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Planning for Practice Continuation or Transition

Whether you're considering retirement or experiencing health issues, you'll need to step away from your career at some point. It might be tough to put your orthodontic practice in someone else's hands, but you shouldn't wait to create plans for practice continuation or transition.


If you don't have a strategy for passing your practice on to another orthodontist, you could put your patients at risk or create complications for your heirs.



Our claims team compiled the following case studies to help you develop a smooth transition or continuation plan.


Situation 1: Planning for Continuation in the Event of Death

An orthodontist passed away, leaving his wife to arrange for the continued care of the practice's patients. The orthodontist's wife was stressed due to the loss of her husband, and she had no experience dealing with practice continuation.


The orthodontist's office was in a remote location, and few orthodontists practiced in the area, so no one was close enough to take over patient care. The patients were unwilling to travel.



If you want to avoid leaving complications for your loved ones, it's wise to arrange a continuation plan before problems develop. Many of you belong to study clubs where member orthodontists agree to fill in for each other in the event of incapacitation.


If you are not in a study club, try to arrange for such an agreement with other local orthodontists. It will benefit everyone.



Be sure the agreement is in writing and all involved doctors are named. Having the agreement in writing will give all participants peace of mind and ensure someone in the group will interface with the estate (if appropriate), or that one or more doctors will fill in during the period of incapacitation.


Situation 2: Planning for Transition Due to Retirement

An orthodontist sold his practice and retired. The doctor who bought the practice bad-mouthed the retired orthodontist's treatment to parents of a patient, resulting in a lawsuit against the retired orthodontist.


The new doctor would not release patient records to the retired orthodontist, and he was unable to completely defend himself. Fortunately, the retired orthodontist had a copy of the patient's treatment chart, so he could refute some of the claims against him.



If you sell your practice, try to keep a copy of all patient records. At the very least, make sure you have all the treatment charts.


As more practices move to digital record systems, it will be easier to keep backup copies of all the patient records, so you will be able to build a stronger defense in the event of a claim.


Situation 3: Planning for Continuation Due to Financial Issues

An orthodontist found himself in serious financial trouble with no borrowing power. He couldn't pay his creditors, so he couldn't purchase supplies to treat his patients. He closed his office abruptly and filed bankruptcy.


The orthodontist was unable to convince local orthodontists to take over patient care. The patients perceived the orthodontist's actions as abandonment, so they filed complaints with the state regulatory agency and notified the media of their dilemma.



When financial difficulties threaten your ability to practice, negotiate with one or more area orthodontists to assume care of your patients. If you can, transfer enough money to cover fees for some of the remaining treatments. Patients who pay for treatment at the beginning will not be willing to pay a second doctor.


If an assisting orthodontist is upset about lack of payment, that can lead to a malpractice claim or a regulatory complaint. To support the claim, the new orthodontist often alleges the original treatment was below the standard of care.


For Every Situation

When you're unable to treat your patients, arrange with your malpractice carrier to endorse locum tenens coverage in your malpractice insurance policy. This coverage allows your successor to be temporarily covered under your policy so they are not exposed to additional risk under their own policy.


If you need more guidance for your transition plan, AAO provides a wealth of practice transition resources here. You should also use AAO's Practice Continuation Agreement