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Create a Professional Will for the Sake of Loved Ones


All physicians should consider a professional will that covers what to do at your practice in the event of an unforeseen death or disability: you won't like going to the trouble and you'll hope that you never need it, but all involved will be relieved if the necessity of its use arises.

We all know what a "last will and testament" for our estate is and know that we, young and old, need one. Although there remains a surprising number of doctors who are anxious about estate planning, in denial and have not yet done any planning, they should also be considering the professional will (PW).

A PW simply states what is to be done at and for a medical practice in the event of an unforeseen death or major disability. The concerns covered by a PW are separate from the personal financial concerns that are typically handled in a standard will.

Many doctors have complicated practice and related business affairs that can be better managed in the event of their deaths or major disabilities with a prior written plan and help from another doctor instead of the sudden, confused scramble that usually occurs.

Increasingly, doctors are opting for salaried work rather than the life of the independent small business owner. A decade ago more than half of all doctors were self-employed and now, under the national radar, less than 25% are. And this latter group is dominated by older physicians, the ones at greatest risk. For those doctors who are in groups, the need for a professional will may be less acute in the event of a personal emergency, as there are doctors who may step in for you. But as you read on, you might still find profit in adopting some of these ideas.

There has always been a strong ethical (and now legal) mandate to ensure the ongoing care of our patients, regardless of an inability of the doctor to continue it. Making a prior contingency arrangement avoids the potential medical, legal and financial hazards that may be precipitated by an unforeseen calamity to the physician.

Having a PW makes so many things easier: finding keys and passwords; knowing where to refer your scheduled and non-scheduled patients and their records; or having a centralized list of important contact numbers — landlord, insurers, utilities, banks, credit cards, billing service, dictating service, practice accountant, and etc.

The most important task is to identify a colleague in advance to step in to see patients and/or oversee many of the things that need to be done in your practice that require a physician's knowledge, rather than just a lawyer or uninitiated family member. First, find an agreeable colleague who is willing to have your back in the unlikely event of such circumstances (and perhaps you would reciprocally do the same for him/her).

Next, write your list of who, what, where and in what order things are to be done. Take it to your lawyer and have a simple agreement drawn up that your friend will sign. Using your lawyer will assure that your PW will integrate with your other legal documents side by side and avoid potential confusion and conflicts.

You should consider some fee appropriate for the task required for your stand-in and where it will come from. If necessary, take out a small term life policy covering the amount. And don't forget to identify a back-up colleague either. Vacations, illness and medical meetings seem to happen at the most inopportune times when you are trying to contact another doctor, don't they?

Part and parcel of this PW document are the circumstance(s) that will trigger its use. And you should plan to review and modify the PW as is needed over time. People, practices (as I noted above) and situations change. After all, the PW is a form of insurance; you don't like going to the trouble, you hope that you will never need it, but all involved will be relieved if the necessity of its use arises.

The whole idea in this exercise is to make things easier for those you care the most about and when they need help the most: when you can't help.

The PW is currently being touted by psychologist organizations, among others, perhaps because the majority of psychologists still practice solo. On the ’net you can check APA.org or the San Diego Psychological Association website (to name just two examples) for further guidance and sample forms that can be adapted and modified.

If the dreaded necessity of the PW's use comes into play, everyone who you care about — your family, your staff and your patients — will thank you for your caring and for your foresight.

Just remember two things; 1) tell them that you have created such a document and 2) tell them where it is!

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Victor J. Dzau, MD, gives expert advice
Victor J. Dzau, MD, gives expert advice