Contemplating Change

Whether you are working as an independent contractor or an employee, there are some important things to consider when contemplating a move. This article highlights some common challenges.

Case study

Dr Smith works in a small practice located in a busy beachside community. There are approximately five general practices in the area.

Dr Smith is an independent contractor, with no written contract. She works six sessions a week and is paid in accordance with normal practice rates. She is a very popular local doctor, with a large and loyal patient list. She has worked at the practice for a number of years and is aware that patients travel from surrounding towns to see her.

A year ago the ownership of the practice changed, and Dr Smith is not entirely comfortable with some of the new practice protocols being introduced. She feels confident that many of her patients would wish to transfer with her if she sets up her own practice. She identifies some suitable rooms a short distance from her current practice. She obtains accounting advice, enters into a lease, and makes plans to set up a new practice.

When the time is right, Dr Smith approaches the owner of her current practice to inform him of the decision to leave. Although she has no written contract, Dr Smith is not anticipating any problems with her decision.

Dr Smith is extremely surprised when the new owner of the current practice becomes angry and upset about the news of Dr Smith's departure, and demands to know why she was leaving. Dr Smith takes the opportunity to describe all the problems she had with the new practice protocols introduced, including criticism of the owner. The owner tells Dr Smith she should finish up at the end of that day’s session, and not return to the practice.

Dr Smith had intended to make arrangements for her patients’ records to be transferred to the new practice. When Dr Smith raises this with the owner, she is told that the records remain the property of the current practice and she is not entitled to them. She is also informed that the practice intends to recruit a new doctor to replace her and will be able to accommodate all of her patients.

Dr Smith was not expecting to leave so quickly, and she also faced a period of reduced income as she was not due to move into her new premises for another month.

Medico-legal issues

• Unless specifically contracted or with patient consent, an employee or independent contractor is not entitled to take/access patient records.
• The practice owner would be entitled to contact the patients with advance bookings and offer to transfer them to another doctor within the practice.
• Exit interviews should be conducted in a professional way and it is generally not the appropriate time to criticise the practice (or individuals).
• It is prudent to plan for your exit on the basis that discussions might not go well and you may be asked to leave immediately.

Dr Smith rang MDA National and received general advice on negotiating with her former practice.

Janet Harry
Medico-legal Adviser
MDA National