From time to time physiotherapists may leave a place of employment or move to another clinic/facility. In these circumstances physiotherapists face two major issues:

  • What to do about continuity of patient care.
  • How to handle patient records.

All too often in these circumstances physiotherapists find themselves in uncomfortable relationship situations reminiscent of a ‘bad divorce.’ Physiotherapy Alberta encourages all physiotherapists to take steps at the time of hire to ensure there is a mutual agreement (regarding continuity of care and the handling of patient records in the event of termination or relocation) between yourself and the employer.

The Leaving a Practice/Re-locating to Another Practice practice guideline is based on the following principles:

  • Patients have the right to chose their physiotherapist provider; no one ‘owns’ the patient.
  • Physiotherapists are obliged to act in patient’s best interest.
  • Patients have the right to access their clinical records.

​View the Leaving a Practice/Re-locating to Another Practice practice guideline as a PDF.

 

Physiotherapists are obliged to ensure continuity of patient care when leaving a practice regardless of the circumstance. This can be accomplished by transferring care to another physiotherapist within the practice. It is also acceptable to provide patients with other alternatives including:

  • Informing them of other physiotherapists in the area. Offering to see patients at your new location as appropriate and feasible.
  • Completing patient’s care prior to leaving.
  • Making arrangements with current employer to continue providing patient care as mutually acceptable until a successor physiotherapist can take over the patient’s care.

​Patients should be provided with the information required to make an informed choice. It is not acceptable for an employer to withhold information about a physiotherapist’s whereabouts if known just to prevent business loss. Likewise, it is also not acceptable for the departing physiotherapist to remove patient information from a clinic for the purpose of business gain. In fact, to do so may contravene privacy legislation as the information will be used for purposes beyond which it was collected. 

Privacy legislation including the Health Information Act (HIA) and the Personal Information and Protection Act (PIPA) governs the collection, use, disclosure, and access to patient information. The patient (or patient designate) has the right to access their record. The record custodian can vary - most often the facility is the custodian for practical purposes unless otherwise agreed upon between the physiotherapist and the facility where they work or the clinic owner/manager.

Physiotherapists have a professional obligation to ensure clinical and related records (e.g., billing) are maintained, generally for 10 years. Physiotherapists must also ensure they have ongoing access to records when leaving a practice. If a physiotherapist is employed by another person or facility, the physiotherapist must ensure that these professional obligations can be accommodated.

There are other ways to fulfill this professional obligation. Other options include that the physiotherapist:

  • Takes patient records or copies when leaving a facility.
  • Has agreement with record custodian that records will be maintained for required period and that physiotherapist will have access if required.
  • Obtains copy of record from patient/patient designate.

Physiotherapists are encouraged to prevent patient record issues by negotiating these matters at the time of hire to avoid conflict when departing. If you find yourself in the position that your professional obligation conflicts with a contractual obligation, seek legal advice.

Four steps are recommended:

  • Agree at time of hire how continuity of care and patient record issues will be handled.
  • Agree how information about a physiotherapist’s departure will be communicated (see sample patient letter).
  • Seek legal advice if needed to review employment contracts to ensure professional and contractual obligations do not conflict.
  • Understand privacy legislation and how it applies to you/your employment situation.

The sample letter below is from a departing physiotherapist or practice owner to communicate a physiotherapist’s departure from practice. This is a sample only and can be customized as required.

Dear (Patient):

On (month, day, year), (I or name of physiotherapist) will be leaving (name of practice) to (retire/go on leave/join a new practice/begin my own practice). As (I or name of physiotherapist) (am/is) presently providing you with physiotherapy services, it is important you know the options available to receive ongoing physiotherapy. These options are:

  • Remain at (name of practice) and transferring care yto (name of physiotherapist).
  • Transfer to another practice in the area, a list will ybe provided to you.
  • Transfer to (name of practice or departing physiotherapist).

Please advise (me, practice owner or administrative person) of your decision so that continuity of care can be assured. You may do so by indicating your choice below and returning a signed and dated copy.

Yours truly,

(Name of physiotherapist/practice owner)

Please choose one of the following options:

  • I wish my file to stay with (name of practice and new physiotherapist).
  • I would like to know about other physiotherapy practices in my area.
  • I wish to continue care with (physiotherapist’s name) at their new location.

Patient signature
Date