In September 1997 when I began my chiropractic practice in Bloomington-Normal, Ill., the face of healthcare was much different than it is today. Health maintenance organizations (HMOs), preferred provider organizations (PPOs), quality assurance, and clinical practice guidelines were terms that weren’t thrown around as much as they are now.
Also during that time, medical physician and chiropractic cooperation wasn’t very common. In my community, medical physicians would not release records to chiropractors, would rarely return phone calls, and sometimes wouldn’t even accept our referrals. The ability to order a special imaging study or laboratory study from the local hospitals was almost an impossible challenge. The idea that a medical physician would even dream about sending a referral to a doctor of chiropractic was a scenario beyond the wildest imagination.
Slowly, however, the situation is changing. Factors affecting the change include rulings by federal courts against the American Medical Association’s (AMA’s) illegal boycott of the chiropractic profession; a growing body of scientific evidence about the safety and efficacy of chiropractic; and a general desire by patients for alternative or complementary medical care. The inclusion of chiropractic physicians on HMO and PPO provider panels has also helped forge such changes.
Members of the medical community have been forced to accept the fact that they are no longer the sole guardians of the public’s health. This acceptance does not mean, however, that medical physicians have rushed to embrace the new face of healthcare that the public is demanding. Medical professionals, like most people, are resistant to change. They have just recently begun to take a hard look at how to deal with the public’s growing desire for alternative methods of care.
The recent changes in healthcare, along with the underlying foundation of distrust that many medical doctors have harbored against DCs, has created some paradoxes for practicing medical physicians. There are several steps we can take to educate MDs/DOs about chiropractic. When we take concrete steps to overcome the years of negative programming these doctors have received, we will be rewarded with an incredible patient referral source.
Challenge Means Opportunity
In order to successfully market chiropractic, we must convince medical physicians of our professionalism, skills, intelligence and compassion. If the chiropractic profession takes a proactive stance, we have the ability to win our rightful share of the thousands of untapped patients from medical physicians who need to be convinced they can be confident about referring patients to us.
This is precisely what I set out to do in the fall of 1997. A series of articles ran in my local newspaper outlining some of the changes beginning to take place in healthcare. The paper interviewed medical physicians, who openly discussed their frustrations with the current revolution occurring in the delivery of their services. I decided to use this media coverage as a springboard from which to attempt to adjust the doctors’ attitudes and understanding of my profession. My mission was to change their attitudes in a way that would position me as an ally with potential solutions to their problems.
The Secret to Medical Referrals
The real secret to gaining the medical referrals all chiropractors deserve is communication. We have to build a bridge of understanding between ourselves and the medical physicians whose patients need our care. We must explain to MDs/DOs why they should have a professional relationship with us, our practices and our profession.
The methods we choose to use to forge an alliance are crucial. Most importantly, we need to speak in terms that our medical counterparts can understand. In our chiropractic education, we learn medical terminology and use standard medical textbooks as part of our training. However, medical physicians have not been raised in a chiropractic culture and are not familiar with chiropractic terminology, methods or colloquialisms unique to our profession. This communication gap means we must communicate with our medical counterparts in the language of medicine – not chiropractic – so they are comfortable with us.
After explaining to medical physicians why a professional alliance with us would benefit their patients, we need to address the misconceptions they may hold about our profession. In addition, we must educate medical physicians about the different types of patients and conditions we can treat most effectively.
How I Did It…And You Can, Too
With these perspectives in mind, I set about the task of contacting local medical physicians. From the Yellow Pages, I assembled a database of internists, family practice physicians, neurologists and orthopedic and neurosurgeons. Next, I wrote an introductory letter describing the revolution in healthcare that was occurring and the recent interest that the research community and general public had for complementary medicine approaches. Finally, I told these doctors about my mission to break down the walls of ignorance that existed between our two professions.
I explained that to help open the lines of communication, I would be sending them a monthly newsletter containing information from the scientific literature about chiropractic practice and treatment methods. I closed the letter by explaining that I had attached my curriculum vitae for their review, and I invited them to contact me if they did not wish to receive the newsletter.
I did a mail merge with my database of medical physicians, printed the letters and my CV, and mailed off everything in an envelope marked “Personal.” To my pleasant surprise, I received only one request to delete a medical physician from my mailing list.
Exactly two weeks after the mailing of my introductory letter and CV, I sent a second cover letter and the first edition of my newsletter, which I named, “Insights Into Chiropractic.” The issue them of the first newsletter was, “Why should medical physicians be interested in alternative or unconventional therapies?”
I provided demographic information on the typical user of alternative medicine in general, and specific demographic information about the typical user of chiropractic. I included statistics on the percentage of the population using alternative medical services and the amount of money the general public is willing to spend on those services. Also included was a summary of an article from a medical journal explaining that most patients never inform their medical physicians if they use alternative treatments. In fact, the article stated, some of the more popular alternative treatments (herbal and/or nutritional remedies) might actually interfere with some types of medical treatments.
I closed the newsletter with the appeal that these doctors at least owed it to their patients to learn more about the popular and/or scientifically validated methods of alternative/complementary health-care approaches.
A few days later, I received a call from a local MD. He thanked me for the newsletter and said he had checked a couple of the referenced article and discovered I had done a good job of summarizing the information. Within a couple of weeks, I received my first referral from him.
This breakthrough stoked my enthusiasm. I faithfully mailed newsletters on the first of the month for the rest of the year. I always selected topics concerning common misconceptions about chiropractic and subjects I thought would interest the medial physicians.
Eventually, I received referrals from a number of family practice physicians, a couple of internists, two physiatrists, a neurologist, and two neurosurgeons. After two years of mailing my monthly newsletters, I can report that about half my new patients are referrals from medical physicians.
The cost of this marketing approach was minimal. The costs included printing about 100 newsletters per month, the envelopes, and the postage – less than $150 per month.
Colleagues, Not Enemies
Medical physicians are not the enemy. Rather, if they are properly educated, they can serve as valuable allies in expanding our services beyond the boundaries that currently exist.
Implementing a newsletter series aimed at educating medical physicians in your area is a worthwhile endeavor. A medical doctor’s practice is one of the greatest untapped sources of new referral patterns available to resourceful chiropractors who are not afraid to adapt to the changing health-care landscape. Why not take advantage of the opportunity – today?