How to handle patient records if you depart the country to practice as a locum tenens.
Q: I am a solo family physician who has decided to close my practice. My intention is to become a locum tenens out of the country. What is the best way to handle patient records upon my departure out of the United States, and how much notice do I need to give to my patients legally?
A: The answer to this question needs to be answered on a case-by-case basis, particularly because the doctor must, at a minimum, comply with the relevant state's medical record retention laws. In addition, some states have laws that specifically require the physician to provide notice to patients when the physician retires or closes his or her practice.
The physician who is closing his or her practice can store the records somewhere that is Health Insurance Portability and Accountability Act-compliant and where the records are accessible to the physician. Or, the physician (whom we will refer to as the "transferrer") can enter into a medical record transfer agreement with another physician, presumably another family physician (the "transferee") who might want these patients. Under this agreement, the medical records of the transferrer are physically transferred to the transferee, but the transferee will not have access to the records unless the patients permit it. The transferrer typically sends a notice to the patients informing them of the transfer and that the transferee will not have access to the records unless directed by the patients. Most patients will assume that the transferee is a good physician and will probably decide to seek treatment with the transferee, but some patients might direct the transferee to send the records to another physician of their choosing. Under the agreement, the transferrer will have direct access to the records located at the transferee's site (in order to comply with the retention laws and also if a patient needs them or the physician has to defend himself against an audit, investigation, or complaint). A problem with this model is if the transferee is directed to send the records to another physician, then the transferrer does not have access to those records.
Answer provided by Barry B. Cepelewicz, MD, JD, of Meisalman, Denlea, Packman, Carton & Eberz, White Plains, New York. Send your practice management questions to firstname.lastname@example.org