Coping with disruptions in practice due to death or disability

By A. Steven Frankel, Ph.D., J.D.
September 10, 2014



Coping with disruptions in practice due to death or disabilityTwo stories from my experience demonstrate how devastating the aftermath can be for survivors if a mental health clinician has not arranged for the handling of professional affairs in the event of death or disability.

I will start with Mary’s story. I had been a lawyer about a year when she called me. She was crying, distressed, frightened and angry. Her husband of well over 30 years, a psychologist, had passed away unexpectedly. He was in his early 60s and had no immediate plans to retire, as he loved his work.

Mary told me, between tearful outbursts, that a colleague of her husband’s suggested she contact me because I was both a psychologist and an attorney. She said, in the midst of her grief, that she had begun receiving calls from various creditors, including her husband’s office landlord and – the most distressing to her – many of her husband’s patients.

The landlord said she needed to pay another month’s rent or he would put her husband’s office furnishings – including his patients’ records – out in the street.

Her husband’s patients, while in the midst of their own grief over losing their treating clinician, wanted their records. Some were involved in litigation; others needed records to support claims for insurance reimbursement for payments to her husband, while still others needed records to document disabilities. She wanted to help them, but she was in “overwhelm” status and didn’t know how to cope with the demands that found their way to her door.

She said in addition to her grief she was feeling enraged at her husband for leaving her with these burdens – and then terrible guilt about feeling so angry.

She asked questions, such as, “Am I allowed to look at his records, to talk to his patients, to give them the records? Would something bad (translation: “legal”) happen if she did get his records, find the patients/clients and hand them over? Was she exposing herself to any sort of legal consequences for that? If so, then what might she do to deal with the (unpredicted) demands on her? At that time in my life (I became an attorney in 1997), I had no idea what to tell her. Now, I would know.

Jack’s story is similar with one legal distinction: He and Susan, a mental health clinician, had been life partners for 15 years but were not married. Susan had been in practice for about 20 years when she was suddenly struck and killed by a drunk driver as she was crossing a street.

In the state in which they lived, Jack had no idea whether he had legal standing to act as if he had been her husband. He knew where her office was and a little about how it was laid out, but had never visited her there, didn’t know what furniture or furnishings she had and knew little of the people she served or her record-keeping responsibilities.

He received the same kind of contacts as Mary but decided he didn’t need to do much except to pay people to take everything out of the office, shred all the records and auction off everything else.

One of Susan’s close friends, also a mental health clinician, called to support him at the time of Susan’s death and tried to help him understand that the people she served and cared for needed their records, that bills had to be paid, lest there be actions against Susan’s estate (her will left everything to him) and “hassles” with the assortment of people who might contact him as a result of his relationship to Susan. That colleague gave him my name and contact information.

Who knew about “professional wills” at that time in history? Even though all of the mental health societies have ethics codes requiring us to prepare for disruptions in practice due to unanticipated death or disability, how many of us come out of denial and do it? How many colleagues put in about 80 hours of work to “clean up” a colleague’s practice?

However, there are resources now that can assist with the three ways to plan for such troubles: a) find a colleague who’ll do it for you if you’ll do it for him/her (sounds good, but one of you’ll have to find another partner at some point) b) put a team together (sounds better, but teams may not remain stable and effective, and often that instability isn’t clear to the rest of the team until it’s too late) or c) sign up for insurance that will provide this kind of support by colleagues and staff trained to intervene.

 

A. Steven Frankel, Ph.D., J.D., is founding president and curriculum director of The Steve Frankel Group (www.sfrankelgroup.com) that offers CE courses for mental health counselors, including instructions in setting up professional wills. An affiliate, Practice Legacy Programs (www.practice-legacy.com) provides a trained staff in an insurance program to handle a planned or unexpected closing of a practice. Frankel may be reached at: drpsylex@earthlink.net.

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