Otherwise other local DCs will beat you to these relationships
SITTING, WISHING AND HOPING YOUR OFFICE WILL BE FLOODED WITH NEW PATIENTS SEEKING YOUR EXPERTISE IS A FUN EXERCISE, but it is worthless without a plan of action. Twenty-two years ago there were very few MDs who would give a chiropractor a doctor referral, or the time of day. In fact, it was only in 1986 that the AMA lifted its member position that it was unethical to “associate” with chiropractors — not that long ago.
To this day, some MDs who were trained during that time frame hold a specific negative impression about chiropractic care, but that is changing. It used to be that only certain radiology groups would actually take an MRI referral from a chiropractor. Then the research and patient satisfaction studies started to come out frequently and positively.
Back then small numbers of MDs gave doctor referrals to chiropractors; this was before pain management was a specialty, and when you could build a huge referral practice with a single surgeon. Times are different now.
JAMA, the New England Journal of Medicine and medical guidelines started including spinal manipulation (their term) in their papers. The effect was immediate and significant for those chiropractors who understood how to use them.
Medical doctors were starting to look for chiropractors who had been in practice a long time — a patient would come into my practice stating, “My primary care physician told me to see a chiropractor, but [he/she] didn’t know any good ones.” That was the first sign of a tidal shift at the grassroots level toward chiropractic care and away from narcotics. But we still have a tremendously long way to go.
Now the vast majority of my new patients come from primary-care physicians, and they are all personal injury cases. We are seeing an unprecedented amount of positive research showing chiropractic as a first line of treatment for spine pain. Neurosurgery journals are talking about missed biomechanical pathology as a reason for failed spine surgery. Chiropractic is being shown to have superior outcomes in relation to disability management compared to medicine and physical therapy.
What is your plan?
Do you sit back and wait until other chiropractors in your area build relationships with the primary care physicians, medical specialists and emergency departments, or do you beat them to the punch? Remember, the medical community is actively looking, and it will happen regardless.
There are three initial things to do to gain the trust of the medical community. There are no shortcuts and it is work — however, the alternative is a drop in volume and new patient appointments, and patients going to chiropractors that MDs are making doctor referrals to. First steps include:
Get documentation in order — It has to be efficient and compliant. It prevents audits and protects your license, but it also serves a marketing purpose. Chiropractors who get treated like specialists enjoy doctor referrals that come with professional reporting. That is critically important as there is little room for lack of communication with MDs, who will look elsewhere.
Ramp up reporting and coding — EMR costs have dropped significantly, and most are run on cloud-based platforms, which are much more secure than local servers in your office. Learn to follow CPT coding guidelines for initial and re-evaluations, as well as daily SOAP progress notes, which is easy to do.
Turn your reporting into a marketing tool — Once the reporting is in order, it is simple to create a “document sharing” system to then share with primary care and medical specialists. This is where a DC’s reporting becomes a marketing tool. It takes a little work and focus to get it up and running, however there is little choice — DCs in your community are moving in that direction, so it may as well be you at the forefront. The busy clinics are not busy by mistake.
Build your CV and get out there
Next, build your curriculum vitae (CV), loosely translated to the “course of your life.” It’s the listing of your professional accomplishments and showcases your expertise — or lack of it. The chiropractic profession is one of the few in health care that most often doesn’t require participants to develop a CV during training. It is important and it matters — a CV is your new business card.
If you find you have difficulty creating a CV, there are free resources to help you, one being uschiropracticdirectory.com; it is foolproof. Ask for a transcript from your school or state association; they are required by law to maintain those records, which is a real shortcut.
Finally, get familiar with the research that supports the profession and get out there to introduce yourself. Visit every primary care physician in the community, especially the ones caring for local patients. Make introductions with your CV, a patient note, research — educate MDs on chiropractic. Make it a daily or weekly exercise, and you may find it a really fun way to practice.
BILL OWENS, DC, is currently in private practice in Buffalo, N.Y., and generates the majority of his new patient referrals directly from the primary care medical community. He also works directly with doctors of chiropractic to help them build relationships with primary care physicians, medical specialists, urgent care centers, and hospitals, and create medical resident rotations within chiropractic offices. He can be reached at firstname.lastname@example.org, via mdreferralprogram.com or by calling 716-228-3847.