• Starting, Closing, or Selling a Practice

    Starting a Practice

    Starting a practice is a detailed and lengthy process. It is important to consider your options, and to evaluate your tolerance for risk. Although it will come with difficulty, starting a practice can have great rewards and is possible with the right resources. The American Academy of Family Physician (AAFP) Starting a Practice tool (149 KB XLSX) helps guide you through the process.

    The tool helps you determine start-up expenses, develop a monthly budget, and assess evaluation and management revenue for a traditional physician practice. It can also help you understand and track your practice’s patient-visit goals. The checklist offers steps that can be taken for a reasonable implementation timeline. Appropriate planning can result in a successful practice, and this tool can help you begin that planning process.

    As with any business venture, it is important to contact an accountant and an attorney for financial and legal advice to start your practice. This ensures you are making sound business decisions and complying with legal issues related to your profession.

    Closing or Selling a Practice

    Retiring and selling or closing your practice can be an exciting, yet complicated process. You may feel consumed by details and deadlines involved with the closing process and may wonder where to begin. The AAFP Closing Your Practice Checklist(1 page PDF) provides you with a number of notifications and tasks that guide you through the process of closing your practice.

    As with starting a practice, closing a practice includes a number of financial and legal issues. You’ll want to contact an accountant and an attorney to help you navigate financial and legal issues related to closing or selling your practice.

    Medical Records

    Keep the following in mind about medical records when closing or selling a practice:

    • Medical records cannot be transferred to another physician without the patient consent.
    • Patients must be given the option to choose another doctor and have a copy of their records sent to the physician of their choice.
    • Medical records cannot be part of the sale of the practice. If you are selling your practice to another physician, that physician can only become the legal custodian of the medical records and respond to record requests from patients, health facilities, or legal entities.
    • The length of time required to keep a patient's medical record varies according to state law. Your state medical board can help you determine the rules for your area.

    Notifying Patients of Practice Closure

    When closing a practice, you should send a notification letter to the patients you have seen in your practice within the last three years. An example letter follows:

    Dear (Insert Patient Name):

    I am writing this letter to inform you that I will no longer be able to serve as your primary care physician at (insert practice name). After ___ years, I have decided to retire and close my practice. (If you are closing your practice for any other reason, this can be stated here.)

    The last day that I will see patients will be (insert date). I will continue to provide medical care for you prior to this closing date. I have enclosed an authorization form for you to complete and return to our office to have your medical records forwarded to a new health care provider of your choice.

    Once the office is closed, your medical records will be stored at (let patient know where they will be stored). Future medical record requests can be sent to (insert address). Requests will be filled as per time limitations dictated by state law retention requirements.

    Thank you for trusting me with your health care needs throughout my time at (name of practice). It has been a pleasure caring for you. I wish you continued health and happiness in the future.


    (Insert Physician Name), MD/DO