When a Doctor Suddenly Leaves the Practice

Jeffrey J. Denning

Disclosures

June 05, 2013

Dear Partners: I Quit, Effective Immediately

You have probably lived through this scenario at least once: A valued physician resigns on short notice. Your days in the office are disrupted, productivity declines, and service levels go into the tank. Profits may be hard hit. Finding the right replacement can be an extreme challenge, especially if it has to be done in a hurry.

Physicians leave practices for a variety of reasons. Several of these situations can be planned for: for example, normal retirement, or resignation to take a faculty or other salaried position. Unexpected exits due to death or disability should be contemplated in a buy/sell agreement among colleagues or be insured against. But when a partner quits on short notice, it's often to enter into competitive practice for one reason or another. Most practices don't have a contingency plan for this situation. They should.

A Constructive Response to a Sudden Exit

No matter the reason, the sudden exit requires some quick thinking by the physician or physicians who remain. They need to assemble a quick plan of reaction. You probably don't think it will ever come up. That's the very definition of a contingency, and the reason you need a standby plan in case it does.

At the least, consider the questions raised by such a parting. Who will see the doctor's patients? Can we preserve his or her practice? How will we cope with overhead in the doctor's absence? Do we need to replace this individual? Should/could the replacement be a physician assistant or nurse practitioner? If not, should the next physician be a new recruit fresh from training or someone from the community who might join us?

In any case, stay calm. No matter what the circumstances, an emotional reaction won't help and could set you back. You may get angry -- justifiably. But that won't help and could hurt matters if it causes you to act rashly or say something you'll regret.

Find out why the doctor is leaving. The stated reason may not be the real reason. Does it make sense? Could you prevent it? Do you want to? If you're feeling hurt or angry, you may not want to reconcile things at this moment. But in some instances, it may be the best thing to do. Remember that some people have trouble articulating their issues.

Physicians are notoriously nonconfrontational. So they bottle up their emotions, only to walk out in a huff later when things get to the bursting point. For some, escape is the only available route to resolve a bad situation. However, if the doctor who wants to leave is given a new chance, it may be possible to redeem the situation and save the upset of a departure.

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