LEAVING A PRACTICE RESPONSIBLY

WHEN A DENTURIST LEAVES AN OFFICE

The College is frequently asked about the responsibilities of Denturists who leave an office or clinic. Can they take their records with them? Must they maintain access to their records? What should patients be told? What happens if the College investigates the departing Denturist? This article is intended to give guidance to members so that they can fulfill their professional responsibilities.

MAINTENANCE AND ACCESS TO PATIENT RECORDS

The overriding principle when a Denturist leaves a practice is patient care. Under the proposed record keeping regulation, Denturists have an obligation to maintain and have access to their records for a period of at least 5 years. Access is required in order to answer questions that patients, their insurers and the College might later have about treatment rendered. Access may also be required if the Denturist continues care of the patient in the new practice. This access can be achieved in one of two ways:

the departing Denturist can take an original or a copy of this or his/her records with him or her; or
the departing Denturist can leave the records behind on the understanding that they will be maintained for the required period of time and that he or she can have access to them if required.

A prudent Denturist will clarify with the remaining practitioner, before beginning employment or a partnership, what the agreement will be on departure. Where the contractual agreement with the remaining practitioner is silent or expressly contradicts this professional obligation, the departing Denturist has an obligation to negotiate an acceptable arrangement with the remaining practitioner. If he or she cannot, he or she can be subject to discipline.

INFORMING THE PATIENTS ABOUT ONE'S DEPARTURE

Again, there is a professional and a contractual part to this issue. If there will be no Denturist care in the location that the Denturist is leaving, then patients should be so informed by the Denturist before the office closes. If the clinic will continue to operate, then it would be a normal professional courtesy, and in the interests of patient choice, for patients to be told about the departure. However, except in the case where the clinic is closing entirely, this notification probably fits into the category of professional courtesy not professional obligation. In other words, a Denturist would not be disciplined if he or she failed to notify patients of the move as long as the clinic itself continues to operate. The Denturist can assume that the remaining practitioners at the clinic will maintain their professional obligations in dealing with the Denturist's former patients.

The remaining practitioners have a professional obligation to respect their patient's right of choice and to be honest in their dealings with patients. The College expects that the professional obligation of the remaining practitioners include being honest with patients (e.g., if a patient books an appointment by telephone with the departed Denturist by name, he or she should be told at the time of the appointment that the Denturist has left). The College also expects that the professional obligation involve a duty to tell a patient, who asks, where the departed Denturist has gone.

An ideal situation would be for the departing Denturist and the employer or partner to agree upon a letter to go to the patients of the Denturist before the departure. Some practitioners may be unlikely to agree to this for the first time after the Denturist has made the decision to go and, therefore, it is very important that this issue be agreed upon at the very start of the relationship.

RESPONSIBILITIES OF THE REMAINING DENTURIST

If an investigator is formally appointed under section 75 of the Health Professions Procedural Code to examine a matter, the remaining Denturist must co-operate. Section 76 of the Health Professions Procedural Code requires the remaining Denturist to provide access to his or her premises and records. Also, the definition of professional misconduct found in paragraph 1.40 also requires the remaining Denturist to co-operate with the investigator. In addition, the investigator could summon any records under the Public Inquiries Act or obtain a search warrant.

Richard Steinecke, Legal Counsel College of Denturists of Ontario January, 1998