Establishing referral sources in the medical community can also bring opportunities to change negative perceptions about chiropractic

A tried and true business barometer is how well you are perceived within your community. Referrals and networking opportunities are similar to planting seeds and nurturing the growth to a tree with strong roots. If you had access to a community focus group and asked the question, What do you know about chiropractic?, how would your community respond?

Our community consists of health care providers, attorneys, educators, corporate administrators, as well as retail establishments and family-owned mom-and-pop shops. These are our potential patients and referral sources.

If we were able to reverse roles and determine what they really think about chiropractic and our role within the health and wellness of their community, we would be halfway toward creating and maintaining a strong, viable practice with enviable community relationships. Communicating and educating are crucial components in a successful, thriving practice.

You may consider establishing a community liaison staff position. This person should have their own business card with the title, “Community Relations.” Their only focus will be to meet and greet all aspects of the community, create databases, follow-up with phone calls, have face-to-face meetings, and provide special health-oriented programs for potential new patients.

Reach Out and Grow
One overlooked area for practice growth is the medical community. Rather than looking at the medical doctor as our enemy, consider them a team player. Their approach is chemical and symptom-effect–based practices, while ours is biomechanical and aimed toward cause correction. There is a need for both, and the bridge between the two should be built on trust and communication.

Their impression may be consistent with the general population’s understanding of chiropractic—DCs are superficially educated and redundant in the health care community. Obviously, this comes from a lack of interaction with chiropractors and a working knowledge of our educational and training process. They may feel that referring to a chiropractor is unethical and unprofessional, even holding them liable if improper care is rendered. This perception has, thankfully, been replaced as more enlightened younger physicians join the ranks.

They may also feel that an orthopedic or physical therapy referral would suffice, and therefore referring to chiropractors is redundant. Whatever their opinions, it is our challenge to reverse it and change their point of view. The result will be a potential referral source. Determine which medical specialists would work best with you.

General practitioner/internist. These doctors are the usual gatekeepers within managed care networks and the referring sources for most patients. They may easily welcome another resource to refer their musculoskeletal patients.

Remember that once a patient is literally within your hands, your educational process should provide extended awareness of the benefits offered with chiropractic care. Start by sending a short supplemental courtesy note to all your new patients’s primary care physicians (PCPs). Find a space within your case history form for the name of their PCPs. During your consultation, mention that your office procedure is to send a courtesy report to their PCPs and ask for their agreement in doing so.

In your supplemental report, describe the history, your findings, and treatment protocol. This is common within the medical community but less so within ours. If they receive a number of supplemental reports concerning your mutual patients, PCPs may be more apt to refer. Include a letter with your standard format of findings (Figure 1).

Be creative with your supplemental reports, which should be both faxed and mailed. Include a few office cards with your first reports. Each report establishes a relationship and team effort for the benefit of a mutual patient. A smart step is to have each patient, who was referred by their PCP or specialist, call the referral staff of that office to thank them for the referral. Positive feedback is golden.

Emergency room (ER) physicians. One often overlooked lucrative area of a practice is personal injury care. Fear of testifying or false consideration that attorneys will dictate care prevents some chiropractors from seeking these patients. But remember, if you or a member of your family were involved in an auto collision, even with a low speed impact, wouldn’t you want a chiropractic evaluation? How many patients have you evaluated with chronic symptoms as a residual effect of previous paraspinal soft tissue trauma?

Everyone involved in automobile accidents should consider chiropractic evaluation, and have the doctor assess physical irritation and necessary care if warranted. This is especially true if they were concerned enough to visit the emergency room of their local hospital. These (ER) visits are usually cursory in nature and offer little in relief or constructive advice.

There are some simple steps to introduce your office to these facilities. First, determine the names of the ER physicians, nurses, and staff. Second, write letters and follow up with phone calls. Be sure to include your insurance affiliation if you are within various networks. If repeated monthly or quarterly, you will establish awareness that results in referrals.

If you are persistent with your mailings and follow-up phone calls, the possibility of opening a referral network between you and the facility where many automobile cases are initially seen will be realized. Many cases have patients who do not have a family physician, and the emergency room staff needs a ready referral source.

Medical specialists. Depending on your extended approach to patient care, you may wish to approach medical specialties such as obstetrician/gynecologists (OB/Gyns), orthopedists, rheumatologists, psychologists, and even physical therapists. These specialists have many patients with chronic problems that may do well with chiropractic care and adjunctive rehabilitative services.

OB/Gyns often have patients with lower back irritation from pregnancy who desire relief without medication. A friendly call or letter, especially a call from a mutual patient, may open the door for referrals. Rheumatologists have patients with chronic conditions that warrant both aggressive and extended relief care. Our conservative and hands-on approach will be an asset to their patients’s care. Orthopedists often have a number of acute and chronic pain patients who are not surgical cases and can be assisted by either physical therapy and/or chiropractic care. Psychologists may treat the mind, but the body component suffers as well. Psychologists versed in our approach to care and suppression of physical stress will often mention your office as a source for increased quality of life. Physical therapists are secondary providers that require a prescription to assist their patients. If you have a relationship with a physical therapy clinic, they may be apt to refer to you when the prescription expires, and the patient would benefit with continued hands-on care.

The possibility of mutual referrals is real and promising only when the medical community is educated to our approach to care, and the feedback from their patients is consistently positive. You will not win the mind and hearts of all, but the few you do will be a regular source of new patients. This area of marketing is promising if you have the attitude that global health care is within the interest of your community. CP

Joel E. Margolies, DC, has been in practice for 25 years in Atlanta and is the author of four books: Smart Start, Workshop Workbook, Chiropractic Marketing and Public Relations, and Personal Injury Workbook. He sends a free weekly chiropractic email newsletter concerning practice management, public relations, and philosophy to more than 9,600 DCs in 31 countries. Margolies can be reached via email: joel3639@aol.com, or website: www.chirosmart.net.