Articles

The first four articles were originally published in the Lifemembers’ Newsletter of the American Psychiatric Association, in their Spring 2014, Summer 2014, Fall 2014, and Winter 2014 editions, respectively. 
[The four articles are reprinted here with the permission of the APA]

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Denial is Great, but Our Patients, Families and Colleagues Need Our Attention – First in a series of articles on “professional wills, wonts and won’ts.”

 

A. Steven Frankel, Ph.D., J.D.[i]

I’m writing to you two months after turning 71 years of age.  I’ve been a licensed, practicing psychologist in California since 1970, I am an attorney at law in legal practice since 1997. and am a member of both the California and D.C. Bars.

This is the first in a series of articles I’ve been welcomed to write for your Newsletter on the topic of planning for/ and/or coping with an unanticipated terminations of practice, due to death or disability.  You might not be surprised by the tendency to turn the page in this Newsletter, to see what else might be fun to read, but try to hang in there for at least a few more sentences so I can tell you how I got to be the person who’s raising this issue with and for you.

I began my psychology career as an academic  – in the Department of Psychology at USC.  After12 years of full time university service, I realized that teaching was fun , but I needed to make a living.  I went into clinical practice, which I still enjoy, but which I now practice only on Wednesdays.  The rest of the week, I’m in the practice of forensic psychology or health care law ( where my primary area of legal practice involves defending health care professionals facing licensing board actions).

Shortly after finishing my legal education, I began to receive calls from the spouses and partners of mental health professionals in California – very disturbing calls – centered around the tragic losses of  a spouse or partner due to unanticipated death or disability.  In the midst of their grief, they also faced enormous additional distress over how to handle calls from patients, insurance companies, landlords, debt collectors, and a host of others.  They were also concerned about demands for records,  Were they permitted to see the records,  or to be in contact with patients who were demanding records and who were suffering in their own grief over the loss of their treating professional.  How were they to navigate all of these issues while grieving.  It might not surprise you to know that I didn’t know what to tell them or how to advise them, nor did anyone else I contacted whom I thought might know.

Another post-law school development was that I was invited to develop and teach post-licensure programs for mental health professionals in lawsand ethics, programs which many colleagues must take for license renewal.  That meant, of course, that I had to learn the minutiae of legal and ethical principles that guide our practices so I could assist colleagues with that knowledge, in the service of safe and ethical practice.  As I began these studies, I discovered that all of the professional societies’ ethics codes for non-physicians require licentiates to prepare for unanticipated terminations of practice due to death or disability, and I also learned that an increasing number of states have enacted laws that impose the same requirements, also including physicians.  Finally, I became aware that there is a group within organized psychiatry that is creating a new ethics code with the goal of having it adopted as the ethics code for psychiatrists, as a replacement for the “Annotations to the AMA Ethical Code, as Applied to Psychiatry”.  The proposed code will include this same ethical obligation.

As I taught this material in my law and ethics courses, I began to see eyes glaze over at the mention of the topic .  When I began to ask how many colleagues had taken steps to address the issues, fewer than one out of every hundred attendees raised their hands.

I tried everything I could think of to raise the consciousness of colleagues and to explore ways that the issues could be addressed – how to break through the denial.  I read (and taught about) “professional wills” – documents that professionals would create that articulated their wishes for what could most benefit their patients, families and colleagues, in the event of an “event.”  I read (and taught) about how to work with a single colleague or groups or “teams” of colleagues, about what to do and how to plan for “events.”  Over the past decade, I have been gratified to see an increase from less than one per hundred course attendees who had addressed these issues in their practices, to the present time, when there are approximately three out of every hundred attendees who had developed plans.

My phone continued (and continues) to ring.  Significant others of colleagues continue to call, frantic, grieving, angry, frightened and lost as to how to cope with the issues that arise as a result of an event.  Surviving colleagues call when they wish to intervene at the time a colleague of theirs has an event, wanting to know how to help and shuddering at the nature of the tasks involved.  To whom should patients be referred, can they actually talk to patients with no without a releases, what about current records, what about the old records, what about furniture, furnishings, bank accounts, art on the walls, office leases, telephone numbers, accounts receivable/payable, and on and on….

I finally “got” that the majority of our colleagues, particularly our seniors colleagues, were not able or willing to come to these issues and tasks without assistance, and that there appears to be a distribution of willingness and ability to embrace the tasks and develop and implement a plan.  Some of us respond to good old-fashioned shame (e.g. “How could you subject me – your partner/spouse/colleague/patient – to coping with both your loss and the desperate practical needs I have to deal with, now that you cannot help?”)

Others respond to contacts from colleagues, such as ”Let’s work together on this – I’ll do it for you if you do it for me.”  Of course, they soon realize that one of them will be doing it for someone else, in the future, since one will invariably pre-decease the other.

Still others respond to something like  “Let’s form a team of colleagues who take on the task of anticipating and coping with such events.  With a team, the loads for each of us to carry are significantly less than if we do this as pairs, and, similarly, the pain is more broadly shared.”

Finally, there is the emergence of a company that is creating a national network of experienced senior (in the sense of having been in practice for at least 20 years) colleagues who work, in coordination with an administrator and an office staff member, to manage the transition of a professional practice when an event has taken place.  Some may find this the most efficient way of handling the issues and worth the financial cost.

In future articles, I’ll address each of these coping strategies and attempt to make the approaches I’ve outlined above more real and clear.  I’ll point out the up-sides and the down-sides of each approach and will try to be as concrete as I can, regarding supportive elements available through colleagues, through the internet and beyond.


[i] If you are interested in a closer look at the issues and support systems, you’re welcome to contact me via www.practice-legacy.com

 

 

“I’ll do it for you if you’ll do it for me.” The Partnership Approach
to Professional Wills, Wonts and Won’ts.
A. Steven Frankel, Ph.D., J.D.i

 

Welcome to the second article on ways to address the problem of how to prepare for unanticipated disruptions or terminations of practice due to death or disability. In this article, I address a way of approaching the problem that has been around the longest in our fields – the professional partnership model.

Where to start:
The partnership approach requires that two colleagues make an agreement to “be there” in the event of a disruption in one of their practices.ii The modal strategy is to form a relationship with a colleague who practices in your geographic area, with the specific agenda of assisting each other with a practice transition in the even of an “event.” The typical approach is to work with a fellow senior colleague, as practice seniority is associated with a good working knowledge of how practices work, the ways in which records are kept and managed, a familiarity with other psychiatrists who practice in the community, their specialties and other indicia of relevance to being good choices for referrals
of one’s patients, etc.
Informed consent:
The standards of care for psychiatric practice require that patients be provided with informed consent to treatment, which typically includes: 1) diagnosis, 2) proposed treatment plan (with nature, purpose, risks/benefits), 3) alternative treatment plans (with nature, purpose, risks/benefits), and 4) likely
consequences of no treatment.iii In addition, informed consent includes information about how the practice operates – limits to confidentiality, fees and payments (including insurance), accessibility, emergency procedures and access to records.
When a partnership between colleagues is created, the informed consent discussion and documentation should include an identification of who the partner is (“if I do not respond to phone calls, letters, etc., please call ……..”), that the partner has agreed to manage the transition of the practice, and that, by signing the informed consent document, patients authorize the partner to view charts and make direct contact with the patients for the purpose of practice transition. The only foreseeable problem with this part of the plan is that, especially in “small” communities, there may be a patient who, at one time, has received services from the colleague, and refuses to sign a release for that reason. For such patients, an alternative means of providing a referral and transmitting records must be found.
Transition Tasks:
In the event of an “event,” the following tasks must be addressed by the surviving colleague: 1. Notification of patients: The surviving colleague’s job begins with the notification of patients that an event has occurred. This process is best done by the colleague rather than an office staff member, as
psychiatrists are familiar with the grieving process and are best qualified to assist patients with the transition of care during that grieving process.
2. Making referrals: The surviving colleague’s responsibilities include referring the patients to a new treater. Ideally, the issue of what will happen in case of an “event” has already been discussed with each
patient, with an eye toward who might be the best colleague for each patient to see in the future. These discussions are typically quite beneficial to patients, who appreciate being thought of in protective ways, such that they already know who they will be seeing for future care.
3. Transfer of records: The surviving colleague’s responsibilities include ensuring that patient records are forwarded to the new treater, or provided to the patients who request them consistent with the laws of the jurisdiction of the practice.
4. Office rental: the surviving colleague’s partnership arrangements should already have been explained to landlords of office buildings, such that provisions for payment of rent, disposal of equipment and
furnishings and associated tasks can be completed smoothly. 5. Family: the families of colleagues going through life transitions will be grieving, and the partnering colleague’s responsibilities include reassuring families that preparations for transitions have been made and are being implemented properly. 6. Estate-planning attorney (wills/trusts): the partner should be aware of the identity of the estate-planning attorney, who, in turn, should have permission to discuss the estate plan and to provide funds for handling practice transitions, as there will be expenses associated with practice transitions.
7. Accounts payable and receivable: an important part of the transition partnership should include  information as to billing and payment processes/procedures, such that the surviving colleague is able to
ensure that bills are paid and collections are received. The partners’ names should be known to the banks, such that checks may be written and deposits made.
8. Telephone: colleagues should contact the relevant phone company and arrange to forward calls to the surviving colleague’s telephone number.

9 Notices: the surviving colleague will place a notice in the local newspaper for two weeks, indicating that the practice is in transition and how to contact the surviving colleague. Further, notice should be provided to licensing boards, insurance companies and professional societies.

10. Computer access: surviving colleagues should be fully knowledgeable as to computer passwords and computer access to information.
11. Insurance: It is strongly recommended that partners take out term life insurance policies of $10k-$20k (which, at this time in history, are quite inexpensive), to support the partner during the transition
period, as the amount of time that colleagues will be putting in to assist with the transition can be compensated in this way.
12. Personal “good-bye” letters: It is a matter of grace and kindness for professionals to leave letters in the charts of all patients – which can then be mailed to each patient, with a simple statement of
farewell, of appreciation for having had the opportunity to provide care, and wishes for future benefits from the care provided.
13. Access to offices: keys, pass-codes, access to files, awareness of staff and their availability – all of these must be known to the surviving colleague.
14. For colleagues who utilize EMR for record-keeping, releases need to be signed by patients to provide access by the surviving colleague.
Down-sides of the “partnership” approach:
If you are still reading this article, you may be coming to realize that the partnership approach has two significant downsides. First, it is exhausting. The amount of time and the degree of detail involved can be overwhelming, and it is this degree of apprehension that has led to such a slow development of
acceptance and implementation of these types of partnerships. Second, a major downside of the partnership model is that one of the partners will most certainly pre-decease the other, such that the surviving partner will have to find another colleague to join with for the future. Thus, the enormity of the tasks and the awareness that more than one of these experiences awaits colleagues who wish to be helpful, add to the general denial and avoidance that keeps us from developing needed plans.
The next article in this series will present a related model, involving a group of colleagues rather than a partnership of two colleagues. Such a model makes some of the overwhelming qualities of the partnership model less foreboding, but has problems of its own. The fourth paper in the series will discuss a quasi-insurance model that has been developed to deal with these issues and problems in ways that are far less intimidating to colleagues. i i If you are interested in a closer look at the issues and support systems, you’re welcome to contact me via www.practice-legacy.com ii Frankel, A.S. (2013). Practice continuity, Nevada Psychiatric Association Convention and Frankel, A.S., & Alban, A. (2010). Professional wills: protecting patients, families and colleagues. California Psychiatrist, February, 2010. pp.4-6. –iii See, e.g., Simon, R.I. (1992). Clinical psychiatry and the law, 2nd Ed. Washington, DC: American Psychiatric Press, p. 128.

 

 

“T-E-A-M, YAY, TEAM!” The Team Approach to Professional
Wills, Wonts and Won’ts.
A. Steven Frankel, Ph.D., J.D.i

 

Welcome to the Third article on ways to address the problem of preparing for unanticipated disruptions or terminations of practice due to death or disability. In this article, I address a more efficient way of approaching the problem, which has developed to help manage the overwhelming set of tasks to be done when a colleague dies or becomes disabled than having one partner at work – the team approach.

Where to start:
The team approach requires that a group of colleagues make an agreement to work together on development and implementation of a management plan in the event of a disruption in one of their practices.ii The modal strategy is to form relationship with colleagues who practice in your geographic area, with the specific agenda of assisting each other with a practice transition in the event of
an “event.” The typical approach is to work with fellow senior colleagues, as practice seniority is associated with a good working knowledge of how practices work, the ways in which records are kept and managed, a familiarity with other psychiatrists who practice in the community, their specialties and other indicia of relevance to being good choices for referrals of one’s patients, etc.
The Team Leader:
The selection of the team leader is a critical part of the creation of the team, as the leader’s function is to decide on the assignments of team members to the list of tasks that must be managed for the team’s work to be successful. This means that the team leader must have a sense of how each member’s
personal style and particular skill set fits with the tasks to be done, to manage the team members’ functioning, and to be sensitive to problem issues that may arise over the course of time. Such problem issues may include life problems or distractions that strike a member of the team from time to time, friction or conflict between one or more members of a team, failures of one or more team members
to abide by commitments to do the work of the team, etc. Team leaders will focus on how the team members are in place in order to manage the crises that develop when any team member has an “event,” such that all members focus on performing their assigned tasks for all of each others’ practices. Team leaders arrange for meetings of team members on a regular basis, to ensure cooperation, readiness and preparation for “events.” Team leaders are more effective when they consider the variations in the
practices of other team members. Thus, while some proportion of the team may engage in a general psychiatry practice, with medication management and psychotherapy, other practices may focus on psychoanalytic treatment, while still others may be primarily medication management in nature. Each style of practice will require team leaders to work with members such that adequate referrals are provided when needed as well as for the differences in referral needs for patients. For example, when a colleague whose practice is primarily devoted to medication management, the team will need to find referral psychiatrists who have medication management openings in their practices and may need to prescribe medications for patients who are low or out of medications when their psychiatrist has an event. Ensuring that such prescription activities are proper within the jurisdiction of the practice falls to the team leader, who should contact the Medical Board in his/her jurisdiction to ensure that such
conduct is proper. Beyond the distribution of practice transition tasks that make a team approach more efficient than a single partnership approach, is the fact that a team that meets and works together is more likely to provide occasions for colleagues to be sensitive to symptoms of possible degenerative neuro-cognitive disorders among team members. Research suggests that at least 10% of colleagues over the age of 65 are likely to develop such disorders, and, as the number of colleagues in that age range increases over the next decade or two, we will be facing significant risk among our colleagues. Thus, the eyes, ears and training of a team of colleagues may be very helpful as regards sensitivity to the development of symptoms among team members.
The size of teams:
The number of colleagues in geographic proximity to each others’ practices will be determinative of team size, as colleagues who practice in small or rural communities will have fewer colleagues close-by than will those who practice in more highly populated areas. Team size will thus, to a great degree, be determined by geography. When possible, teams of 4-5 colleagues appear to be most helpful in making the work efficient and the team effective.
Division of tasks:
The tasks faced by the team are identical to those described in the second article in this series, dealing with the partnership model.

Informed consent:
When a team of colleagues is created, the informed consent discussion and documentation should include an identification of who the team members are, that the team members have agreed to manage the transition of the practice, and that, by signing the informed consent document, patients authorize the team members to view charts and make direct contact with the patients for the purpose of practice transition. One foreseeable problem with this part of the plan is that, especially in “small” communities, there may be patients who, at one time, have received services from one or more of the team members, and refuse to sign a release for that reason. For such patients, an alternative means of providing a
referral and transmitting records must be found.
Transition Tasks to be assigned to specific team members:
In the event of an “event,” the following tasks must be addressed by a team member:
1. Notification of patients: The team member’s job begins with the notification of patients that an event has occurred. This process is often best done by a team member rather than an office staff member, as psychiatrists are familiar with the grieving process and are best qualified to assist patients with the transition of care during that grieving process.
2. Making referrals: The team member’s responsibilities include referring the patients to a new treater. Ideally, the issue of what will happen in case of an “event” has already been discussed with each
patient, with an eye toward who might be the best colleague for each patient to see in the future. These discussions are typically quite beneficial to patients, who appreciate being thought of in protective ways, such that they already know who they will be seeing for future care. 3. Transfer of records: The team member’s responsibilities include ensuring that patient records are forwarded to the new treater, or
provided to the patients who request them consistent with the laws of the jurisdiction of the practice.
4. Office rental: the team member’s arrangements should already have been explained to landlords of office buildings, such that provisions for payment of rent, disposal of equipment and furnishings and associated tasks can be completed smoothly.
5. Family: the families of colleagues going through life transitions will be grieving, and the team member’s responsibilities include reassuring families that preparations for transitions have been made and are being implemented properly.
6. Estate-planning attorney (wills/trusts): the team member should be aware of the identity of the estate-planning attorney, who, in turn, should have permission to discuss the estate plan and to
provide funds for handling practice transitions, as there will be expenses associated with practice transitions.
7. Accounts payable and receivable: an important part of the transition team member assignments includes information as to billing and payment processes/procedures, such that the team member is able to ensure that bills are paid and collections are received. The team member’s name should be known to the banks, such that checks may be written and deposits made.
8. Telephone: a team member should contact the relevant phone company and arrange to forward calls to the team member’s telephone number.
9. Notices: a team member will place a notice in the local newspaper for two weeks, indicating that the practice is in transition and how to contact the surviving colleague. Further, notice should be provided
to licensing boards, insurance companies and professional societies.
10. Computer access: a team member should be fully knowledgeable as to computer passwords and computer access to information.
11. Insurance: It is strongly recommended that team members take out term life insurance policies of $10k-$20k (which, at this time in history, are quite inexpensive), to support the team during the
transition period, as the amount of time that colleagues will be putting in to assist with the transition can be compensated in this way.
12. Personal “good-bye” letters: It is a matter of grace and kindness for professionals to leave letters in the charts of all patients – which can then be mailed to each patient, with a simple statement of
farewell, of appreciation for having had the opportunity to provide care, and wishes for future benefits from the care provided.
13. Access to offices: keys, pass-codes, access to files, awareness of staff and their availability – all of these must be available to the team members.
14. For colleagues who utilize EMR for record-keeping, releases need to be signed by patients to provide access by the team member
Down-sides of the “Team” approach:
If you are still reading this article and if you have ever worked with a group, you may be coming to realize that the team approach has two significant downsides. First, depending on the geographic area of one’s practice, assembling a team may be next to impossible. Second, a major downside of the Team model is that it is a group, and, as those readers who are familiar with group processes know, groups do not always function smoothly. Disruptions in the lives of group members, conflicts between group members, problematic assignment of transition tasks to group members, problematic management style of group leaders, all can lead to disruptions and ineffectiveness of group process and effectiveness. These difficulties add to the general denial and avoidance that keeps us from developing needed plans.
The next article in this series will present a newly developing model, involving a quasi-insurance approach which assigns a colleague who is trained to be a “Transition Specialist” (“TS”) to a  Subscriber’s” practice. The TS visits the Subscriber’s practice annually, assisting with the planning and management of the practice so as to facilitate practice transition at the time of an “event,” and who works with office staff (or “temps,” where there are no office staff members already) to effectuate a smooth transition .i i If you are interested in a closer look at the issues and support systems, you’re welcome to contact me via www.practice-legacy.com
ii See Dr, Ann Steiner’s “The Therapist’s Professional Will” at www.sfrankelgroup.com

 

 

“We Do It All For You”: a Quasi-Insurance Approach to
Professional
Wills, Wonts and Won’ts.
A. Steven Frankel, Ph.D., J.D.i

Welcome to the fourth and final article on ways to address the problem of preparing for unanticipated disruptions or terminations of practice due to death or disability. In this article, I address a most efficient and effective way of approaching the problem – an approach which has developed as a result of the
view that, given the enormity of the task, colleagues need considerable support in order to fulfill the legal/ethical responsibility to prepare for thee transitioning of practices when colleagues die or become disabled – a quasi-insurance approach. Currently all medical malpractice insurance companies are focused on “risk management” or “prevention.” The program I write about in this article and its options are risk prevention tools for the new world order where people continue to function into what used to be called “advanced age”. Insurance plans typically respond with funds or funded services when a condition which is covered by a policy occurs. The quasi-insurance approach to the problem of dealing with sudden disruptions of practices goes a step further, in that it funds an annual visit with a psychiatrist-colleague with at least 20 years of practice experience, who has been trained to assess practices and to facilitate
transitions when the time comes for transition services. That colleague is termed a “Transition Specialist”
(“TS”).
Subscription Services:
When a practitioner subscribes to the quasi-insurance program s/he becomes a subscriber and a TS is paid to make annual visits to the subscriber’s practice to assist with ensuring that patients have been advised of the subscriber’s involvement with the program, that proper releases have been signed by each and every patient, providing for the TS to review charts, talk with patients when transition services are rendered, and to refer the patients for continuing care with a psychiatrist in the community – and referral priority is given to other subscribers, thus providing a way to increase the practice value of
subscribers. During the annual visits, the TS reviews the condition of the records of treatment, including medication records, and apprises the quasi-insurance company of any support needs that a subscriber might have (e.g., recordkeeping, medication prescriptions/records, etc). TSs also have authority, per the
quasi-insurance company’s planning, to prescribe limited medications for patients who may short or out of medications at the time of an “event,” which will carry the patient through the time needed to transition to another provider of continuing care.
If the subscriber employs one or more office staff members, those staff members will be provided with a Manual created by the quasi-insurance company that provides for all of the “heavy lifting” needs discussed in prior articles, such as where furnishing and furniture should be transported, how to take care of funds, billables, receivables, telephone and electronics (computers), record storage, etc. If the subscriber does not employ such staff, a trained “office temp” who is familiar with similar manuals may be assigned to the practice to carry out those same functions. By following these procedures, the TS and office staff or temp collaborate to transition the practice with maximum efficiency and care for patients,
colleagues and the families of subscribers. Finally, since subscribers’ practices have been vetted by TSs, they are eligible to receive patient referrals when other subscribers cease to practice.
Emergency Services:
In addition to the subscription services for planning and implementing the practice transition, the company also provides an emergency service for practitioners who have not subscribed or planned ahead. This emergency service also makes use of paid TSs and office staff/temps, armed with a court
order signed by a probate judge, when necessary, to contact the affected colleague’s family or personal legal representative and then to provide all of the services described above.ii
Opportunities for Subscribers to Become TSs:
One of the features of the Quasi-Insurance approach lies in the possibility that a subscriber can become a TS. Subscribers who see the helpfulness and compassion of the quasi-insurance model may, given that they have been in practice for at least 20 years, become TSs by taking the training and learning
from how their own practices have been assessed and supported by subscribing, assist other professionals who are interested in preparing for unanticipated disruptions of practice.
Time Commitments for TSs:
TSs who work with subscribers typically put in one 4-6 hour visit to each TS’s practice per year. When an “event” occurs, if it falls after the first year or two of TS visits, the TS’s responsibilities are less demanding, in that the patients have already been advised as to their follow-up treater and have already signed releases such that records can be transferred. TSs might be needed by some patients who are grieving the loss of their subscribing treater, for support during the transition. However the bulk of the work will be under the purview of the office staff or temp. Since we do not contemplate a rash of needs for subscribed practice transitions in any given community, it is not likely that the company’s
calls to engage a TS will be a very frequently occurring event, and thus the TS’s practice and personal life will not likely be disrupted by the call to duty very often. The presence of several trained TSs in a professional community will also allow the frequency of the company’s calls to be low and non-disruptive, while the services are, in the words of one of the subscribers, “a god-send.” TSs who are willing to be involved with emergency transitions will be putting in more hours per case than those who work with subscribers. Files will have to be reviewed for appropriate follow-up care, patients will likely need to talk
to TSs, to sign releases, review their records, and deal with their grief. Office staff and temps will still cope with the “heavy lifting” described in prior articles, but TSs should count on putting in a week-10 days for emergency practicetransitions.
Administrative Involvement:
The company has an administrator who is available and accessible to TSs and office staff and temps. The administrator will coordinate the activities of the TSs and office staff and temps, will arrange for court orders when needed, and will have direct interaction with the families of the stricken colleagues. The
administrator will be able to support the on-site work of the company’s agents at all times.
Up-sides and Down-sides of the quasi-insurance model:
The up-side to the quasi-insurance model is that the company does the entire project in ways that care for patients, colleagues and families of practitioners. Those people are safe to grieve their losses and carry on with their lives with minimal disruption or distraction. The feelings of safety and being
cared about are priceless, which leads to the down-side of the quasi-insurance model: as with insurance of any sort, payment must be made to the company to secure its services. It should be noted, however, that I have strongly recommended that subscribers purchase term life insurance policies for their
colleagues if they us either the partnership or team models, such that payment, in and of itself, is found in all three models.
Conclusion(s):
Thank you for reading the four articles that have described the problems of practice transition and the various solutions to those problems. The three pathways to manage and address these problems each have their own advantages and disadvantages, and may suit particular individuals differently,
depending on their practices, their locations and their life situations.
Summary of Four Models of Preparation for Practice Terminations:
Model: Do Nothing Single Partner Team Quasi-Insurance Intervention: Emergency One TS 5 TSs TS, Office Staff Advantages: None Completion Completion Completion Disadvantages: Disruptions Excessive work Group Financial Dysfunction Commitment i i If you are interested in a closer look at the issues and support systems, you’re welcome to contact me via www.practice-legacy.com
ii The company’s programs have been vetted and endorsed by the second largest psychiatric malpractice insurer in the United States, and the company is actively seeking professionals interested in both subscription services and in becoming TSs.

 

More Articles of Interest:

Frankel, A.S., & Alban, A.  (2010). Professional Wills: Protecting Patients, Family Members and Colleagues, California Psychiatrist, Fall 2010

Frankel, A.S. (2014), Denial is Great, but Our Patients, Family, and Colleagues need our attention, Senior Psychiatrist Lifer’s Line, Winter 2014 , page 2

Frankel, A.S. (In Press), Preparing for Death/ Disability, Psychotherapy Networker

Frankel, A.S. (In Press), Coping with disruptions in practice due to death or disability, National Psychologist