Insider Knowledge: Four Reasons Why MDs Won’t Refer
Dr. Steele and I have spent our professional lifetimes building relationships with medical providers. Those efforts pay off to the tune of more than 300 new patient MD referrals each year. We consider that statistic a “win”… but we’re still not satisfied.
We recognize that MD referral patterns vary from you being the leading option to “well…if you insist on visiting a chiropractor, then I want you to see Dr. ______.” Despite connecting multiple times per year for the past few decades, some obstinate medical providers are still reluctant to refer anyone.
We wanted to know why, so we asked more than a dozen primary care MDs why they or their peers would be reluctant to refer to a chiropractor. Their candid replies allowed us to assemble this list of the top four factors that chiropractors MUST address in order to successfully attract medical referrals.
Please recognize the following statements are not our words. We tried to relay each MD’s concern verbatim, whether we agreed or not. We encourage you to read each statement with an open mind; recognizing that perception and reality sometimes differ, depending upon the view from where you stand.
Ready? OK… Hold your breath, we’re going in. Here are the MD’s answers to our question: “Why would a PCP not refer to a chiropractor?”:
1. The Trust Factor
We only work with like-minded people who we know and trust. We’re looking for a relationship with someone who will consistently treat our patients the way we would want to be treated.
Family physicians are paternalistic in nature, we work to protect our patients from making healthcare decisions that could produce undesired results.”
Do no harm is the most important metric.
Whenever I refer, I’m placing my reputation on the line - and that’s not something I’m willing to risk on someone who needs a billboard or full-page ad in order to attract a new patient.
I frown upon (any provider) peddling supplements in the office – especially when their patients “need” a new one every visit. (We heard multiple variations of this concern)
2. The Substandard Care Factor
We’re skeptical of unfamiliar things that don’t have good evidence. We hear that manipulation works, but still have concerns about the “less well-studied” options that are employed by some chiropractors.
Saliva testing and hair analysis are instant red flags that maybe this is someone who does not adhere to the diagnostic standards that I would expect.
We know what you’re telling our patients -they come straight back to us. If someone suggests unfounded therapies or criticizes an established medical treatment like vaccination, you can forget about ever seeing one of my patients.
When I see an uninterruptable X-ray facility, I won’t encourage my patient to use it.
In the doctor’s lounge, we joke about certain chiropractors' notes that contain odd or superfluous language.
3. The The Ignorance Factor
Truthfully, we don't know what you do. In medical school, we’re not really taught about what a chiropractor does or how it works.
We don’t know much about your specialty, and much of the feedback we receive is from your failed cases – patients with good results don’t need us afterward.
Maybe you’re a placebo…. and that’s OK, but…(tails off into a distressed look of ignorance).
4. The Over-engagement Factor
Some (needy) patients seek attention without the capacity to ever get better. Healthcare is their very expensive form of entertainment and there are plenty of providers, not just chiropractors, that are willing to sell long-term tickets to that show. Again, this problem is not unique to DC’s. Medical specialists, pain management, surgeons, and physical therapists, are also guilty – the worst is home health care. To stand out, before accepting a case, you need to ask yourself, “Will this care really matter long-term?”.
Accountable care health plans, particularly Medicare advantage plans, rely on limiting costs. We serve as financial stewards for those plans. If a provider runs up a bill (from excessive care or a patient who simply desires excessive care), either we’re kicked out of the system or the plan ultimately collapses—regardless of the cause, that’s bad for everyone.”
Don’t feel that you need to achieve resolution in every case. Measurable improvement of a chronic condition is realistic. What I want more than resolution is a reasonable treatment plan with goals and an endpoint.
Well, there you have it, warts and all: a collection of knowledge that could only be harvested from decades of interaction. While you might not like to hear some of these stories, we hope this information helps you reassess your potential for integration and medical referrals.
If you allow truth to enter your ears,
be absorbed by your brain,
and grow in your heart,
someday, it might just save your ass.
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