One of the largest challenges facing a solo practice, paper-based physician is the ability to find a replacement physician. Many new graduates prefer to practice in a team setting, with a fully functional EMR/EHR and shared responsibilities within the group for addressing day-to-day operational requirements. Some ways to address this include:

• Ensuring your clinic promotes what may be attractive to new graduates. This includes group practices, EMRs, financial considerations, work-life balance, mentorship, vacation coverage, equitable workload, and diverse practice options. 
• Do specific outreach to select someone to take over practice. This can include finding a candidate who may be a new graduate or locum you bring into the practice. Take the time to help them learn the practice and get to know the patients. While this may be a large time investment, it can yield a high return on investment. The checklist in Appendix A can assist you in keeping track of important details.

Identify all your practice locations, private or government owned clinic, hospital, LTC, private surgical facility, etc., is an important start to developing a plan to transition care to another provider. The first step may be to discuss with the Medical Director of any facilities you attend to ensure the Medical Director is assisting in the retirement process from a replacement and continuity perspective.

• Colleagues may be able to assist by taking on some of your patients. Contacting other physicians may open some pathways for your patients. 
• The Manitoba Family Doctor Finder Program is an additional resource. Encourage your patients to assist in the search by having them consult with family members, friends, and neighbours as there may be some colleagues willing to take a family member of a current family they care for. 
• Ensure patients with complex needs are given ample time to secure care from another physician. 
• For those without CMPA coverage, ensure you check with your underwriter about coverage post-retirement.

Expect it to be an emotional event. While your patients may be happy for you, they will be concerned for their ongoing care. Be prepared and plan a bit more time as these may be longer appointments.

• Plan for a smooth transition. Update your patient records to ensure you have correct contact information. Have a script prepared (see Appendix B) for a consistent message. 
• Samples letters for transferring or closing your practice can be found here.
• For staff, ensure their needs and concerns are addressed, including offering a retention bonus to stay until the end and job placement resources if needed. 
• Make sure to check in about your own wellness. Ending your relationship with patients can be stressful and emotional. Doctors Manitoba has physician health programs and services to support you.

Your last day of clinic won’t be the last day of work. There will likely be still follow up reports and lab results that need to be handled. The fee-for-service claims system may still be dealing with your most recent claims and any queried or pending claims. The billing cycle will continue until the last of your claims are resolved. Maintaining access to your patient and billing records is essential in case you are audited. 

CMPA has discretionary capacity to provide assistance to physicians after they have retired in case an issue arises. For more information from CMPA related to retiring or ending your practice can be found here.