5 Mistakes Physicians Make When Closing Their Practice
We all know that doctors are extremely intelligent. Yet, no matter how smart they are, they’re only human and make mistakes. Doctors’ most common mistakes happen when it comes to dealing with their patient records, either after retirement or when the practice closes. During the past few years in the Patient Chart Custodian Services (PCCS) industry, our team at HarborSafe has seen many repetitive mistakes and has come up with the 5 most common ones we see from case to case. Like any important decision in life, it is essential to plan your patient charts’ appropriate care once your practice closes or you retire. Without a plan, many problems may arise that could affect finances, family members, and your happiness. Before examining the five mistakes, I want to quickly mention the effect that poor patient records management could have on the medical professional responsible.
From a legal standpoint, the doctor is responsible for managing and distributing their medical files to authorized requesters for several years, depending on the state laws. If a patient makes a request, and the doctor cannot locate or produce the chart, it could result in a hefty fine, and even worse, the patient is left without their medical history. A doctor could have thousands of patient records, and managing and sending those documents puts a significant burden on the doctor or the doctor’s family if he or she is deceased.
Now that we briefly skimmed through some consequences of mismanaged medical records let us look at each mistake and understand why they are so common.
1. Choosing to manage your patient records for your closed practice.
The number one mistake we see on a case to case basis is doctors choosing to do the work themselves without realizing the full responsibilities and commitment to do it correctly. As mentioned above, the amount of risk, cost, and chaos is significant when attempting to manage your own patient files. Many states require you to keep the charts at least 7 years after the last date of service, and if you see patients that are minors, you may have to keep the chart until they turn 18! Now consider, if you have physical paper charts, you will have to pay to store them for several years. Even if you have a place to store the charts (if they are paper), you will have to have access to them AND have an idea of which charts are in which boxes. When and if you find the chart, will you send it in compliance with HIPAA and HI-Tech laws? Equally important, would you be incurring the cost of delivering the chart? How would you process the payments? Would you keep track of every request as required by HIPAA laws?
More importantly, do you see yourself doing this 20-30 times a week? I’m sure you don’t, but these are all questions that need to be understood and answered before deciding to do the work yourself. Mishandling records could expose Protected Health Information (PHI) that could result in fines or lawsuits. Choosing to do the work yourself is certainly a daunting task, and it is because of this that physicians will often contract with a records management custodian.
2. Choosing a records storage vendor that does not have custodian experience or resources.
Choosing to store your records with a vendor that only offers storage services may seem like a good idea on the surface; however, it can get you in much trouble. When choosing a PCCS partner, it is essential to be sure that they have experience and the resources to do the job correctly. A poor records custodian may mishandle the information leading to PHI breaches, which extends to the doctor because it is ultimately their responsibility. Also, a regular records storage company may not be aware of HIPAA laws and retention laws, leading to prematurely destroyed documents. It’s important to keep in mind that any mistake extends back to the doctor, which is why it is so essential to understand the difference between a records storage vendor and a PCCS partner.
3. Assuming there will not be a large number of requests.
While the practice is still operating, it may be easy to overlook how records are seamlessly located and sent to the patients. You may also not have realized how frequently this happens weekly. Due to these oversights, you may think that you can handle the number of requests you will receive or that there will not be many requests. But the opposite is true. Based on our experience, when a patient hears their doctor’s practice is closing, they will ask for a copy of their records to bring to their next doctor almost right away. This kind of request is the most common type of request, and let’s not forget that a patient can make an unlimited number of requests during the retention period. There are also other kinds of requests, sometimes it can be attorneys or insurance companies or government agencies, all needing a certain aspect of the patient file. This set of requests, especially those deemed as an emergency, must be fulfilled within a reasonable time frame. Timing is also an extremely important factor when alerting your patient’s about the practice closing.
4. Alerting patients before choosing a custodian
Without proper planning, things can get messy quickly when choosing a custodian. When you choose a PCCS partner, you have to alert your patients on how to acquire a copy of their chart from them. The law also states that you must also notify the state that you are closing your practice. Alerting patients, before choosing a PCCS partner results in chaos for the doctor responsible for fulfilling those requests. Similarly, alerting patients to make requests to the custodian before the transfer of data/boxes results in the custodian unable to satisfy those requests. From our experience, we have encountered many occasions when the doctor has alerted the patients of their closure before releasing the records to us and has only resulted in having several confused and upset patients. These both situations are examples of poor communication and only creates a dreadful experience for requestors.
5. Not knowing or ignoring the laws for notification and retention.
Like mentioned before, there are several laws regarding both notification and retention when closing your medical practice. Retention laws are set by each state determining how long records must be kept. As mentioned in the beginning, the retention periods can be anywhere from 7 to 18 years. Failure to abide by these laws can result in fines. Alerting the Federal and State authorities may seem like a small, easy thing to do, but it can be forgotten just as easily. Hence, a good number of physicians seek the guidance of specialized attorneys during the process. One recommendation based on our experience: when you think of closing, consider having a healthcare attorney look through your documents to verify that everything is in line.
Hopefully, this list has given you a good idea of some of the mistakes made by retiring medical professionals. I also hope that it raised awareness of some of the issues that arise when a medical practice closes. We see these mistakes being made regularly, and we want to help. HarborSafe was created to provide solutions to these problems. We have the knowledge and over 20 years of experience to help you close your practice and enjoy your retirement.