Texas Medical Board (TMB) Rules and Requirements
TMB Rule 163.4 Physician Responsibilities when Leaving a Practice:
(a) Upon retirement, termination of employment, or
leaving a medical practice, a physician must provide patients reasonable notice to obtain copies of their records or arrange for the transfer of their medical records by:
(1) letter or email to each patient seen in the last two years by the departing physician; and
(2) posting a notice in a conspicuous location in the physician's/practice office and on the practice website at least 30 days prior to the termination, leaving, or sale or relocation of practice.
(b) The notice must include:
(1) the date of the termination, retirement, or departure;
(2) instructions as to how patients may obtain or transfer their medical records;
(3) the name and location of new practice, if any; and
(4) the name of another licensed physician, practice, or custodian if ownership of records is changing.
(c) If the physician's license is surrendered or revoked, the notice must be provided immediately in accordance with this section.
(d) The following physicians are exempt from providing notice to patients:
(1) a locum tenens physician at a practice location for less than six months;
(2) a physician who only treated the patient in the following settings:
(A) a hospital, as defined under §
157.051(6) of the Act;
(B) an emergency room;
(C) a birthing center; or
(D) an ambulatory surgery center; or
(3) a physician who only provided the following service:
(A) anesthesia;
(B) radiology; or
(C) pathology.
TMB Rule 163.4(e) also discusses
the responsibilities of the medical practice:
(e) Responsibilities of Practice
(1) A physician, physician group, or practice must provide a list of patients seen by the departing physician in the last two years for the purposes of providing notice to patients.
(2) A departing physician's group or practice is not required to provide the requisite notice to patients.
(3) If the departing physician's group or practice agrees to provide the requisite notices to patients, they must do so in accordance with this section.
(4) No physician remaining at the group or practice may prevent or interfere with the departing physician's duties to provide notices described by this section.
Opinion of the Texas Medical Association (TMA) Board of Councilors:
If requested by the patient of that physician, the group practice must inform that physician's patient of the departing physician's new address, and that copies of the patient's medical records may be forwarded to the departing physician's new practice. It is unethical for any remaining physician member of the group to withhold, or allow to be withheld, such information upon request of a patient. Additionally, the fact that a physician leaves a group practice should not cause any patient to be neglected or abandoned. It is unethical to interfere with the relationship between the departing physician and his or her patients by withholding information, even when there are other physicians remaining in the group who are qualified to render the necessary care.
Guidance and Resources
As the Harris County Medical Society (HCMS) frequently receives calls from patients who are looking for their medical records, please also notify our office so we may let these patients know who has custodianship and how they may request a copy of their records. Call 713-524-4267, ext. 219, or send a letter to Harris County Medical Society, John P. McGovern Building, 1515 Hermann Dr, Houston, TX 77004-7126.
The TMA whitepaper Notice to patients on the departure of a physician discusses the TMB regulations and the practice-employer and physician legal risks.
TMA Board of Councilors Current Opinion - Patient's Rights upon Physician's Departure from a Group.
AMA Code of Medical Ethics - Privacy, Confidentiality & Medical Records Opinion 3.3.1 Management of Medical Records
For information on closing a practice, visit our Closing or Selling Your Medical Practice page.
Notifying Patients
Notifying Your Patients When You Leave a Practice - TMA discusses how to notify and who is responsible.
Leaving a Practice? Notice to Patients Has Gray Areas - TMA provides guidance on who is responsible for notifying patients and how they should be notified.
Sample Letters
TMLT has sample Leaving a Practice letters.
TMA has other practice change sample forms.
Medical Records Resources
Records Management, Storage and Retrieval Resources in the Houston area. (This list is provided for reference only; not an endorsement of any of these companies.)
Also, refer to the HCMS Buyers Guide for records management resources.
For more information, including retention requirements, refer to our Medical Records page.
Who Owns the Medical Records?
Who owns the medical record? (TMA) - Physicians should agree about ownership up front before entering into a multiple-physician arrangement to avoid any ambiguity over medical records ownership.