Closing a Practice Without Notice and Withholding Records
Dr. W, age 68, decides to retire in 10 days. He sells his practice to Dr. N, a younger dentist who will take over the office and the records. Dr. W posts a sign on the front door: 'Closed. Records transferred to Dr. N.' He does not send letters to his 1,200 active patients. Three patients are mid-treatment: one has a temporary crown, one is six weeks into clear aligner therapy, and one has a fractured tooth scheduled for extraction. Patient X calls for a copy of her radiographs and chart; she owes $340. The front desk tells her records will be released only after the balance is paid. Dr. W also tells staff not to mention Dr. N because 'patients will figure it out.' The patient with the temporary crown cannot reach anyone, goes to an emergency department with pain, and complains to the Board. Dr. W says he sold the practice and 'the records went with it,' so he has no further duty.
1. What Board rule or legal principle governs patient abandonment when a dentist closes a practice? Did Dr. W comply?
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The Board treats abandonment as unprofessional conduct. A dentist who closes or sells a practice must give active patients advance written notice, tell them where records will go, and give them a reasonable chance to transfer care. A sign on the door is not adequate notice for 1,200 patients. Dr. W did not comply: he gave no individual notice, no explanation of how to obtain records, and no plan for patients mid-treatment. The patient with the temporary crown was left without a contact, which is a classic abandonment risk. Selling the practice does not automatically end the dentist's professional obligations to patients of record.
2. May Dr. W withhold Patient X's records because she owes $340? What must he provide and how quickly?
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No. A patient's clinical records and radiographs belong to the patient's care, not to the dentist as security for a bill. The Board and general law prohibit withholding records to collect a fee. Dr. W may charge a reasonable copying or duplication fee, but he cannot condition release on payment of the outstanding balance. He should provide copies promptly, typically within a set number of days under the Board's rule or state law, and may send them to the patient's new dentist with written authorization. He should document the request and the response.
3. What should Dr. W have done for the three mid-treatment patients and for record transfer generally?
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He should have identified all active patients, sent written notice at least 30 days before closing (or the period the Board requires), offered to transfer records to Dr. N or another dentist, and obtained patient authorization for transfer. For mid-treatment patients, he should have arranged completion of care or a direct handoff with a specific appointment. He should have kept records secure and accessible, posted notice only as a backup, and trained staff to answer questions. If he could not meet the notice period, he should have delayed retirement or arranged emergency coverage.