Private Practice Letter sent 9/30/08   Download and Print this letter by following this link

My private practice will be changing as of November 1, 2008

As you may know, my private psychiatry practice filled, and has been closed to new patients for several years.  Accordingly, those who remain tend to be stable and doing well.  Most need only infrequent appointments, and are in touch by telephone for brief check-ins or refill requests.  Because I have not been charging for these services, the revenue from my private practice has dwindled.  Additionally, since I am not seeing my patients often, but remain responsible for them, I am concerned about management of liability.  I have decided to change the model. 

 Please read and sign the attached treatment contract that best applies to you 

 Option #1:  Yearly payments

Option # 2: Transfer of care to another provider

 I have enjoyed working with you and hope you are able to stay with me in my private practice. 

 Please respond promptly to this letter.  If I haven’t heard from you within two weeks I will assume you have chosen option 2 and need no medication refills for the time being. 

 If you do stay with me, be advised that I may be moving appointments to my home office, in Duxbury, about 2 miles off Rt. 3 at exit 10.  Location updates will be posted at www.JeffTurley.com

 Sincerely,  

Jeff Turley, M.D. Child, Adolescent, and Adult Psychiatrist
 

Contract Option #1: Stay with Dr. Turley’s private practice

 Enclosed is my check for $500.00.  I understand that this non-refundable fee entitles me to:

R      Six (6) medication management visits, phone consultations, or email consultations for the calendar year beginning with payment. 

R      At the end of the calendar year, or when the 6 contracted contacts are used, another payment will be required. 

R      I will complete a questionnaire manually, or on-line at www.JeffTurley.com at least once every 3 months to update Dr. Turley on my status. 

R      The medication visit form can be found at http://jeffturley.com/Forms/patientparentreport/index.htm ). 

R      Dr. Turley will no longer issue prescriptions without this clinical update. 

R      I understand that Dr. Turley, at his discretion as a physician,  reserves the right to require a face to face meeting at any time, prior to prescribing medications. 

R      If Dr. Turley is not able to continue to provide services, I will receive a prorated refund for the balance of the contracted year. 

Signed:                                                                                                                   Date:                                    

                Guardians sign for minors

Patient name:                                                                                                        

Your relationship to patient if applicable:                                                                     

 Contract Option #2:  I will find another prescriber and arrange to transfer care 

□        I request a                             supply (up to 2 months) of medication as currently prescribed.

□        I do not require medication refills.

□        I understand that option 2 will close my record with Dr. Turley’s practice. 

□        I attest to the fact that the condition requiring treatment is stable and there is no need for immediate care. 

□         If the condition worsens prior to my finding another prescriber, I agree to use the local emergency room.

 Release:  I request a summary of my care from Dr. Turley. 

(Check one): 

□        Email attachment.  My email address is:                                                                                              

 □        Fax:  My Fax number is                                                                                                                            

 □        Mail: to this address                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   

□        I do not need a summary of care at this time.

Signed:                                                                                                                   Date:                                    

                Guardians sign for minors

Patient name:                                                                                                        

Your relationship to patient if applicable:                                                                     

Medication referrals

Agencies: 

North River Counseling 781 834-7433

Mass Bay Counseling 800-338-5885

South Shore Mental Health (617) 847-1950

Duxbury Counseling (781) 585-4311

Brockton Area Multi-Services www.bamsi.org (508) 580-8700 

Referral resources

Pathways:  781-749-5386  x174

Parents-Professionals Advocacy League (508) 542-7860