The two-year glide: shrinking a panel with dignity

What a retirement wind-down actually is

A retirement wind-down for a solo is a planned, gradual handoff of a practice that has no partners to absorb it — you stop taking new patients, help current ones land elsewhere, retire your obligations in order, and secure the records that outlive you. A common approach spreads this over about two years so no patient is dropped and no deadline is missed. Treat the glide as a continuity plan, written down, rather than a decision you announce and improvise 1Ref 1U.S. Department of Homeland Security (2026).Ready.gov Business.The continuity-planning framework that a retirement wind-down should be written as — a plan, not an improvised announcement..

Retiring is not the same as selling or simply closing: selling seeks a buyer for the goodwill, closing shuts the doors on a date, and a wind-down does the middle work of neither abandoning patients nor leaving money and records untended. This page is that middle work.

The two-year timeline: shrinking a panel with dignity

The two-year glide works because it separates the decisions that need runway from the ones that happen fast. In outline: in the first year you stop accepting new patients and begin transitioning the ones whose care can move; in the final months you set a last-visit date, arrange records custody, and notify everyone owed notice. Notice conventions vary, but many practices give active patients a season, not a week.

Enough runway lets a patient find and establish with someone new before your last day, which is the whole point of gliding instead of stopping.

These windows are conventions, not statutes, and your own board or lease may impose its own notice period — but the shape holds: the slow, dignity-preserving work first, the closeout last.

Telling patients, and protecting continuity

Telling patients is the part that carries the most risk of doing harm, so it gets the most runway. Give active patients written notice with the last-visit date, a clear route to their records, and referral options, and reach the people who are mid-treatment personally rather than by form letter. The professional standard you are protecting is continuity — no active patient left without a next step. Professional practice organizations publish wind-down and practice-exit checklists you can adapt to your discipline 2Ref 2APA Services, Inc. (2026).Practice — APA Services.That a professional practice organization publishes wind-down, practice-closing, and professional-will guidance a solo can adapt to their discipline..

Stagger the message so the patients who most need a warm handoff hear it first and earliest. Document who was notified and when; that record is what distinguishes an orderly transition from what a board would call abandonment. A referral list and a records-request path in the same letter answer the two questions every patient will ask next.

The records outlive the practice

When you retire, the records do not; they carry obligations that can outlast your career by decades. Plan a records custodian and a retention schedule keyed to your state's rule, and keep the safeguards running on whatever you retain. HIPAA's Security Rule still applies to the electronic records you hold after your last visit — administrative, physical, and technical protections, scaled to a now-tiny practice 3Ref 3HHS Office for Civil Rights (2026).Summary of the HIPAA Security Rule.That the Security Rule's administrative, physical, and technical safeguards still apply, scaled to size, to the electronic records a retiring solo retains..

Before you decommission any system, run a final security risk analysis — the free ONC/OCR Security Risk Assessment tool is sized for exactly a small practice — so you can show the retained data landed somewhere protected and the rest was securely destroyed 4Ref 4Office of the National Coordinator / ASTP (2026).Security Risk Assessment Tool.That a free ONC/OCR risk-assessment tool sized for small practices lets a retiring solo run the final risk analysis before decommissioning systems.. And remember the far tail: a patient who dies leaves records protected for fifty years, so a decedent's chart can be the last one your custodian is still holding 5Ref 5HHS Office for Civil Rights (2026).Health Information of Deceased Individuals.That a decedent's PHI stays protected for fifty years and the personal representative exercises the access right — the far tail of records the custodian may still hold..

A professional will in case the glide is interrupted

A two-year plan assumes you are there to run it, so build the backstop for the years you might not be. A professional will names who steps in if you die or become incapacitated mid-wind-down: who reaches patients, who secures the records, and who has the access to act. Without it, a solo's sudden absence strands an active panel and a room full of charts with no one authorized to touch them.

Draft it early in the glide, not at the end. Professional bodies treat the professional will as core practice-management guidance, with templates you can adapt to your discipline 2Ref 2APA Services, Inc. (2026).Practice — APA Services.That a professional practice organization publishes wind-down, practice-closing, and professional-will guidance a solo can adapt to their discipline.; the estate side matters too, since a deceased patient's personal representative may later exercise the access right through your custodian 5Ref 5HHS Office for Civil Rights (2026).Health Information of Deceased Individuals.That a decedent's PHI stays protected for fifty years and the personal representative exercises the access right — the far tail of records the custodian may still hold.. The document is short, but it is the difference between an interrupted plan and an abandoned one.

The money and overhead wind-down

The financial wind-down runs on its own track: as visits taper, so should the overhead, but some obligations end on their own schedule, not yours. Map every recurring cost and commitment — lease, EHR contract, malpractice coverage and its tail, business loans and any personal guarantees — and line up when each can end. Model the budget for the shrinking years so you are not paying full overhead against half a panel.

Building the annual budget in an afternoon, revisited each quarter, keeps the glide from quietly losing money. If you consolidate the remaining visits to telehealth to shed office overhead, confirm each service you still bill sits on Medicare's current telehealth list, since the audio-only and permanent-versus-temporary designations change year to year 6Ref 6Centers for Medicare & Medicaid Services (2026).List of Telehealth Services.That CMS publishes the annual list of Medicare-payable telehealth codes, with audio-only and permanent-versus-temporary designations — the lookup if a wind-down consolidates to telehealth.. Watch the guarantees: your credit is the practice's credit, and a personal guarantee on a lease or loan survives the closing until it is paid or released. If the numbers do not support a graceful glide at all, that is a different decision — the insolvency options are their own path, not a wind-down.

The final closeout

The closeout is a checklist, and running it in order is what turns a wind-down into a clean exit. On the last stretch: file your final claims and reconcile receivables, transfer the records to the custodian, deactivate or update your NPI and payer enrollments, terminate or return-and-destroy under each business-associate agreement, and run one last risk analysis before the systems go dark 4Ref 4Office of the National Coordinator / ASTP (2026).Security Risk Assessment Tool.That a free ONC/OCR risk-assessment tool sized for small practices lets a retiring solo run the final risk analysis before decommissioning systems..

• Money: final claims filed, receivables reconciled, refunds issued, accounts closed after the last check clears.
• Records: transferred to the custodian under a signed agreement, with the retention deadlines noted on each chart.
• Identifiers: NPI deactivated or updated, Medicare and Medicaid enrollments closed, commercial panels notified.
• Vendors: each business-associate agreement ended with return-or-destroy honored; the EHR exported and receipted.
• Security: a final risk analysis run and the destruction of what you did not retain documented 4Ref 4Office of the National Coordinator / ASTP (2026).Security Risk Assessment Tool.That a free ONC/OCR risk-assessment tool sized for small practices lets a retiring solo run the final risk analysis before decommissioning systems..

Keep proof of each step. A retiring solo who can show the records were secured and the identifiers retired has actually closed the practice, not just stopped seeing patients.