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not been involved in the active practice of medicine in the past 3 years, supervision by the full time director of the county public health unit or licensed physician is required for a period of 6 months, unless the Board determines that a shorter time period is sufficient.The recipient of a limited license may practice only with public agencies or institutions or nonprofit agencies or institutions meeting the requirements of §501(c)(3) of the Internal Revenue Code (a nonprofit, charitable, educational or scientific organization). Such agencies or institutions must be located in the areas of critical medical need as determined by the Board of Medicine. Holders of a limited license must keep current on their CME requirements. However, holders of a limited license are not required to maintain medical malpractice insurance.While medical malpractice insurance is not required, it still may be in the physician's best interest to keep a policy in force. Holders of a limited license are subject to suits for malpractice in the same manner as those with regular licenses. Florida's Good Samaritan Act provides no additional protection. Limited license holders, however, who work for a state agency or subdivision or have contracted with the state to provide free care and treatment to indigent patients are statutorily afforded sovereign immunity protection. Having been vested with such protection, it is not necessary for these physicians to maintain medical malpractice insurance. It should be remembered, however, that such immunity only applies for acts or omissions of the physician while working within the scope of his employment with the state agency or subdivision or within the scope of duties pursuant to his contract with a governmental contractor.This article is presented for educational purposes only and should not be taken as a substitute for legal advice, which should be obtained from personal legal counsel. Nevertheless, the FMA hopes that the information provided here and in its other publications continues to assist physicians in answering many of their most common legal questions allowing them to treat patients, instead of addressing legal concerns. Last Update: April 2013 RETIRING/CLOSING/RELOCATING A PRACTICE Section 456.057, Florida Statutes, sets forth the requirements that must be followed when a physician retires, closes his office or relocates his practice. The statute adopts the concept of a “records owner.” A “records owner” may or may not be a physician. “A ‘records owner’ means any health care practitioner who generates a medical record after making a physical or mental examination of, or administering treatment or dispensing legend drugs to, any person; any health care practitioner to whom records are transferred by a previous records owner; or any health care practitioner's employer, including, but not limited to, group practices and staff-model health maintenance organizations, provided the employment contract or agreement between the employer and the health care practitioner designates the employer as the records owner.” Section 456.057(1), Florida Statutes. The statute requires the “records owner” to notify patients of the retirement, closing or relocation of a practice. When the records owner retires, terminates a practice, or is no longer available to patients, Section 456.057(13), Florida Statutes, requires the records owner to notify the patients of the termination, relocation or unavailability in the following manner:1. Publish in a local newspaper a notice containing the date of termination or relocation and include an address where the records may be obtained from the physician terminating practice or another licensed physician. This is now required by law per Florida Administrative Code 64B8-10. 002(4). A copy of this notice must also be submitted to the Florida Board of Medicine.2. Physicians may also, but are not required to, notify patients in writing of the date of termination or relocation and include an address where the records may be obtained from the physician terminating practice or another licensed physician) or place a sign in a conspicuous location on the façade of the physician’s office.3. Both notices must advise patients of their opportunity to obtain a copy of their records.In addition, Section 456.057(14), Florida Statutes, requires that the records owner notify the Florida Board of Medicine and advise the Board who the new record owner is, and where the physician’s medical records can be found. The records owner should also review all managed care contracts to determine if any notification provisions must be complied with.This change will primarily affect employed physicians whose employment agreement designates the employer as the records owner. It will have little effect on other physicians, especially those physicians in independent practice. In that case, the physician who generated the record after treating the patient will be considered the “records owner,” and therefore the requirements discussed above will fall upon that physician. In the case of an employed physician (whose employment agreement designates the employer as the records owner), this responsibility is placed upon the employer.It is important to note that the Board of Medicine has adopted a rule that imposes certain requirements on physicians who relocate or terminate their practices and are no longer available to patients. Rule 64B8-10.002(4), Florida Administrative Code, requires physicians to publish a notice once a week for four consecutive weeks in a local newspaper of greatest circulation. The notice must contain the date of termination or relocation and include an address where the records may be obtained from the physician terminating practice or another licensed physician. A copy of the notice must be submitted to the Board within one month from the termination or relocation. The rule also gives physicians the option of either placing a sign in a conspicuous location in or on the façade of the physician’s office or notifying patients by letter of the termination, sale or relocation of the practice (this is NOT required, however), in addition to publishing the notice in the local newspaper. The sign or letter must notify patients of their opportunity to transfer or receive their records. The requirements set forth in the Board’s rule are separate and apart from the requirements set forth in Section 456.057, Florida Statutes, and must be followed by all licensed physicians. Concomitantly, a physician is responsible for ensuring that these records will be available to his former patients for a period of five (5) years from their last visit. A physician thus must make arrangements to either have another physician become the new records owner, have a medical records service store copies of the medical records and provide copies upon request to former patients, or himself be available to provide copies.This article is presented for educational purposes only and should not be taken as a substitute for legal advice, which should be obtained from personal legal counsel. Nevertheless, the FMA hopes that the information provided here and in its other publications continues to assist physicians in answering many of their most common legal questions allowing them to treat patients, instead ofaddressing legal concerns. Last Update: March 2013 SCHOOL PHYSICALS State law (Section 1003.22, Florida Statutes) provides that all Florida students need a school entry exam to attend school and that each county health department, with the approval of the school district, shall develop policy regarding initial school entry health examinations (Rule 64F-6.002, F.A.C.). Which type of physician must perform these exams is left up to each county/school district.Florida law states that a "licensed practicing physician" must sign forms relating to: (a) medically related immunization exemptions (Section 1003.22(5)(b), Florida Statues); (b) absences due to sickness or injury (Section 1003.24(4), Florida Statutes); (c) attestations regarding the age of the student (Section 1003.21(4)(g), Florida Statutes). Since the statutes are silent regarding whether
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