While you may have been preparing financially for your retirement well in advance, chances are you haven’t given much thought to the administration of closing your practice or leaving the profession.
You’re not alone - while most doctors are prepared financially for retirement well before the time comes, many of them haven’t considered some of the administrative work associated with leaving practice. With no mandatory retirement age for physicians, the timeframe for leaving practice is up to you - but careful planning can help make this transition smoother. Here are some things to consider before you hang up your stethoscope for good:
1. Contact Your Medical Body
While there is no mandatory retirement age for physicians in Canada, doctors who are discontinuing practice will need to let their governing medical body know so they can be placed in a retired physicians directory or retired doctors list. Whether you’re in BC, Alberta, or Ontario, the same body that registers you to practice in the province will also need to know that you’ve ceased operations. In addition, you’ll need to provide them with information about how you’ll manage your patients, any triplicate prescriptions you haven’t used, the location of your patient records, and a forwarding address for your mail.
Some provinces, like BC, have more stringent guidelines for physician retirement like posting visible signage in waiting rooms and making sure all patients are placed with a new physician, whether in your own practice or the community. Others might be less specific. Providing this information can also help to get you on a retired doctors list, where you can voluntarily resign from your duties prior to leaving practice, or on a provincial retired physicians directory.
Whichever province you are registered in, you should check in with your regulatory body well in advance of when you’re actually looking to leave in order to make sure you’re following all of the guidelines. These regulations are in place to protect both you and your patients, so make sure you give the appropriate notice as well as keeping track of when and how it was sent.
2. Notify Your Patients
How much notice you give will be up to you, however, the more notice you can provide the more easily your patients will be able to find a suitable replacement. Even if your practice is remaining open, more notice is generally better than less. Some provinces - like BC - require you give your patients at least three months of advance notice, although all provinces generally recommend providing as much notice as possible.
In some provinces, again as seen in BC, physicians must be able to prove that they made a reasonable effort to contact all patients and notify them in person or via mail. This notification should include not only information about you leaving and when you’re expecting to do so, but also contain information on where they can go to access their medical records and any physicians in the existing practice or community that might be taking on new patients. Retired doctors in Ontario will need to provide this notice within a 90 day timeframe.
3. Take a Practice Inventory
If you’re leaving your practice, you’ll need to decide whether or not you’ll be selling or giving your practice to another physician, transitioning your patients to other doctors in the community, or hiring a locum to gradually take over your role. Whichever you choose, you’ll need to take a look at what your practice looks like right now - what are your hiring needs in the time period before and after your retirement? Do you have colleagues who are also interested in retiring? Are you looking to sell, and do you have any offers?
Once you know what your ideal scenario is, it’s time to start looking at what you’ll need in a replacement. Physicians with a very large patient book (for example, over 2000 patients) might look into hiring more than one locum to cover off their hours for retirement, while doctors who offer additional services (for example, acupuncture or obstetrics in a family medicine clinic) would ideally look for a locum who has these skills.
If you’re looking to sell or transition your practice, it’s also a good time to think about things like transitioning your patient records (whether paper based or EMR), whether your administrative staff are interested in staying on with the practice, and any other upgrades or equipment you’ll need to handle before turning over the reins to a new doctor.
4. Transition Patients
If you have a large or complicated patient book, or if your practice will be continuing on without you after retirement, you might want to consider giving your patients some help transitioning to a new physician. In many cases this will include hiring a locum doctor who wants to transition to full-time practice at the same time as you start to transition out, but this is typically done at least a year in advance of your retirement as it can be a lengthy process.
Retired doctors in Ontario will need to keep in mind that some patients - such as those who need urgent referrals, ongoing monitoring for the use of certain medications, chronic pain management, obstetric patients, and any other patients who require ongoing care - will need documentation for your attempts to provide continuous physician coverage, the extent of which will depend on your governing medical body.
After letting your patients know that you will be retiring, it’s a good idea to keep them - and everyone else in your office - up to date on your timeframe. Many physicians end up working later than they intended to either because of problems of continuity or because they enjoy their work. This continuity is good from a patient perspective, but if you’re sure you’ll be leaving the practice in the near future, it might be a good idea to encourage your patients to see the new doctor at least a few times before you leave.
5. Consult an Accountant
If you’re closing a practice or transitioning away from living off of employment income and into your savings and investments, it’s a good idea to consult an accountant and get a sense of what you’ll be required to do in terms of taxes and the reporting of your income.
While this is fairly simple if you’re leaving an employer owned practice, it becomes more complicated if you’re selling or even just closing your doors. Leading up to the sale of your practice, you might want to look into incorporation and how to make sure you can use the Lifetime Capital Gains benefit to avoid a hefty tax bill from the sale. If you’re simply closing your practice, you won’t have a gain on the sale and therefore won’t have the tax bill, however you may have some other tax implications caused by your departure. A good accountant will keep you in the loop with this well before it becomes necessary.
6. Retire or Update Your Technology
If you’re using a billing system, specialty hardware or software, or other technological tools to make your life easier as a physician running your practice, you will need to protect the data on these tools or cancel your subscriptions to any services prior to you leaving. Keep in mind that deleting patient records from your computer is not the same thing as completely removing them.
Retired physicians in Ontario can call a Physician Advisory Board and get information on how to clear these records from computer hardware and how to retain and store your patient data following your departure. Retired physicians in other provinces can reach out to their provincial governing body for access to this information.
While it might seem like you have enough to think about when preparing yourself and your family financially for retirement, the time leading up to your departure has never been better to read up on the administrative and organizational changes you’ll need to make. The sooner you start preparing the better, as the more organized you are the more time and care you can put into preparing your practice to close or carry on without you. Whichever route to retirement you choose, make sure to finish your career with the same duty and care you conducted yourself with during your time as a physician. Your patients and fellow physicians will thank you!
This article offers general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. All expressions of opinion reflect the judgment of the author(s) as of the date of publication and are subject to change. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBC Ventures Inc. or its affiliates.