Practice closure: frequently asked questions

The OMA’s Practice Support Directory (member-only content) has a list of medical storage companies in your community.

The OMA does not recommend or endorse any vendors but you can request physicians’ references from the company you select.

Even after retirement, you are responsible for your practice’s records and must ensure the storage company adheres to the same standards required of physicians. It is strongly recommended you have a contract with the company you use.

Yes, but they must be protected from disasters, such as fire, kept in a safe and secure environment to ensure confidentiality and adhere to the policies of the College of Physician and Surgeons of Ontario.

Yes. You can charge patients a fee for obtaining a copy or summary of their medical records. The CPSO provides guidelines that must be followed when determining a reasonable fee.

When determining fees, refer to the OMA’s Physician’s Guide to Uninsured Services, which is updated annually.

You should not charge a transfer fee if another phyisican is replacing you.

The CPSO’s policy requires that physicians keep medical records for the following periods:

• Adult patients: 10 years from the date of the last entry in the record
• Patients who are children: 10 years after the day on which the patient reached, or would have reached, 18 years

The CPSO says it is prudent to maintain records for a minimum of 15 years. A provision of the Limitations Act states that some legal proceedings against physicians can be started 15 years after the act or omission on which the claim is based occured. For more information, read the CPSO’s Medical Records Management policy.

According to the CPSO’s Medical Records Management policy, physicians must only destroy medical records once their obligation to retain them has ended.

Billing records are part of your financial records and must be kept for seven years, according to the CRA. Appointment scheduling books, such as patients’ scheduled visits, do not need to be kept as they are noted in patients’ medical records.

Consult with your accountant regarding CRA rules on maintaining financial records.

HealthForceOntario, a marketing and recruitment agency that is part of Ontario Health, assists physicians with the transition out of practice, including succession planning. It may also assist you with finding a physician to take over your practice or a locum to temporarily run your practice.

• Post the job opportunity on HFOJobs.ca
• Connect with your local regional adviser and/or community recruiter/hospital HR or medical department staff
• Ask colleagues if they, or anyone they know, are interested in buying it

Both physicians must engage in discussions about several aspects of the practice before the final handover. To facilitate patient access, you must make appropriate arrangements to retain, store or transfer patient medical records.

The OMA’s Transferring a medical practice document outlines legal obligations.

You must retain your patients’ original medical records if you are the health information custodian under the Personal Health Information Protection Act. Any record that you transfer should be a copy, not an original. You must only transfer copies of patients’ records if you are permitted to, or required to do so by law. For electronic records transferred to a new physician, a legal agreement must be established to arrange patient access to files. For more information on such agreements, email OMA Legal Services.

When transferring files, always send a copy of the entire record unless the receiving physician and/or patient has requested otherwise. Ensure the transfer is secure, also documenting the date and method of transfer in the medical record. This transfer must occur no later than 30 days after a request (and urgently, if necessary). Contact OntarioMD for guidance on transferring medical records from an electronic medical system.

You should not charge a transfer fee to your patients if another phyisican is replacing you.

Informing your patients is an emotional step in this process. A minimum of three months notice is suggested, but a longer time of six months is encouraged to allow patients adequate time to find another physician.

See template for patient notification

CPSO’s acceptable methods to notify patients of a practice closure include:

• Calls to active patients
• Letters to active patients that emphasize the importance of continuing care and provide information on where to find another physician
• Printed notice posted in the office (even when the office is closed)
• Advertisements
• Recorded messages on the office voicemail
• Notice on the practice website
• EMR one-way emails to patients

Access the OMA templates for patient notification.

You and/or your office staff should review patients’ records to identify who requires transfer of care and followup. For guidance, see the CPSO’s Continuity of Care guidelines.

No. However, the CPSO’s policy encourages “physicians to take reasonable steps to facilitate ongoing care. Recognizing that what is appropriate will depend on the reason for the practice closure, the needs of the patient, the risks to them if ongoing care is not arranged and the system resources available in the physician’s community. For example, what steps are reasonable would look different for a family physician in a well-resourced community compared to an underserviced community, or when planning well in advance of an upcoming retirement when compared to an unexpected closure due to an illness.”

Notify your staff before notifying patients.

Align notice requirements with the Employment Standards Act, which vary based on employment length. If there is no employment agreement, case law will determine obligations to staff, which may exceed those required under the act.

If you do not provide enough notice, you must pay staff in lieu of notice, which could be costly.

If possible, inform staff at least three months before your closing date and align with Ontario labour laws.

Bonus/incentives or severance packages could be given to staff who stay on until the practice closes. Before notifying staff, you should seek legal advice regarding your obligations.

Written notification of the pending change to your practice must be given to licensing and professional organizations. These include, but are not limited to, the Ministry of Health, Canadian Medical Protective Association, CPSO and the OMA. Refer to the OMA’s Closing a Practice: A Guide for Physicians for a list of professional organizations.

With contracts, review the terms for ending the business arrangement. Without a contract, notify those you do business with at least three months before closure. This includes colleagues, associates, employers, financial institutions, hospitals where you work, laboratories, pharmacies, utility companies, and so on. Sample notification templates, and a list of utility companies to contact, are available in the OMA’s Closing a Practice: A Guide for Physicians.

Meeting with professional advisers, such as lawyers and accountants, to inform them of your practice closure should be a first step in the process. They can get the legal and financial procedures underway as you wind down your practice.

They can also assist with timelines for getting things done (such as evaluating terms of your lease or giving notice to your landlord, human resources obligations and terminating contractual agreements) and outline the information you will need to provide, while ensuring smooth transitions.

Yes. However, your membership fee may be reduced, as you will no longer require all support services and benefits.

To discuss your changing insurance and retirement needs, email OMA Insurance or call 1-800-758-1641 (select option one).

•  Contact medical equipment suppliers, who may purchase it from you
•  Consider donating your equipment to non-profit organizations
•  Ask colleagues if they want or know another physician interested in the equipment

Yes, you can still maintain your medical licence if you retire.

For more information, email the CPSO, call 1-800-268-7096, ext. 673, or 416-967-2673, or visit their Resignation from membership web page.

Note: Once your medical licence and certificate of registration expire, you must immediately cease all practice activities, including prescribing medications.

There are several options to continue practising medicine without operating full-time. These include:

•  Hiring a locum
•  Involving residents in your practice
•  Working part-time

Get more information on finding, hiring and being a locum in Ontario.

The OMA understands that the process of retirement is a significant transition in a physician’s career and life and can impact their loved ones as well. The OMA’s Physician Health Program is a service that is ready to support or assist in these circumstances. Call the PHP confidential line at 1-800-851-6606 or email php@oma.org.