You must make patients aware of how and where they can obtain copies of their records. Send a notification letter to patients, post a notice in the office prior to practice closure and/or arrange with the landlord to post a notice at the practice location for a period of time after closure.
Disputes between practitioners or contractual arrangements should not affect the future treatment of patients, restrict patients' rights to choose the dentist of their choice, or limit the access of patients to their dental charts or records.
PHIPA allows a Health Information Custodian (HIC) to disclose personal health information to a potential purchaser for the purpose of assessing and evaluating the operations of the HIC’s practice. In order to do so, the custodian must first have the potential purchaser enter into a confidentiality agreement.
The selling dentist must notify the patients of the practice in writing about the change in ownership.
When the outgoing dentist is unable to notify the patients (because of incapacity or death, for example) the incoming dentist must notify the patients in writing of the circumstances and that patient records are in their possession
The purchase and sale agreement typically contains provisions that transfer the responsibility to retain the records to the purchaser and gives the vendor the right of access to the records if required for the defence of a complaint or a claim against the dentist.
Prior to the sale, review the ongoing treatment needs of individual patients and identify those who are part-way through treatment.
Establish a plan of completion for these patients, with financial arrangements that do not cause them unnecessary hardship.
The purchasing dentist may have a more limited scope of practice or different areas of expertise than the selling dentist. If the completion of treatment will require a referral to a general dentist or dental specialist outside the practice, consider who will make the referral, and the effects on financial arrangements.
Make a plan for retreatment of failed treatment. Include the plan as part of the agreement of purchase and sale.
Consider a transition period in which both dentists work at the practice, and patients have the opportunity to get to know the new dentist. Ideally, the selling dentist will complete treatment and take care of retreatment.
Identify patients with special financial arrangements with the selling dentist (e.g. a payment plan or assignment of dental benefits). The purchasing dentist could either agree to continue those arrangements, or notify patients in advance of any change in office financial policy that will affect them.
The purchasing dentist should discuss in advance with the patient the rationale for performing a comprehensive new patient examination, as well as the related cost. Patients charged a much higher fee than they are accustomed to for their first examination must be informed of the difference between this exam and their usual recall examination.
You should inform the patient of the treatment required. The purchasing dentist should consult with the selling dentist about the treatment provided. If the selling dentist is no longer working in the practice, any release of personal health information will require the patient’s consent.
All dentists, regardless of their expertise, will have outcomes from time to time that were not anticipated and the purchasing dentist may not be aware of circumstances that may have contributed to the failure of the patient’s treatment.
Consider ways to smoothly introduce any change in dental treatment philosophy. Discussing changes in treatment plans with patients will help avoid misunderstandings. Both parties may wish to discuss their respective treatment philosophies at an early stage in the sale negotiations to determine whether the practice is a good fit.
Dentists will continue to be covered indefinitely by the errors and omissions coverage under the Professional Liability Program for claims arising out of professional services provided to a patient in Ontario while they were a member of the College.