Closing a Medical Practice

Updated expectations approved by Council

The College has approved a policy that describes what steps a physician should take when closing his or her practice in order to minimize the impact on the practice’s patients.

The policy updates expectations that had been articulated in the Practice Management Considerations for Physicians who Cease to Practice, Take an Extended Leave of Absence or Close a Practice Due to Relocating.

The Closing a Medical Practice policy updates expectations around patient notification, and physicians’ obligations in facilitating continuity of care. It also provides guidance reflective of the different circumstances leading to a closure, whether it is an unexpected closure because of death or sudden illness, suspension or revocation or a planned closure as a result of retirement or relocation.

Notably, the policy states that physicians must provide 90 days notice to patients who are being actively managed prior to a planned closure of the practice — an expectation shared by other Canadian medical regulatory authorities. However, this timeline is flexible if there is a physician taking over the practice. The contents of this notice and acceptable methods of communication are also set out in the policy.

The policy also requires physicians’ efforts to reasonably assist patients in arranging care from another health-care provider. What is reasonable depends upon the reason for the practice closure, patient needs, and the health-care providers and/or health-system resources available in the community.

The policy applies to all physicians who are closing a medical practice, including those who work in group practices or institutional settings, regardless of practice area or specialty.

Here are some additional things to know about the policy:

• In the event of an unplanned closure, ensure ahead of time that you have a designate in place to facilitate compliance with the policy. (Please see article about succession planning on facing page).
• Ensure that appropriate follow-up occurs for tests ordered by you, where the test results are pending.
• Notify patients whose care you have actively managed of a practice closure, and if you intend to transfer custody of the medical record, you must notify all patients.
• The policy has various notification requirements. Notify patients directly, either in writing (i.e., letter-mail or secure email), by telephone, or in person at a scheduled appointment.
• Notification must also be provided to employers, hospitals or other facilities where you hold privileges, employers, and to the College of Physicians and Surgeons of Ontario. The CPSO must be notified within 30 days of a practice relocation.

An advice document has also been developed to provide further assistance.