Practice Issues

Below are resources to address many issues and questions that arise in a medical practice. These are provided for informational purposes only. Licensees should contact a private attorney for legal advice.

Obligations Upon Closing or Leaving a Medical Practice

Board Rule 540-X-9-.10(3):

  • When a physician retires, terminates employment or otherwise leaves a medical practice, he or she is responsible for ensuring that active patients receive reasonable notification and are given the opportunity to arrange for the transfer of their medical records.
  • A physician or physician group should not withhold information from a departing physician which is necessary for notification of patients.
  • A physician or the estate of a deceased physician transferring medical records in connection with the sale of a medical practice should notify the physician’s active patients that the records are being transferred and should provide the patient with information sufficient to secure the transfer of the medical record.

Medical Licensure Commission Rule 545-X-4-.06:

  • Example of unprofessional conduct: "The refusal by a physician to comply, within a reasonable time, with a request from another physician for medical records or medical information when such request is accompanied by a properly executed authorization of the patient."

Code of Medical Ethics Opinion 3.3.1, Management of Medical Records:

Physicians should:

  • Make the medical record available to the succeeding physician or another authorized person when the physician discontinues his or her practice (whether through departure, sale of the practice, retirement, or death).
  • Never refuse to transfer the record on request by the patient or the patient’s authorized representative, for any reason.
  • Charge a reasonable fee (if any) for the cost of transferring the record.
  • Appropriately store records not transferred to the patient’s current physician.
  • Notify the patient about how to access the stored record and for how long the record will be available.
  • Ensure that records that are to be discarded are destroyed to protect confidentiality.

Section 34-24-338 of the Code of Alabama:

  • If any registrant shall change his address during the year for which any certificate of registration shall have been issued by the commission, such registrant shall, within 15 days thereafter, notify the commission of such change, whereupon the commission shall issue to such registrant without additional fee, a duplicate registration certificate for such new location.

FAQ—Obligations Upon Closing or Leaving a Medical Practice

There is no specific time period required. Board Rule 540-X-9-.10 states "reasonable notification" must be provided. This may vary from practice to practice. If you are uncertain, check with your practice attorney or malpractice insurance carrier.

While the Board rule does not specify the mode of notification, it would be difficult to ensure patients received notification by a newspaper ad. If you use certified, return receipt mail, you can place a copy of the letter and return receipt in the patient's file in case there is ever an issue of notification. Physicians are also advised to place a written notice of the closing on the door or other visible area of the office building with instructions as to how copies of medical records may be obtained.

Again, the Board rule does not specify the meaning of "active," because this may vary from practice to practice. If you are unsure, check with your practice attorney or malpractice insurance carrier.

It does not matter which party sends the notifications. If the departing physician is responsible, the remaining group may not withhold patient names and addresses required for the notification.

  • The patients of a physician who leaves a group practice should be notified that the physician is leaving the group.
  • Patients of the physician should also be informed of the physician’s new address and offered the opportunity to have their medical records forwarded to the departing physician at his or her new practice location.
  • Board opinion concerning costs of notifying patients and transfer of medical records when one or more physicians leaves a practice

Interpreters for Patients with Communication Disabilities

  • The Americans with Disabilities Act requires a physician to provide adequate communication options for all patients with communication disabilities, including those related to vision, hearing, or speech. 
  • These “auxiliary aids and services” are required for any patient, or a patient’s parent, spouse, or companion in appropriate circumstances when needed.
  • It is the physician’s responsibility to provide these services when requested.
  • It is up to the physician to determine if a patient’s companion satisfies ADA requirements; often friends and family members lack impartiality or the necessary specialized knowledge.
  • Click here for more information about the ADA and its requirements.

Medical Records

  • Board Rule 540-X-9-.10 concerns medical records management, the release of medical records, cost for reproducing medical records, and transfer or disposal of medical records.
  • Commission Rule 545-X-4-.09 concerns minimum standards for medical records. 
  • Board opinion concerning costs of notifying patients and transfer of medical records when one or more physicians leaves a practice
  • The American Medical Association's Council on Ethical and Judicial Affairs has issued Opinions on Physician Records concerning the availability of information to other physicians, access by non-treating medical staff, sale of the medical practice, and retention of records.

FAQ—Medical Records

The Board does not specify a particular time period because retention times may vary from practice to practice. The Board rule states records should be retained "for such period as may be necessary to treat the patient and for such additional time as may be required for medical-legal purposes." A good rule of thumb is ten years. If you are unsure, contact your practice attorney or malpractice insurance carrier.

The same retention times apply to EHRs as well as paper records.

While there is no specific rule, in general, a physician should transfer, with the patient's authorization, any medical information in the patient's record which is pertinent to the patient's medical history and/or to any ongoing course of treatment. Psychological, psychiatric and drug or alcohol treatment records should not be routinely forwarded.

The Board’s jurisdiction extends only to licensed physicians. The Board recommends that third-parties who come into possession of medical records consult an attorney to ascertain the scope of any duty or obligation to retain the records or make them available to patients.

In Alabama, there is no license for acupuncture or naturopathy.  Acupuncture is considered the practice of medicine or chiropractic and may only be performed by individuals licensed by the state of Alabama.

Commission Rule 545-X-4-.05 addresses the practice of acupuncture in Alabama:

(1) Acupuncture is deemed by the Medical Licensure Commission to be an experimental procedure of which the safety and medical effectiveness have not been established. The Commission, therefore, determines that while acupuncture practice by licensed physicians should not be absolutely prohibited, some safeguards are necessary to ensure that the public is not harmed or victimized by unprofessional practices, such as the unskilled or uninformed application of acupuncture treatment, or unfounded claims of effectiveness.

(2) The Commission, therefore, determines that it shall be deemed unprofessional conduct, and grounds for action against the license of any physician pursuant to § 34-24-360(a), Ala. Code (1975) for a physician to offer or administer acupuncture treatment except in compliance with the requirements set forth by the Federal Food and Drug Administration in Federal Register Vol. 88, No. 46, p 6419 (March 9, 1973). In administering this requirement, the Commission establishes the following criteria, which must be adhered to by physicians licensed by the Commission:

       (a) All acupuncture devices in this State must be labeled properly according to applicable Federal Food and Drug requirements,

       (b) A physician must secure a patient's informed consent according to the guidelines established at 21 Code of Federal Regulations Section 130.37, and no claims of therapeutic or diagnostic effectiveness may be made by a physician.

(3) The Commission hereby announces its intention to require that physicians wishing to investigate and experiment with the use of acupuncture treatment must comply fully with the above state requirements of this Commission and with the requirement of the Federal Food and Drug Administration cited herein.

Address and Name Change

Replacement Wall Certificate/Duplicate Annual Renewal Certificate

  • Application for Replacement of Lost or Destroyed Wall Certificate
    • For a new wall certificate, please use the application for replacement of lost or destroyed wall certificate ($25 charge).
    • New licenses issued after Oct. 15, 2020, bear a new certificate design.  Licensees wishing to replace their existing wall certificate with the new design may do so at no charge by returning their current certificate along with the wall certificate replacement request form.
  • Duplicate annual renewal certificates
    • Duplicate annual license and ACSC renewal certificates can be printed at the Licensee Portal.