caring for doctors by doctors since 1869

IN LIFE, PREPARE...

This book is not a legal document.

It describes legal steps which must be taken. It offers essential advice for all medical families, especially younger ones with limited knowledge of what is entailed in medical practice.

It also details the priorities of action to be taken when the practitioner dies or is incapacitated.

This brochure has been inspired by experience within the Medical Benevolent Association of New South Wales, The Doctors' Health Advisory Service (NSW), the New South Wales Branch of the Australian Medical Association, of the problems encountered by doctors and the families of doctors when serious or prolonged illness or death strikes a medical practitioner.

CONTENTS

Part 1: What the doctor can and should Do NOW

Part 2: The Impaired Doctor

Part 3: What the Survivors Will Have To Do

1st Edition: October 1982

2nd Edition: December 1988

3rd Edition: February 1993

4th Edition: May 2001

PART 1: What the Doctor Can and Should Do NOW

MAKE A WILL - KEEP IT UP TO DATE - A SOLICITOR SHOULD BE CONSULTED

Immediate cash is a necessity for the family. There may be delay in issuing a death certificate; funeral costs have to be paid reasonably quickly; women, especially, still face difficulties in obtaining loans or other advances through banks and finance companies.

Records and Cash

It is desirable, while the doctor is well and active, that those close to him/her should have some general knowledge of the business affairs and practice procedures.

The primary need is for a record, kept constantly up-to- date, of the whereabouts of all the documents that will be needed. These include:

1. The will
2. The birth and marriage certificates
3. Deeds of property
4. Car registration
5. Taxation files
6. Bank accounts
7. Safe deposit boxes
8. Insurance (personal and property)
9. Investments
10. Credit cards
11. Drug register (which must be kept up-to-date always)
12. Partnership agreements
13. Medical and hospital funds
14. War service (including discharge and details of decorations)
15. Membership of associations and other professional, social and sporting bodies

The Doctor's Medical Practice - a valuable family asset

The primary need in the event of disablement or death of a doctor in practice, whether general practitioner or specialist, is for the practice to be kept going. A locum, or partners, should take over at once, pending permanent arrangements.

There are several agencies which will help with information about locums and assistants.  The Medical Benevolent Association can assist with this information.  Colleagues within the same discipline often are able to advise concerning availability of younger colleagues willing to act as locums. 

Our experience is that doctors need sickness and accident cover, as well as term life insurance. 

Patients Needing Attention Are:

Drugs, Supplies and Equipment

All drugs kept by the doctor for treating patients should be locked in a secure place.

The drug register should be included and patients' records and X-rays should be placed in safe custody, to be available only if needed.  Patients may be offered transfer of their records to a new doctor.

Where a locum is to be employed a stocktake of Schedule 8 drugs (drugs of addiction or habituation) and a comparison with the Drug Register is essential prior to his commencing work and at termination of employment.

It will be necessary to decide on the disposition of leased vehicles and equipment, all furniture owned or leased in the waiting rooms and surgery, and all other possessions directly used in and related to the practice.

In the case of partnerships, the partnership agreement should have made appropriate provision for the death or prolonged disability of a partner.  Maintenance contracts on equipment should be continued until decisions concerning sale or otherwise are made.

Sale of a Practice

There are several reputable agents who will provide advice as to the value and certain technical matters which may arise in the disposal of the practice. 

Salaried Medical Officers

An increasing number of medical practitioners are working in salaried positions, in the public health system and in private enterprise.  While superannuation programs are usually available, these generally are inadequate in the case of death or severe disability, particularly in the early years of employment.

PART 2: The Impaired Doctor

Illness or other incapacity can be a serious episode in a doctor's professional career as well as in his or her private life.  Sickness may be temporary or permanent.  It is sometimes self-inflicted; it is too often neglected or treated inadequately by the doctor himself, to his detriment and the detriment of the family - and the patients.

Doctors with physical, emotional and mental problems are often shielded by others, causing an unsatisfactory situation.  Unfortunately, medical students are not at present taught about the possibility of personal illness and how to cope with them.

There are five  categories of "impaired doctors":

There are two organisations actively dealing with the problems of the Impaired Doctor:

1. The Doctors' Health Advisory Service (NSW)

The DHAS has been in operation since 1982.  It stresses four points:

Doctors often make difficult patients especially when they refuse to acknowledge their problems or to seek help. As a profession, we must develop a caring attitude towards our colleagues who should be treated like ordinary patients with proper referrals, consultation, history taking, examination and records.

We have a responsibility to help our medical friends and to look after their interests.  We are our brothers' keepers.  No-one else can appreciate the stresses of our work.  No-one else is better qualified to offer a helping hand.

All doctors should have a personal doctor.

Doctors' Health Advisory Service - (02) 9437 6552

2. The Medical Benevolent Association of NSW

For over 100 years, the MBA has been dealing with the social and financial problems of the impaired doctor, his/her family and dependents.  The Association has found it necessary to support the families of doctors who have failed to prepare their affairs either for death or prolonged illness.  It is amazing how often a family has been left with no liquidity because certain elementary precautions have not been taken.  These families need ongoing support but do not know where it can be found.

The Association has the authority to fundraise.  Its services are available to all registered medical practitioners in NSW and the ACT and their families.  It helps with advice and practical support as well as financial relief.  Each case is assessed by the Council acting on the advice of its professional social worker who is a trained counsellor and resource person.

The Association may be contacted through (02) 419 7062, or through The NSW Branch of the AMA (02) 439 8822.

PART 3: What the Survivors Will Have to Do

If the advice given on earlier pages has been followed, the burden on those who survive the doctor will have been lessened.  They will know to whom to turn for advice and help; they will be aware of where the essential documents are kept and they will have ensured that those documents are up-to-date.

A reliable funeral director can help with all necessary arrangements. You must discuss all costs in detail.

Notification to Organisations

In the case of a doctor, the persons (other than relatives and personal friends) and organisations to be advised of death are:

Government agencies mentioned earlier should be advised.  The addresses are:

The Secretary
NSW Medical Board
PO Box 104
GLADESVILLE NSW 2111

NSW Health Department
73 Miller Street
NORTH SYDNEY NSW 2060

The Director
Commonwealth Department of Health, Housing and Community Services (NSW Branch)
GPO Box 9848
SYDNEY NSW 2001

The Secretary
Department of Veteran Affairs (NSW Branch)
GPO Box 3994
SYDNEY NSW 2001

Armed Forces Reserve
Department of Defence
CANBERRA ACT 2600

Social Security Assistance

Current information (on types of assistance) should he obtained from the Department of Social Security which is listed under Commonwealth Departments in the telephone directory.

If the deceased doctor was in the Armed Forces, seek advice from the Department of Veteran Affairs - Social Service Department

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