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Closing your medical practice and transitioning into retirement


The decision to leave clinical practice is not one which is undertaken lightly we know.

But having decided to leave, there are still a number of options available to you, as a qualified and registered (or formerly registered) medical practitioner where you can use your knowledge and skills to the benefit of others. 

For those closing their private practices there may be a number of “housekeeping issues” you need to address.  These will include some of the following if not all.  There will be some State/Territory jurisdictional legal differences to, so please take advice from your State or Territory AMA or your legal adviser. 

Ideally you will be able to stage your exit from your practice in an orderly way, but sometimes, despite best intentions, this is not possible.  For information on the urgent closure of a practice, contact your State or Territory AMA, your medical insurer and/or your legal adviser.

Scroll down for more information.

Registration and other basics

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Be aware of the Medical Board’s registration requirements and the categories of registration which may apply. 

You will need to retain your registration if you intend to “practise” and you should check with the Medical Board as to the registration you need to have.  The example below applies to non-practising formerly registered medical practitioners.

http://www.medicalboard.gov.au/Registration/Types/Non-Practising-Registration.aspx

This extract from the Medical Board’s website clearly defines what you can do as a retired clinician.

This type of registration may be suitable for medical practitioners who:

  • have retired completely from medical practice,
  • are having a temporary absence from practise (for example, on maternity or paternity leave) or
  • who are not practising in Australia but are practising overseas.

The Board’s definition of ’practice‘ is:

Any role, whether remunerated or not, in which the individual uses their skills and knowledge as a health practitioner in their profession. For the purposes of the Board’s standards, practice is not restricted to the provision of direct clinical care. It also includes using professional knowledge in a direct non-clinical relationship with clients, working in management, administration, education, research, advisory, regulatory or policy development roles, and any other roles that impact on safe, effective delivery of services in the profession.

Under the National Law, medical practitioners with non-practising registration must not practise the profession. The definition of practice is intended to be broad and inclusive. It allows individuals with medical qualifications to be registered if they are using their skills and knowledge as a health practitioner, regardless of whether they are providing direct patient care. This definition does not prevent individuals working in non-clinical roles from holding registration as long as they meet the relevant registration requirements.

The Board has published a statement on Medical Registration – What does it mean? Who should be registered? to help individuals with medical qualifications to decide whether or not they should be registered. It also provides advice on the activities that can be undertaken without requiring practising registration.

Medical practitioners with non-practising registration must not:

  • provide medical treatment or opinion about the physical or mental health of an individual
  • prescribe or formally refer to other health practitioners.

Non-practising practitioners seeking to prescribe and/or refer to other health practitioners may apply for general or specialist registration and will need to meet the Board’s registration standards for:

  • continuing professional development
  • recency of practice
  • professional indemnity insurance arrangements
  • criminal history

There is a reduced fee for non-practising registration.

Patient records and closing your practice

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GENERAL SOURCES OF INFORMATION

The Australian Medical Association’s “Privacy and Health Record Resource Handbook” provides comprehensive information for medical practitioners in the private sector.

The Resource kit is not intended to be comprehensive and is not a substitute for a thorough reading of the privacy legislation, the APPs and the guidelines. More importantly, the guide is not a substitute for independent legal advice where necessary. For more information, contact your indemnity insurer or your local.

The Medical Board of Australia’s “Good Medical Practice: a code of conduct for doctors in Australia” can be downloaded from http://www.medicalboard.gov.au/Codes-Guidelines-Policies/Code-of-conduct.aspx.  This publication also advises on closing a medical practice.

MDA National also advises on medical records and closing a practice in its publication “Australian Privacy Principles, your privacy policy and medical record management.”  It is available at

http://www.mdanational.com.au/~/media/Files/MDAN-Corp/Medico-Legal/Medical-Records.pdf?la=en

MIGA has a Fact Sheet on closing your practice, which details NSW and Victorian legislative requirements.  It can be found on their website:  http://www.miga.com.au/riskresources/library/11RRFS02.pdf

The RACGP has a GP Management Toolkit which includes information on closing a practice.  It can be downloaded from the RACGP website (Module 13: Closing a medical practice) and is for members only. It can be found at: http://www.racgp.org.au/your-practice/business/managementtoolkit/module13/

STATE AND TERRITORY LEGISLATIVE REQUIREMENTS

AUSTRALIAN CAPITAL TERRITORY

In the ACT, the Health Records (Privacy and Access) Act 1997 provides that patients must be notified of the closure, merging or relocation of the practice and where they may access their records.  The Act specifies how this will occur; eg, public notice in a newspaper and that patients are entitled to 30 days’ notice.  How this is advised to patients can be found in one of their fact sheets.

The ACT Act also requires the practitioner to advise the Health Directorate of the closure or relocation of the practice and the Act should be read in preparation for the closure.  Template letters and notices are also available.  For further information:  http://www.health.act.gov.au/professionals/health-practice-closure-merger-or-relocation

Check too the requirements in the ACT for charging patients to access their records and the ways in which this can be done.  This information is found at: http://www.health.act.gov.au/sites/default/files//RECORD%20ACCESS%20FEES%20July%202017.pdf

NEW SOUTH WALES

New South Wales has legislation regarding health records and the transfer or closure of a medical practice; ie, New South Wales Government (Medical Practice Regulations 2008) which can be found that http://www.legislation.nsw.gov.au

VICTORIA

Victoria’s Department of Health has guidelines on closing a practice and you need also to consider the Health Records Act which stipulates your obligations in relation to patient records.  Further information can be found at the Department of Health, Victoria www.health.vic.gov.au/healthrecords/

No other State or Territory has legislated to mandate your obligations when closing a medical practice as far as we can ascertain.

Other important basics – this list is indicative but not conclusive

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  • You will need to notify Medicare of your intention to leave clinical practice and provide a date on which this becomes final.
  • If you have a VMO contract (or similar in which you are contracted to provide services to patients), contact the Health Department to discuss termination of the contract and finalisation of any outstanding payments including superannuation contributions if applicable.
  • Contact any other hospitals with which you are associated and advise of the final date of your medical practise and finalise any outstanding payments, cancellation of theatre lists, clinics etc.
  • Notify the general practitioners who refer patients to you of your intention to leave and thank them. Your State AMA publication may be happy for you to take a small advertisement advising the profession of your intentions.  If you are a GP let the specialists to whom you refer know of your intentions to close your practice.
  • Notify your patients of your intention to leave clinical practice and advise them where they may access their records. This should be read in conjunction with State and/or Territory legislation on closing a medical practice.
  • Contact your MDO or professional indemnity insurer as make sure that you are covered for whatever you do next, if appropriate.
  • Make sure that paper prescription pads and other important documents are either destroyed or securely stored.  Likewise for any pharmaceuticals in your possession.  Your local pharmacist may be able to help you with disposal of drugs.

Practice staff and the decision to close

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This will obviously be a big consideration as you wind up your practice.

You will need to ensure that staff entitlements are correctly calculated and the appropriate payment/s made.  Your State or Territory AMA can assist you with this.

Long service leave and annual leave will need to be calculated as part of this, but no payment is expected for sick leave credits.   Any residual superannuation payments will need to be calculated and remitted in the statutory time period. 

You will also need to ensure that you provide the usual end of year statements to staff in compliance with taxation legislation.  Your accountant should be able to assist you with these matters.

Leases and financial matters

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Four key groups or individuals should be involved in the closure of your practice: the bank, and other financial institutions with whom you have money invested; your financial adviser; your accountant and your legal adviser.

Whether you have operated your business in your own name or as a corporate entity, you will of course need to consider terminating any commercial property leases you have and make arrangements regarding any leases for vehicles etc.  Your accountant should provide assistance with these.  If you have an associate or practice partner, you may be able to negotiate whether he/she continues to lease the premises after your retirement.

Consumables and medical equipment in good order may be sold along with commercial premises if owned by you or your practice company.  Seek advice from both your accountant and a commercial real estate agent and do due diligence by seeking a “second opinion”.

Take advice from your legal adviser on the ongoing status of your practice company and dealing with any outstanding issues which may have an impact on your retirement.  Such issues, of course, could include any outstanding medical litigation which involves you will need to ensure your indemnity insurer is aware of your pending retirement so that you can maximise your protection in retirement.

Part of “wrapping up” the practice, will include closing bank accounts.  Your bank will advise on any financial investments you have and you should, of course, also consult your financial adviser. You will also need to ensure that you have sufficient regular funds in retirement so your superannuation needs will also need to be factored in.  Again, this is where your financial adviser will be important.

Your financial adviser will also be able to provide advice on leased motor vehicles etc.

What’s next? Volunteering, Teaching, Education

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Depending on the type of registration held, you can use your medical knowledge in a variety of ways. 

Teaching the next generation of medical practititioners.  If this interests you, contact your local Medical School and enquire about opportunities.

Maintaining social and collegiate contact with colleagues.  Some State AMAs facilitate regular (or occasional) events for “retired doctors” so check what your AMA offers in this regard.

Volunteering with organisations such as those below and there are others may be something you would like to explore.  Further links are on our “medical employment opportunities page” (www.ama.com.au/careers/medical-employment-opportunities)

Education expenses might prohibit formal learning but there are a number of places where you can exercise your mind including University of the Third Age (U3A) and there are networks in each Australian State and Territory.  U3A might have a volunteer role for you too.

News flash!

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We will post here any new information which comes to hand.  Please feel free to contribute by emailing careers@ama.com.au.

DISCLAIMER: 

This material is generic in nature and is made available on the understanding that the AMA is not engaged in rendering professional advice. Before relying on the material provided, users should carefully evaluate its accuracy, currency, completeness and relevance for their purposes, and should obtain professional advice relevant to their particular circumstances where necessary.Whilst every effort has been made to ensure the accuracy of the information on this Resource Hub, the AMA or its employees cannot be held responsible for any loss or damage arising to any person as a result of using this site.

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