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Post: Retirement Weekly: Your doctor quit. You never even got a letter. What’s going on?

You don’t expect your doctor to disappear. Mine did.

And just like that…he was gone. I never got to say goodbye.

It’s not like he was a fixture in my life. I had only seen him four times. But still, he is (was) my pulmonologist.

I never received a letter informing me of his departure. I learned about it by accident: I needed to refill a prescription and the pharmacist kept telling me my doctor wasn’t responding.

When I called his office, a receptionist told me the doctor had left a few months earlier. She said the other pulmonologist in the practice would call in my refill.

She added that no letter was sent to patients informing them of his leaving. Wait a sec: Isn’t there a rule that doctors must send an “I’m leaving” letter to their patients?

There’s no easy answer.

Healthcare delivery is heavily regulated at both a federal and state level. But when it comes to notifying patients of a doctor’s exit, state laws vary.

“In my experience, most physicians really value their patient relationships and want their patients to know why they’re leaving,” said Kate Hickner, a Cleveland-based healthcare attorney at Brennan Manna Diamond, a law firm. “But state laws can limit a physician’s ability to notify patients.”

Why would states prevent doctors from informing patients that they’re leaving the practice?

We tend to think of doctors as self-employed. Actually, they’re often employed by a health system, hospital or other corporate or nonprofit entity. And their employment contract may prohibit them from contacting patients, due to noncompete or non-solicitation agreements in place that reflect the employer’s right to protect its patient list and other confidential data.

Other factors come into play as well. Many states have medical boards that set rules on what physicians need to do before leaving their practice. Examples include specifying the lead time they must give before they move on and explaining how patients can gain access to their medical records or transfer them to another provider.

Finally, the American Medical Association code of ethics includes a rule that physicians notify patients before they head out the door. Yet that rule sometimes clashes with employers’ rights.

Confused? The web of regulations explains why many outgoing doctors retain a healthcare attorney for guidance.

What are patients, especially retirees with longstanding ties to their doctor, supposed to do if their provider suddenly vanishes? Even if the physician does not (or cannot) send you a so-long-I’m-out-of-here letter, nothing stops you from doing a little digging.

“The patient can Google the physician to find out [where they have moved],” Hickner said. “You can then reach out to that physician. Patients have a right to choose their provider,” even if it means tracking them down to a new office.

When solo practitioners retire, different rules apply. They cannot abandon their patients, so they must notify them of their retirement and review the protocols for handling the patient’s medical records and authorizing the release of those records.

My dentist retired last year. She sent a heartfelt letter explaining her rationale—and urging her patients to stick with the new guy who acquired the practice.

Similarly, Jen Brull wrote a personal letter to her patients about her pending retirement. A Plainville, Kan.-based family medical physician who owns her practice, Brull gave her patients almost a year’s notice.

“I’m a planner and I was pretty intentional about my timeline in telling the people I wanted to tell,” Brull said. “I wanted to say goodbye to my patients and them to say goodbye to me. And I wanted to give them time to think through the transition.”

Brull, who decided to leave her clinical practice after roughly 20 years and move into administrative medicine (which affords her more flexibility to travel), sent about 300 patient letters. On about half of those outgoing letters, she jotted a handwritten sentence or two at the bottom with a personal message.

“It was bittersweet. There were lots of tearful conversations,” she said. “To a person, all my patients said, ‘Good for you. You deserve this.’”

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