Creating a Referral Relationship with the Medical Profession
February 22, 2010161 views
"Creating a Referral Relationship with the Medical Professional"
By Mark Studin DC, FASBE(C), DAAPM, DAAMLP
Creating relationships is a long term project as it takes time to build relationships and to gain the trust of the Medical Professionals in your area. As with any successful practice building program, it takes time and with some exceptions, there are no “get rich quick” schemes. There are only 2 “get rich quick” practice building programs; one introducing yourself to your community and the other is to have an event and we will discuss those in future consultations.
The steps to get started in building a referral relationship with MD’s are easy and will not involve too much of your time on a daily or weekly basis. If you begin with your next new patient or the new ones that came in over the last few weeks, you will start to build the foundation of a whole new referral source for years to come.
You may be asking yourself, “Why do I want to get involved with the medical community in my area?” My answer to that question is, “the medical community sees and takes care of more than 95% of the population while we as chiropractors see about 5%.” They see the patients and we need to become part of their referral base. The time is ripe because managed care requires communication between all providers. MD’s do not like to treat musculoskeletal problems such as neck and back pain because primary care providers live in the world of “infectious disease” not musculoskeletal diseases and consider it a nuisance clogging up their offices. They will be quick to refer out to the local Physical Therapist or Orthopedist, so why not make you and your office an option?
Think about this: If you as a Medical Professional were the recipient of a consistent and professional effort by a local DC, would that change your opinion of the DC and the chiropractic profession in general? This is about you generating consistent and professional initial reports, interim reports, and discharge summaries. Unlike 10 and 20 years ago, chiropractic is main stream with most MD’s as the newest generation has grown up with chiropractic a viable part of their community and accepted unlike previous generations.
You need a few components to get started and make this program work:
1. Work...your desire to work and the persistency to keep at it. If you do not sustain your efforts over time, don’t even start. Short bursts will make you look worse than doing nothing.
2. It will take you being the best at what you do and that requires you to be well read in the research community. I urge you to join the American Academy of Medical Legal Professionals. An organization dedicated to providing peer reviewed research as part of your dues. You can find them at www.AAMLP.org. Remember, MD’s live in the world of the printed material and that is a very good thing, because too much rhetoric and not evidenced based findings mislead too many.
3. A scientific explanation of what you are doing when queried. Just saying “I adjust and the patient’s scoliosis gets better because I say so” doesn’t cut it.
4. A professional, admissible CV. You can build yours on this site by clicking on the CV Editor & Builder. This is the single most influential item for referrals.
To begin, add a space on your intake forms for the name and address of the patients’ primary care doctor. On your consultation ask the question “Is it okay for us to forward a report of our findings to your family doctor?” If the answer is yes, then the following reports should be part of your communication with that MD: 1) Initial “Narrative” report that must be typed and similar in look and format to all other specialists 2) Interim reports, 3) Discharge summary.
Initial Report:
Medical professionals expect a report once a referral is made, no different than any other specialist they work with.
It doesn’t have to be lengthy and overly detailed but it must be complete.
It should take no longer than 3-4 minutes to read and must have a conclusion outlining the problems and your solutions.
If you do not have a complete evaluation to create a report from, go to www.teachchiros.com or www.cmcsmanagement.com and click on “Forms & Templates” to find an evaluation template that satisfies a “5” level evaluation and re-evaluation. The MUST be typed or dictated, which is what I did and highly recommend. Be careful of the computer generated forms and too many look canned and will make you look the “fool” if so and defeat the entire process. The report should include:
1. Introduction- your patient consulted me today or Thank you for referring ________
2. History
3. Examination findings- positive findings only
4. Assessment: Clearly state your diagnostic impression as per ICD-9 nomenclature
5. Treatment plan: Includes all modalities, therapies, frequency, and when your next re-evaluation will be (no longer than 4-6 weeks). This includes all testing and referrals. Refer back to the MD when clinically indicated.
Get this report out within 3 days of the initial visit. Do not try to get the report out…get it out!
Interim report:
This report is very important to keep the referral system moving. Make this in narrative style as well. Show and report all improvements and include any new diagnostic test results or orders.
Discharge summary:
This is a very important aspect to help establish trust and credibility. This is only a discharge that relates to the injury or condition for which the patient was referred to you. No matter your practice philosophy you still have a duty and obligation to educate your patient about the benefits of a lifetime of health and wellness and how you as a chiropractor can help.
If you follow this plan it will show the MD that this is not about trying to take over the control and care of their patient, but that you want to co-manage the care of the patient with the MD. It will show you as part of the overall medical community in caring for patients.
If you do your job properly and your education process is in place then the patients will develop the confidence in you and your office and begin to refer others to you.
Conclusion:
I also urge you to communicate directly with the MD. If you have questions about the patient’s condition, or there are potential problems that MD is not aware of based on his reports, call and talk to the doctor as a co-treating doctor. It will be appreciated.
In future consultations, I will talk about how to utilize research and other materials in building a relationship with the MD’s in your community.