Two Issues to Consider When Joining a Clinic

Registrants need to consider several things during the process of joining a clinic. Some are business-related, such as the rental agreement with the clinic owner, and some are regulatory-related, such as who owns the patient records.

From the regulatory perspective, two of the most frequent practice related issues Registrants ask us about are, who owns the patient files and how are patients to be notified when the Registrant is leaving a clinic. Discussing these issues with the clinic owner and putting them in writing when joining a clinic will make things much easier should the Registrant later choose to leave.

It’s recommended that Registrants consult with a lawyer who is familiar with the College’s regulations and standards of practice before signing a contract. Understanding the College’s requirements and having a written agreement in place can be helpful in avoiding future disagreements with the clinic owner, and reduce disruptions to patient care and access to patient records.

Ownership of Patient Records

Registrants are responsible for all patient records they have created and must make sure that they are maintained and stored in accordance with the Standard of Practice for  Record Keeping. It’s recommended that the contract clearly states that the Registrant owns the patient health records and consequently retains the original files should they leave the clinic.

If a Registrant has signed a contract giving the ownership of patient records to the clinic, and the clinic owner will not allow the Registrant to take the original records when they leave, it is the responsibility of all parties to act professionally and come to an agreement to ensure patient records are retained according to the Standard of Practice for Record Keeping and the Personal Health Information Protection Act.

Keep in mind that the issue of whoever retains and maintains the patient record is separate from the issue of who the patient chooses to receive their health care from. The original patient record may be stored in one location while the patient chooses to see a practitioner somewhere else. The clinic where the patient first saw the naturopath does not and cannot “own” the patient. This can often be a point of contention when the naturopath leaves a clinic.

Notifying Patients

The Code of Ethics states that “reasonable notice of termination of care is to be provided to the patient”. The Standard of Practice for Record Keeping says that when a Registrant moves their practice “patients are notified in writing as to how they can obtain access to their patient records.”

Depending on where the Registrant is moving to, patients may choose to continue care with them or remain at the clinic if a new naturopath is taking over. Either way, it’s the Registrant’s responsibility to ensure that patients are notified in writing that they are leaving and where their records will be located. The Registrant, however, may designate someone to notify patients on their behalf. This should be discussed, agreed upon, and included in the contract. The College does not dictate how far in advance patients are to be notified. This depends on how far ahead of time the Registrant knows they will be leaving. In some cases notification can be months ahead or sometimes weeks.

While it may seem inconvenient or awkward to request from the clinic owner that a contract be put in place, all parties, including patients, will be better protected in the long run.