I talked to someone at The Villages Health about this. Many TVH patients have an appointment with their physician every 6 months. Doctors at TVH are asked to give 6 months notice so they can personally tell their patients that they are leaving and then recommend a new physician. So... instead of a letter, they try to tell their patients face-to-face. For the patients that won't have an appointment before the physician leaves, they will get a letter but will have the opportunity to come in and meet with the physician that is leaving to talk about their new doctor.
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