Seller guide
How to Tell Patients and Staff You Are Selling Your Practice
Tell people too early and you risk the deal. Too late and you break the rules or lose your team. Here is the order most sellers follow.
Short answer
Tell key staff when the buyer needs them, usually around the letter of intent or due diligence, and everyone else at or near closing. Patients usually hear last, but your state may set the timing: Texas requires a letter or email to patients seen in the last two years and a posted notice at least 30 days before a sale, and Ohio requires notice at least 30 days before your last day seeing patients.
The usual order
- Your partners and advisors, before you go to market.
- One or two key managers, when the buyer's due diligence needs them, often after a letter of intent.
- All staff, at or shortly before closing, when the deal is certain and you can answer their questions.
- Patients, on the timeline your state requires, ideally in a joint letter with the buyer.
Leaks are the risk. An AMA Journal of Ethics case starts with a patient overhearing staff in the waiting room talk about the practice being sold to private equity. Keep the circle small until you can explain what changes and what does not.
Telling your staff
No law sets a staff notice date for a small practice sale, outside the WARN rules below. Advisors commonly bring in key managers at the letter of intent or diligence stage, because buyers often want to meet them and may make their retention a condition. General staff typically learn at announcement, at or shortly before closing. If the practice will close rather than sell, Medical Mutual Insurance Company of Maine recommends telling staff at least three months ahead.
What staff want to know
- Do I still have a job, and with whom?
- Will my pay, schedule and benefits change?
- What happens to my unused PTO?
- Who do I report to after closing?
In a typical asset sale, the seller ends each employee's employment and the buyer rehires the people it chooses. That means final paychecks on your state's deadline and payout of accrued PTO where state law or your handbook requires it. Agree with the buyer in advance who pays what.
Stay bonuses
A stay bonus can keep your best people through the transition. We found no published survey of stay bonuses in practice sales. As a general reference, MGMA has described retention bonuses of 5% to 15% of annual salary, often with repayment if the employee leaves early.
Does WARN apply?
The federal WARN Act generally covers employers with 100 or more employees and requires 60 days' notice of a plant closing or mass layoff, so most independent practices fall below it. In a sale, the seller is responsible for notice of layoffs up to the closing and the buyer after. Some states set lower thresholds: California's applies to employers with 75 or more employees, and New York's to those with 50 or more full-time employees in the state, with 90 days' notice.
Telling your patients: state rules
| State | Who | When | How |
|---|---|---|---|
| Texas | Each patient seen in the last 2 years | Posted notice at least 30 days before a sale, departure or closing | Letter or email, plus notice in the office and on the website |
| Ohio | Patients seen in the 2 years before your last patient date | At least 30 days before your last day seeing patients | Mail, with the date documented, or a HIPAA-compliant portal message |
| Florida | The public | Once a week for 4 weeks; copy to the Board within a month | Newspaper notices in each county |
| New Jersey | Patients treated in the prior 6 months, and the public | Newspaper monthly for the first 3 months after you stop | Newspaper, plus reasonable efforts to contact patients directly |
| California | Patients | "Sufficiently in advance" (no fixed period) | Letter; the CMA recommends certified mail |
| North Carolina | Active patients seen in the last 1–2 years (suggested) | Not specified | Not specified |
Texas exempts some physicians, including those who practiced only in hospitals, emergency rooms or surgery centers, and anesthesia, radiology and pathology. In New York, the carrier MLMIC recommends written notice at least 60 days before you stop, and no less than 30. Pennsylvania's 90-day rule applies to an employer when a practitioner leaves, not to a practice sale. If your state is not listed, check your medical board early.
The AMA Code of Medical Ethics also asks physicians who sell or leave to tell patients how to get their records and for how long they will be available.
Sample patient letter
Dear [Patient name],
After [number] years of caring for you and your family, I want to let you know that [Practice name] is joining [Buyer name] on [date].
Your care will continue at the same office, with [the same doctors and staff / Dr. Name]. You do not need to do anything to keep your appointments.
Your medical records will be kept by [custodian name and address]. If you prefer to get a copy or transfer your records to another doctor, call [phone] or write to [address] before [date].
Thank you for trusting us with your care.
[Your name]
Texas requires the notice to include the date, how to get or transfer records, the name and location of any new practice, and the new custodian if ownership of records is changing. Have your attorney check the letter against your state's rules.
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Get a Free Practice ValuationCommon questions
When should I tell my staff I am selling my practice?
Most sellers tell one or two key managers around the letter of intent or due diligence, and everyone else at or near closing. No law sets a date for small practices outside WARN.
How much notice do patients need when a practice is sold?
It depends on your state. Texas requires a posted notice at least 30 days before a sale and a letter or email to patients seen in the last two years. Ohio requires notice at least 30 days before your last day seeing patients.
Does the WARN Act apply to a medical practice sale?
Only if the practice has 100 or more employees, or meets a lower state threshold such as 75 in California or 50 in New York.
Who keeps the medical records after a practice is sold?
Usually the buyer, as custodian. Patients must still be told how to get copies or transfer their records.
Related reading
Sources
Figures are attributed to their source and date. Ranges are published estimates, not a valuation of any practice.
- 22 Texas Administrative Code §163.4, "Physician Responsibilities when Leaving a Practice," effective January 9, 2025 (Cornell LII). Link
- Ohio Administrative Code 4731-27-03 (Ohio Laws). Link
- Florida Administrative Code R. 64B8-10.002 (Cornell LII). Link
- N.J.A.C. 13:35-6.5 (Cornell LII). Link
- Medical Board of California, "Practice Information." Link
- North Carolina Medical Board, Position Statement 2.1.2, "Departures from or Closings of Medical Practices," amended January 2025. Link
- MLMIC, "Considerations for Selling or Closing a Medical Practice," May 24, 2022. Link
- Duane Morris, "Pennsylvania's New Fair Contracting for Health Care Practitioners Act Limits Post-Employment Restrictions," July 26, 2024. Link
- AMA Code of Medical Ethics, Opinion 3.3.1, "Management of Medical Records." Link
- AMA Journal of Ethics, "When and How Should Patients Be Informed About Clinicians' or Organizations' Sale of a Clinical Practice to a Private Equity Buyer?," May 2025. Link
- Medical Mutual Insurance Company of Maine, "Closing Your Practice – Retirement – Relocation – Selling your practice." Link
- MGMA, "Ask MGMA: Optimizing medical practice staffing using bonuses," September 14, 2023. Link
- U.S. Department of Labor, Employment Law Guide, "Notices for Plant Closings and Mass Layoffs." Link
- 20 CFR 639.4, WARN notice responsibility in the sale of a business (eCFR). Link
- California Employment Development Department, "Layoff Services: WARN." Link
- New York State Department of Labor, "Worker Adjustment and Retraining Notification (WARN)." Link