Making the first move: how to encourage physician referrals

To encourage primary-care physician referrals, start by extending a professional invitation.

Physician-referred patients are a source of pride for the fortunate practices that receive them. A physician’s referral is a strong endorsement. A base of referring physicians can generate large numbers of new patients and, if arranged properly, become a self-sustaining business model.

Yet reaching out to local physicians is something that many chiropractors hesitate to do. They enjoy practicing in their comfort zone—but this can be a colossal mistake.

The rise of the specialist

When adults have a fever, nasal congestion, or a common condition such as asthma, more than 40 percent will seek medical care from a specialist rather than a primary care physician (PCP).

Many patients believe that specialists are better able to treat specific conditions than general physicians. The nation’s shortage of PCPs is also leading patients to obtain medical services from specialists. By 2020 there will be an estimated shortage of 45,000 PCPs, according to the Association of American Medical Colleges.

If you can’t beat them

Why are specialists so busy? They learned long ago to behave as specialists. Specialists send reports without being asked and acknowledge the professionals who refer patients to them.

Some chiropractors don’t receive many direct referrals from allopathic physicians. You can change this by acting like a specialist and sending reports and acknowledgments to PCPs as if they were direct referrals.

The first step in building these relationships is to ask the name of the patient’s PCP (even for non-referred patients). Also ask patients if you can send their physician a report of your findings. At first, you may not hear anything from the PCP, but once a few of your reports and thank-you’s come across the PCP’s desk, the referrals will start to flow.

To accomplish the first step, simply meet the expectations of being a specialty practitioner. You may choose to call PCPs initially if you have no prior experience with them, and then follow up by sending a report.

Sending reports to PCPs introduces you as a healthcare professional. It lets them know that their patient was in for a neuromusculoskeletal evaluation and that you will provide an initial report of findings as well as periodic updates of the patient’s progress.

This reassures PCPs that you will provide noninvasive, conservative treatment and that you will refer back to them.

Keep reports short

Long narrative reports are critical for potential litigation cases such as personal injuries, but they are not necessary for PCPs. Reports to PCPs and other healthcare professionals should be brief and to the point. The reports you receive from radiologists serve as an example—they are likely brief, factual, and without filler language.

The personal follow-up

Choose one evening to be a “work night” and invite a medical doctor or osteopathic PCP to dinner. If the PCP hasn’t referred a patient to you lately, referrals will increase overnight after you visit over a meal. Make it a social evening by including your spouses or significant others. In addition, sporting events such as golf or tennis work effectively in this regard.

In the allopathic community, specialists treat referring doctors like gold. Pay attention to your own referring doctors. Patients who are referred from MDs and DOs are like diamonds. They look up to you as a specialist. They follow through, they pay, and they refer other patients like themselves.

Professional breakfast meetings

Morning coffee gatherings can work well for professionals with busy schedules. Everyone has time for a breakfast meeting or at least a short get-together for coffee and a muffin at the local shop. Develop and nurture the relationships that you form in your professional community. If you don’t, someone else will.

To get started, develop a list of the medical doctors you are targeting for referrals. This list can be extensive, but try not to limit your thoughts to who you believe would or would not refer you. You may be surprised.

Once you identify a doctor you would like to take to breakfast, the next step is getting the professional to meet with you. It’s easier to obtain a meeting when you know someone in common.

For example, you may have a patient in common with another healthcare provider. You can call the provider and explain that you’ve begun treating one of his or her patients, and that you always like meeting with the other members of a patient’s healthcare team.

You may also have a patient who knows the physician from the golf course or another social context. Ask your patient to intervene and give the “seal of approval” before you call the doctor to set up a meeting. During these interactions, closely follow HIPAA policy.

Track your results

Create a file on the professionals you connect with and record the results of each meeting. Details worth noting include doctors’ likes and dislikes, family information, and items about their practice. In addition, track the referrals that come from each professional.

Implement these strategies successfully, and you’ll tap into a virtually unlimited stream of medically referred patients.

Mark Sanna, DC, ACRB Level II, FICC, is a member of the Chiropractic Summit, the ACA Governor’s Advisory Board, and a board member of the Foundation for Chiropractic Progress. He is the president and CEO of Breakthrough Coaching and can be reached at 800-723-8423 or through mybreakthrough.com.