Regulation Matters 2022 - Issue 1, May

Professional Practice Question: What Do I Need to Know about Closing My Private Practice?

Thinking of closing your private practice? Are you retiring or moving out of a private practice setting? Here are three topics to consider if you’re thinking of transitioning from private practice:

Record Keeping: What considerations are there for my client records when closing a private practice?

Dietitians in private practice should have formal arrangements for the safekeeping and transition of client records in the event of any changes in practice (e.g., bankruptcy, illness, transferring to a successor). Dietitians are encouraged when entering into group practices, such as clinic settings, or starting their own practice, to have such formal agreements.

Such agreements may include contractual agreements and policies designating roles and responsibilities for client records, and who will be responsible for client health records in the event that a dietitian is no longer able to practise. A proper succession plan can help mitigate the risk of abandoned health records and ensure clients have access to their health records while maintaining privacy.

You can start by asking whether you are the Health Information Custodian (HIC) or the Agent. Custodians have obligations as outlined in the Personal Health Information and Privacy Act, 2004 (PHIPA). These College resources (and part two) may help you determine whether you are the HIC or the Agent. Knowing this can help you determine your responsibilities.

If you are the HIC (e.g., usually a solo practice): You must retain client health records securely for the retention period specified in the College’s Professional Practice Standards for Record Keeping – usually 10 years after last client visit, or 10 years from the date a client turns 18 years of age, if a pediatric client. You must also inform clients how to access their records, if they wish, in the future.

If you are the Agent (e.g., usually a shared clinic-based practice): You must comply with PHIPA and any organizational policies developed by the HIC in their workplace or clinic. You have an obligation to work with the HIC to take reasonable steps before ending services to ensure that records are dealt with appropriately, and to identify clients which require ongoing dietetic care.

Dietitians must make reasonable efforts to ensure that clients know where their records are and if they are in an electronic medical record (EMR), clients may still be able to access this via the clinic. If you have paper charts, there needs to be a system of retention in place so clients can access them. Additionally, the Information and Privacy Commissioner of Ontario has an excellent resource on how to avoid abandoned health records.

Transfer of care of clients: Who do I have to notify of the closure?

If the private practice is being transferred to another dietitian, the departing dietitian is responsible for notifying clients — preferably before the transfer of care to a new dietitian — of the new dietitian’s contact information. There is no specified amount of time in which to do this but it should occur within a “reasonable” period of time. This allows clients to determine whether they wish to continue with the new dietitian or seek dietetic services elsewhere. Clients should be provided options on how to access dietitian services.

When transferring records to a successor, the successor becomes the custodian. For example, when a dietitian retires, the records may be transferred to another dietitian. 

If the practice is not being transferred to another dietitian, and is closing permanently, the dietitian should notify clients of the closure. If a client requires dietetic service, a dietitian should not discontinue care unless the client requests the discontinuation, alternative services are arranged, or the client is given reasonable notice to arrange alternative services. Information on how to access alternative dietetic services should be provided by the departing dietitian if clients request this, in both situations.

Member profile information: Inform the College of updates

Got a new job or change in job? Retiring? Congratulations! A final consideration, and an easy one to check off your list, is to inform the College of any updates or changes to your practice. Dietitians must update their member dashboard profile within 30 days of changes to your personal contact information, employment details, changes in work status or concurrent registration in another jurisdiction. If you are resigning from the College, you must notify the College online or via email if you intend to resign your membership. Further details can be found here.