)
• Send out general advertisements by zip code
• Advertise in the local papers, bus benches, association papers, and Google, Bing etc.

Statutory Requirements of what to do when a physician changes offices:

Under Section 456.057, Florida Statutes,  a “records owner”  means any health care practitioner who generates a medical record after making a physical or mental examination of, or administering treatment or dispensing legend drugs to, any person; any health care practitioner to whom records are transferred by a previous records owner; or any health care practitioner's employer, including, but not limited to, group practices and staff-model health maintenance organizations, provided the employment contract or agreement between the employer and the health care practitioner designates the employer as the records owner.  Section 456.057(2), Florida Statutes.  The “records owner” may or may not be a physician, it can be the employer of the physician.  The statute requires the “records owner” to notify patients of the retirement, closing or relocation of a physician.  When the records owner retires, terminates a practice, or is no longer available to patients, Section 456.057(13), Florida Statutes, requires the records owner to notify the patients of the termination, relocation or unavailability in the following manner:

Publish in a local newspaper a notice containing the date of termination or relocation and include an address where the records may be obtained from the physician terminating practice or another licensed physician.  This is now required by law (Florida Administrative Code 64B8-10.002(4).)  A copy of this notice must also be submitted to the Florida Board of Medicine.

Physicians may also, but are not required to, notify patients in writing of the date of termination or relocation and include an address where the records may be obtained from the physician terminating practice or another licensed physician) or place a sign in a conspicuous location on the façade of the physician's office.

Both notices must advise patients of their opportunity to obtain a copy of their records.  In addition, Section 456.057(14), Florida Statutes, requires that the records owner notify the Florida Board of Medicine and advise the Board who the new record owner is, and where the physician's medical records can be found.  The records owner should also review all managed care contracts to determine if any notification provisions must be complied with. This change will primarily affect employed physicians whose employment agreement designates the employer as the records owner. It will have little effect on other physicians, especially those physicians in independent practice.  In that case, the physician who generated the record after treating the patient will be considered to be the “records owner,” and, therefore, the requirements discussed above will fall upon the physician.  In the case of an employed physician (whose employment agreement designates the employer as the records owner), this responsibility is placed upon the employer.

It is important to note that the Board of Medicine has adopted a rule that imposes certain requirements on physicians who relocate or terminate their practices and are no longer available to patients. Rule 64B8-10.002(4), Florida Administrative Code, requires physicians to publish a notice once a week for four consecutive weeks in a local newspaper of greatest circulation.  The notice must contain the date of termination or relocation and include an address where the records may be obtained from the physician terminating practice or another licensed physician. A copy of the notice must be submitted to the Board within one month from the termination or relocation.  The rule also gives physicians the option of either placing a sign in a conspicuous location in or on the façade of the physician's office or notifying patients by letter of the termination, sale or relocation of the practice (this is NOT required, however), in addition to publishing the notice in the local newspaper. The sign or letter must notify patients of their opportunity to transfer or receive their records.  The requirements set forth in the Board's rule are separate and apart from the requirements set forth in Section 456.057, Florida Statutes, and must be followed by all licensed physicians.

A physician is responsible for ensuring that these records will be available to his former patients for a period of five (5) years from their last visit.  For a patients that are minors the period shall be for when the patient reaches the age of 18 plus 5 years.  A physician thus must make arrangements to either have another physician become the new records owner, have a medical records service store copies of the medical records and provide copies upon request to former patients, or himself be available to provide copies. However if the physician has an employer who is the records custodian, they have a combined duty and right to notify patients. The physician has a duty to not abandon patients.  In an ideal world, the practice and the physician should agree to send out a joint notice to patients. The notice will contain at least the three elements proposed above, and whatever else that the practice and physician can agree to.

64B8-10.002 Medical Records of Physicians Relocating or Terminating Practice; Retention, Disposition, Time Limitations.

(1) The Board of Medicine and the Legislature recognize the need for maintenance and retention of Medical Records in order to protect and serve patients. For that reason, the Legislature has directed the Board to promulgate rules setting standards that will provide a minimum requirement for retention and disposition of patient records of deceased practitioners and practitioners relocating and terminating practice. However, the Board is concerned that the promulgation of these rules may mislead the licensed physicians. Rule 64B8-10.002, F.A.C., sets forth standards which if not met will constitute a violation of section 456.058, F.S., and will subject the physician to disciplinary proceedings by the Department of Health. Physicians should retain records as long as needed not only to serve and protect patients, but also to protect themselves against adverse actions. The times specified in rule 64B8-10.002, F.A.C., may well be less than the length of time necessary for protecting the physician. Further, the times stated may fall below the community standards for retention in their communities and practice settings and for specific patient needs. For the latter purposes, the physician may wish to seek advice from private counsel or their malpractice insurance carrier.

(2) A licensed physician medical records owner shall maintain the full and total responsibility for and control of all files and records relating to his patients and his medical practice for a period of at least five years from the last patient contact. All such records shall remain confidential except as otherwise provided by law and shall be maintained in the licensed physician's office or in the possession of the licensed physician.

(3) A licensed physician shall keep adequate written medical records, as required by section 458.331(1)(m), F.S.

(4) When a licensed physician terminates practice or relocates and is no longer available to patients, patients should be notified of such termination, sale, or relocation and unavailability by the physician's causing to be published once during each week for four (4) consecutive weeks, in the newspaper of greatest general circulation in each county in which the physician practices or practiced and in a local newspaper that serves the immediate practice area, a notice which shall contain the date of termination, sale, or relocation and an address at which the records may be obtained from the physician terminating or selling the practice or relocating or from another licensed physician or osteopathic physician. A copy of this notice shall also be submitted to the Board of Medicine within one (1) month from the date of termination, sale, or relocation of the practice. The licensed physician may, but is not required to, place a sign in a conspicuous location on the façade of the physician's office or notify patients by letter of the termination, sale, or relocation of the practice. The sign or notice shall advise the licensed physician's patients of their opportunity to transfer or receive their records.

 Reasons to retain an attorney: 

Most physicians do not understand the intricacies and ramifications of physician employment agreements. To review and negotiate a contract that does not limit the future of a young physician, it is best to get legal help earlier in the process to navigating the 5 most important things. 

• Long lasting consequences of Non-compete  
• Compensation is not clear or fair market value  
• CME (Continuing Medical Education) benefits are not clearly listed – (association dues, license dues, course registration, and travel expenses) 
• You may be restricted from serving on certain insurance panels 
• You may have to relocate out of the area. 

What does it cost to Have an Attorney Review a Physician's Contract? 

Our firm reviews physician contracts: 

- Option 1 - for $1,250, and we will give you insights on what and how to negotiate and conduct a background check on the employer.

- Option 2 - Some physicians prefer for us to negotiate their contracts, ask us about fees if that is your preference. 

Ben Assad Mirza is a Florida attorney with a finance background, who has negotiated from both sides of the table; to put Ben's team to work for you, reach out by calling or texting (954)634-2370, or email Ben at [email protected]

Ben Mirza is not only an attorney but was formerly a CPA, with a masters of public health.  There are over 100,000 attorneys in Florida, less than 500 of whom were ever Certified Public Accountants, and even less have the trifecta combination of law/finance/strategic healthcare background.   The benefit of this combined and layered skillset works well for clients who want an advocate to approach the issues holistically.