Articles and Case Studies

Death of a colleague

08 Sep 2020

Gae Nuttall B and W

by Gae Nuttall

Doctors seated at desk in practice

The death of a colleague is not something we like to think about but if it happens the impact on the team and practice can be significant. This resource provides practical tips and ‘things to think about’, noting that each practice setting will have different needs.

This information may also be relevant if a colleague has a serious accident or illness.

Inform staff and colleagues

Decide who is best placed to do this, ensure this is done privately (away from waiting room and patients). Allow staff time to process, offer appropriate person to de-brief with if required.

Ascertain who at the practice will communicate with the family/appropriate contact person.

Consider regular team ‘check-ins’ to keep communication open and support each other.

Patient handover

You need to inform patients (and certainly those who have appointments).

You may have someone on the team who is more comfortable to do this e.g a new staff/doctor

Notifications to patients:

  • Nominated person to notify every patient that attends practice or calls re appointments with the deceased doctor. Offer alternate doctor. Some long term patients may need to speak with another doctor or practice manager.
  • Place a notice in reception with an appropriate message e.g XXXXX has some sad news we wish to share with our patients. Dr xx passed away this week. Please understand that we are all saddened and coping as best we can and appreciate your support at this time.
  • You may choose to send a letter to all of the doctor's regular patients, wording similar to the notice above.
  • Notify any Residential Aged Care Facilities that have patients of the doctor – arrange immediate follow up of any patients if required. Consider future care of RACF patients.
  • If the doctor has inpatients these would need to be handed over very promptly to a colleague.
  • If a surgeon, patients booked for surgery will need to be informed.
  • In the case of a solo practitioner, patients who are in the system for follow up may need to be informed, including when follow up is due.
  • Any interaction with patient about notes and transfer of notes to be briefly documented in the patient record.
  • You may like to have a ‘Condolence book’ in the waiting room for patients to express their sympathy.

Investigation results

Follow up of patient results (pathology, radiology, specialist referrals etc)

  • Plan/delegate the responsibility to review incoming results and letters, (e.g. one colleague will follow-up pathology and radiology, another colleague could view and action letters).

Medical Records

  • Kept securely for minimum 7 years, and to age 25 for children. Some states have their own laws for storage and destruction of records so check with your medical indemnity provider.
  • If patient requests transfer of record to another practice then follow usual procedure - then make their file ‘inactive’.
  • Document in record patient has been given record copy/transferred to xxx practice etc.
  • Generally records may remain the property of a practice.
  • If the practice is sold, the records may be included in the contract of sale and responsibility for them will pass on the new owner. If the practice closes, you will need to organise transfer of records and storage of records.
  • Cancel the deceased doctor's computer system access. Divert emails to practice manager/alternate doctor.

Equipment

Claiming of personalised equipment:

  • Collect and destroy script pads / stamps / labelled stationery or other identifying material that could be used to falsify identity.
  • Personal equipment to be packed and given to family/contact when appropriate.

Financial arrangements

Who will follow-up accounts and what forwarding arrangements are required. An arrangement to forward earnings should be made. Consideration of any financial obligations by Practice should be considered (subscriptions, outstanding fees).

Mail

Instructions should be provided for incoming mail – e.g. destroy any advertising material, present investigation reports and correspondence letters to a specific person (in the absence of another doctor already being involved), billings to be sent to the practice manager, all other mail to be forwarded every [how often and for how long] to family/contact.

Notify relevant others (some of these tasks may need to be done by family/contact)

  • Neighbouring or referring GPs
  • Specialists and other health professionals referred to/who referred to the doctor
  • Medicare – cancel provider and prescriber numbers
  • Ahpra
  • Medical College/professional associations
  • Medical indemnity insurer
  • Notify other relevant providers (and provide alternate contact where appropriate) e.g.:
    - Pathology and radiology
    - All services who send electronic results e.g. hospitals
    - State health vaccine supplier
    - Medical and admin suppliers (e.g. oxygen, liquid nitrogen)
    - Local hospitals and healthcare centres
    - Business/finance/banks/payroll and account system

 Other practical considerations

  • Will you need a locum? Do you have access to arranging a locum?
  • Review all insurance policies and update:
    - Workers compensation
    - Public liability insurance
    - Commercial insurance
    - Practice insurance
  • Further considerations if practice is closing:
    - Phone message saying practice is closed and ceased to practice. Contact xxxx etc for any enquiries. Suggest this occurs for 12 months
    - Mail re-direction - also minimum 12 months
    - Onotice on front door to advise contact details
    - Onotify Medicare of practice closure (and cancel provider number) 
    - Check/cease/alter equipment leases
    - Contact utilities e.g. electricity, water, internet and phone services
    - Dispose of S4 and S8 drugs - check with the Drugs and Poisons Regulation Unit of the State Department of Health
    - Letters via post or email to active patients advising of change with a transfer of records request form

Employee issues

The Fair Work Commission (https://www.fwc.gov.au/), your HR contact or accountant can help with making appropriate arrangements to finalise staff employment entitlements.

Plan ahead

  • Ensure that you have at least two signatories for banking and finance matters (or more if two signatures required for bank transactions) so the business can continue in the absence of one signatory.
  • Have an up to date Business Continuity Plan which is reviewed at least annually
  • Consider business continuity insurance
  • Have a current Will, and consider an estate plan. This plan could include an Enduring Power of Attorney, Enduring Power of Guardianship and an Advance Care Directive.
  • If you are a Practice business owner you may also consider having a business owners plan.

Staff support resources

Doctors health advisory services (NSW/ACT, NT, SA, QLD, VIC/TAS, WA)

Local psychologist/Counsellor

beyondblue 1300 224 636

Communication with Colleagues, Communication with Patients, Confidentiality and Privacy, Doctors Health and Wellbeing, Employment Essentials, Medical Records and Reports, Practice Management, Regulation and Legislation, Technology, Anaesthesia, Dermatology, Emergency Medicine, General Practice, Intensive Care Medicine, Obstetrics and Gynaecology, Ophthalmology, Pathology, Practice Manager Or Owner, Psychiatry, Radiology, Sports Medicine, Surgery, Physician, Geriatric Medicine, Cardiology, Plastic And Reconstructive Surgery, Radiation Oncology, Paediatrics, Independent Medical Assessor - IME
 

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