Resource Centers:(News, information, and tools to support your practice)
November 2009
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Speaking their language
Market to MDs with treatment plans
By Bharon Hoag
It is a fact that medical and chiropractic disciplines each have their missions, their avenues to successful outcomes, and their respective merits within the healthcare universe.
But these two professions can, and should, aim toward a degree of collaboration.
As always, communication is the starter. Once a positive communication atmosphere has been established, you can work together successfully for the patient’s, as well as your own, recovery and overall well-being.
MDs can be an amazingly productive referral source, and the results can be astounding and beneficial for all concerned. You can take on difficult cases that don’t respond well to conventional medicine and that MDs would prefer not to deal with — chronic pain, workers compensation, and personal injury cases.
Communications techniques
So how should you communicate? By speaking doctors’ language through a medium they need, know, and respect — the treatment plan. Fortunately, it’s part of your language as well.
If you’re treating a family practice patient, send the doctor a treatment plan, clearly marked as such, accompanied by a brief and professional cover letter that explains what you’re sending and why you’re sending it.
Stamp the envelope “Patient Records: Confidential.” By addressing the envelope this way, doctors are legally required to open the envelope and read what is inside. What you include inside determines whether or not they read on. If you present the material well, you are taking a giant step toward a positive professional relationship.
The marketable treatment plan
One can not emphasis enough the importance of writing a good treatment plan. The treatment plan is developed out of the evaluation and management process, which in turn is informed by the Medicare Guidelines for medical necessity.
It should convey clearly that the case has been accurately diagnosed and that you have followed logical steps in coming up with a care plan, focusing on data, strategy, and rationale. Medicare outlines it as follows:
• Frequency and duration;
• Treatment you plan to provide and why;
• Specific treatment goals; and
• Objective measures for treatment effectiveness.
The plan you share with the primary care physician should also include the following supportive documentation, all of which normally is developed out of the initial patient visit:
History: Describe the complaint, registering what the patient says is wrong and what
Exam: Be clear about how you respond to the patient’s description of the pain or impairment. Be complete and concise, and wherever possible support your conclusions by referencing recognized guides such as clinical notes systems or exam forms.
Medical decision-making: Demonstrate that your treatment decisions are based on reviewable data, diagnoses/case management options, and/or evaluation of risk of complications (morbidity, mortality). Establish the problem severity level using at least two of these three factors.
Show that your decision-making is informed through the patient history and your examination. Indicate clearly that the problem has been thoroughly thought-through and that you have followed logical steps in coming up with a care plan.
It should come as no surprise that the reason this approach works is that it follows a model also basic to the activities of the primary care physician.
Easy does it
You must be mindful of patient considerations. Patient records are confidential, but the intake forms your patients sign should include the option to decline sharing the information with their primary care physician.
Most have no problem with this, but an exception might be the occasion in which the patient specifically does not want the primary care doctor to know he or she is seeing another doctor.
This highly effective marketing initiative shouldn't require any additional work from you. Assuming that an automated notes/documentation solution is in place, the documentation involved is stored and formatted at the conclusion of each patient visit. All that remains is to print the report and courtesy letter, which can be formatted for easy adaptability and distribution by the front office.
The same procedure should be followed each time you do a re-evaluation and over time, your MDs will discern that you are serious about case management; that you are highly professional; that you comply fully with healthcare regulations; and that you are a reliable option for handling certain cases that don’t respond well to conventional medical treatment.
Bharon Hoag, chief consultant of ACOM Health Chiropractic Consulting Group, has worked in the chiropractic profession for 11 years and taught for eight, developing his unique “nondoctor” approach through ownership of four clinics and management of up to nine. He can be reached through www.acomhealth.com.
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