Empowering Women in Chiropractic – Why MDs May Not Be Referring to You – Nicole Lindsey

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Welcome to ChiroSecure’s Empowering Women in Chiropractic the Facebook live show for successful women by successful women. Proving once again, women make it happen. Join us each week as we bring you the best in business growth, practice management, social media, marketing, networking leadership, and lots more. If it’s about women in practice and business, you’ll hear it here. [inaudible] now join. Today’s host dr. Nicole Lindsey, as she talks overhead debt and creating other sources of income. And now here’s dr. Nicole.

Hello, everybody. Welcome to today’s live episode of empowering women in chiropractic as always thank you, ChiroSecure for allowing us to do this show, put this on and put out great information. And I hope if you’re listening to this, you give ChiroSecure, thumbs up and a shout out as well. I have a great show for you today. As we navigate our new normal in everyday practice know that healthcare providers and other businesses they are doing exactly the same thing, whether it’s keeping up with the positive cases in your County, your area challenging updates on new laws, mandates and orders that are happening, new precautions, you need to take number of people max, in your office masks. Should you enforce it? How do you enforce it? All of these things that are happening to you are happening everywhere in every business right now, just two days ago, our local governor, he changed his direction on our school plan for kids in school.

So we went from 50 50 hybrid structure to now 100% virtual. So any single one decision that you make or anyone makes in any situation in, especially right now can greatly affect the end result. It can affect the lives of many, many people for years to come. So let’s go to the slides here, because what I want you to know is, and what we’re going to talk about over the next few minutes is why MDs may not be referring to you, knowing the best appropriate steps you can take and what you should be doing will make or break the outcome. No matter what the situation is. So specifically speaking, and for the next few minutes, we’re going to be talking about MD referrals, how you handle these ND referrals can determine whether you actually will get more. So tip number one, let’s just jump right into the content here.

Marketing MD tip. Number one is properly handling your first MD referral. We’re determined whether or not you receive any more. So has this ever happened to you? You’ve received a referral from an MD. You treated the patient. You figured out what their problem was because they were referred for an acute problem. You got fantastic results with that patient. The patient got out of pain, maybe it was low back pain, neck pain, their headaches went away. The patient said great things. The patient was really excited and wanted to refer their family members in and other people in. But somehow you never received another referral from that MD again, what happened? What went wrong? Well, once you get that referral, what you need to do is properly communicate to the MD that you actually did receive a referral. This is commonplace for healthcare providers to communicate to each other all the time.

So what we do not want to do is just as equally important as to what we do need to do, which we’ll talk about in a minute, but here’s three scenarios. I want to give you of what not to do when you receive that first MD referral scenario. Number one, the MD makes the referral. You get great results, but you forget to communicate back to the MD that the patient came in. Scenario. Number two, do not do this. MD makes a referral patient never returned your call, your front desk calls and calls and reaches out to schedule the appointment. But the person never calls you back. You make no communication to the MDs office that this ever happened. Do not do this scenario. Number three, the MD makes a referral to you. The patient comes in, you treat the patient. The patient does not respond well to your care.

And you make a referral out. You do not communicate this to the MD, do not do this. So these three scenarios are things that you do not absolutely want to do. And if you have done this and you have not received a referral from an MD, this may be why. So what should you do? Let’s talk about that scenario. Number four, the MD makes a referral. The very first thing that you want to do here, regardless of whether the patient shows or not shows is let the MD know that you’ve got the referral. So what we do in our office is we have a form and we send via fax or email to the MDs office, whichever way they prefer to communicate that we did receive the referral. And if the patient was scheduled, because my staff reached out to that person and actually made the appointment, we indicate on that form.

When the appointment is, if the patient is contacted in our office, our role is three attempts. We call twice. And if we have an email address, we’ll email the third time. If that patient does not respond, we’re going to let the MDs office know we’re going to take that form, fill it out and thank the MD for the referral and let them know that our office made three attempts to schedule the patient. And the patient did not return our call. So make sure that you’re letting the MD know that you got the referral and that they came, or they didn’t co because if you’re not letting the doctor go, you’re dropping, you’re dropping the ball there. We do have a form. And if you’d like this form, I’ll be happy to share it with you just PM me or, or let ChiroSecure. No, and I’ll be happy to share that form with you.

MD marketing tip. Number two is communicate your findings to the referring MD. This is really, really, really important. Have you ever had a patient that was very acute, low back pain? It was a 10 plus out of 10 on the pain scale. Uh, you gave them really good care. The best that you offer, you pulled out all the tools that you have to you and the patient is not responding. So you refer the patient back to the MD or out to an MD, or maybe out for an MRI. And you, then you take that step, but you never hear a word back from the patient. And you think about this patient often. In fact, you may even wake up in the middle of the night thinking whatever happened to Dan Jones. I wonder if he went to the orthopedist that I set them up with.

I wonder if he ended up meeting surgery, this is the kind of stuff that keeps me up at night, but has that ever happened to you? Well, this happens to the MDs too. Why? Because they care. They do care for their patients as well, and they want to know what’s happening. So they make the referral to you. They want to know what you found. Remember musculoskeletal problems is not their big strength, especially if you’re getting referrals from a family, medical doctors. So keep that in mind and know that when you’re getting one, a referral, they care about that patient. That’s their patient. They want to know what you found. So I’ve had the pleasure of meeting probably four dozen, maybe more medical doctors in my area, building relationships with them over the course of 20 years of practice and marketing to MDs. And one of the most common things that I hear from MDs is, especially when I’m with them one on one, and they can let their guard down and really ask me questions and tell me things that they want to know.

What they say is I would really like to know what you find is the problem. This fascinates me. They really don’t know, and it’s not in their wheelhouse, so to speak. So when you receive a referral from an MD properly, send a note, explaining your findings. And this is what my initial note will include. I’ll do a general narrative. Um, I won’t send an eight page narrative that they do not have time to that in any given day, they’re reading through 50, 60 notes a day. It may be more if they have more volume in their practice. So they simply do not have time to read an eight page note. So condense it and create some sort of note that you can input the basic information. And what I’m going to put in that is just basic subjective information. What they came in with, was it acute low back pain, chronic low back?

What was it I’m going to have my objective findings. Was it decreased range of motion? Did they have an antalgic lean forward head posture where their muscle spasms trigger points, name, the specific trigger points that were present in their body and any ortho neuro tests, make sure you indicate those. And then of course, if you take x-rays and you found maybe some degenerative findings, lumbar [inaudible] disc, um, phase three degeneration, um, maybe you do motion studies like I do in my office. And I found that in addition to the disc degeneration at [inaudible], I found no movement, uh, left to, right? So I’m going to put this in a few sentences in this note. So the doctor can read this. Now, most importantly as the assessment, this is where I’m going to tie what I found objectively. And I’m going to connect that to the patient’s symptoms, which is in my opinion, the key, this is giving the MD exactly what they want.

They want to know what you found, right? Right. And this is where you tie it all together. So you don’t, I want to just simply say, I found antalgic lean and trigger points in the muscle. No, you want to say, you know, the, the x-ray show degenerative disc, a positive straight leg raise on the right. Um, this is indicative of a disc issue pressing on the nerve root. The muscles are in spasm around that segment. Explain exactly why the patient is experiencing low back pain. That’s radiating down their leg. And then of course your plan of action, your recommendation for care MD marketing tip number three is to actually be specific specific with the MD about your recommendation for care and let them know. So maybe you have a wellness based practice and you believe that lifetime care, um, is for everyone that everybody should be adjusted forever rest of their life, that you want to adjust sublets all the time.

I get it. I love this model. I love this mission. Uh, I’m a life grad, say it all the time. And I big part of my practice as wellness MySpace, and, and I do convert these acute patients to lifetime wellness care. But is this something that you want to communicate to the MD when they send you a referral for this for the first time? Well, let me ask you this. Do you think it is acceptable when you go on a date with somebody for the first time, it’s been a long time since I’ve done that, maybe for you, you too, but I’m sure you can put yourself in that place. And do you think it is appropriate to ask that person on that first date? If it’s okay if you spend the rest of your life with them, um, if you, if you can marry them.

I think that that may be a bit much on that first date. Um, every once in a while it is rare, people do do that, but yeah. Uh, I think you would agree with me that if you did that with the MD, uh, through this note that it is not making sense to them, this is not their language. So in order to build relationships with MDs, this is something that this tip is really important because you need to learn to speak their language. So when recommending care, these are some of the things that MDs want to know. They want to know, what is your plan of care? Are you recommending adjustments? Are you recommending therapies? In addition to that, if so, be specific, what kind of therapies are you recommending? For example, in my office, if a patient with a disc issue that is the culprit pressing on the nerve root, causing the symptoms of radicular apathy, I’m going to recommend decompression therapy.

And I’m going to explain that a couple of seconds in this note to the medical doctor, there’s a belt that wraps around the lumbar, the lower half of the spine and another belt, the upper half of the spine, and gently tractions opens up the segments that are in question and is going to create a vacuum effect and allow that disc bulge, that material that’s pressing on the nerve root to come back into its place. And then we’re going to follow that up with some modalities to help with inflammation, some cold laser, to, to block pain, flush out inflammation and, and help that disc heal. So be specific. And this way the MD really can gain respect and an understanding for what you’re doing. They want to know the length of care. Now, if you do believe that everybody should be adjusted for the rest of their life, that you’re treating their subluxations.

Um, this is, this first note is not the place to put that. Okay. Eventually you will be able to have this conversation with the MD, trust me, but not on this first date, if you will. So length of care, um, how long are you going to see this patient in this, or do you recommend initially in this acute care, how many visits, um, will there be, and will there be a reassessment, will you be checking in with the patient to recheck some of those tests, the orthopedic and neurological tests that, that, um, proved there was a problem in the beginning? What are the specific goals? You know, maybe the patient indicated that they could not tie their shoes. They couldn’t bend over to tie their shoes. So this would be a great goal to relay to the medical doctor that we are, we are aiming to get the patient, to tie their shoes after four weeks of treatment, without discomfort.

And then they want to know, should we collaborate? Is this something that we need to work together? In other words, do, do we recommend that the patient get a corticosteroid shot or some kind of pain relief, um, anti-inflammatory or more muscle spasm, um, prescription in addition to what we’re doing. So collaborating and letting them know what our plan of acts action is, is really important. The MD wants to be part of the solution, part of the process. So include them MD marketing tip number four is communicate the patient’s response to care. All of it, the good, the bad, and even the ugly. I will never forget one of my patients miss June, let’s call her. Uh, she was a referral from a local MD who I really respect and greatly. This was the first referral that he sent to me. And she came in with a migraine headaches, chronic migraine headaches, and he is a headache specialist.

He tried everything and couldn’t get results. So I handled her, myself, I with, with everything I had in me, all my, my tools, I gave her the best care I could. I made sure she was comfortable throughout her care. I mean, you know, you’ve been there. You’ve had those patients that you’ve had to, to really pamper and really give the best care to. She started to get results in the beginning of her care. And then all of a sudden she took a turn for the worst. And, you know, it happens, um, especially with some of these complicated migraine cases. Well, she came in and took it out on me that her migraines were getting so bad again. And it was all my fault and she never wanted to come back and she was gonna make sure she told the medical doctor, um, her experience and how I made her worse and that she wouldn’t be coming back.

So when she left the office that day, I knew that I needed to do something something fast in order to, uh, preserve my relationship with this medical doctor. And they needed to get to him before she did. So that’s when I decided that I was going to call the medical doctor and just let him know the good, the bad and the ugly. And that’s exactly what I did. So I called doctor the doctor, I conveyed this, this, this whole thing, this whole story with the doctor in a matter of a few minutes, got them on the phone and let him know, um, exactly where she was at and exactly what she said. I was so nervous about doing it. But here’s the interesting thing is that the medical doctor’s response was, Oh, that patient. Yeah. She she’s known for doing that. She can take a turn for the worst on a dime and she can take it out on you.

So don’t let that upset. You just keep doing what you’re doing. If you feel like you’re making progress and you’re helping her just keep doing it, that that’s all I needed to hear. And from that, I went forward, I started calling MDs like this and made this part of my protocol. And guess what? After that phone call that day with that medical doctor, I got another referral from him. So make sure you’re communicating the patient’s response to the medical doctor, whether it’s the good, the bad, the ugly, the ugly. So if these are some tips, if the patient is not responding as expected, do like I did get on the phone and call the MD, let them know. Maybe you don’t have time to do that, or you’re nervous. You don’t know what to say. Um, I do coach chiropractors, how to do this. I have an online course.

If you need more help on that, I’ll be happy to help you, but is a wrong and right way to do this. Do you know that, um, if they’re not responding, go to plan B, um, make sure you have a plan B in your arsenal, um, recommend they get an MRI, set them up for an MRI so that you can continue to give this case, uh, put it in the right direction and refer out, you know, give the patient a couple of names of other doctors set the patient up with, uh, with an orthopedist, um, maybe says, send him back to his MD, make sure if that patient is not responding, that you properly handle the case and you let the MD know this in the note that you send to the patient. If the patient is responding as expected, send a followup note for sure.

Let the MD know the great results that the patient got. In fact, let the patient know that they too should tell the medical doctor. And what I simply do is tell the patient, you know, this is how we’re going to truly change. Healthcare is we’re going to educate more and more medical doctors about what we do. And we’re going to let them know that we can help those patients, that aren’t responding to medication. So I would really appreciate it. If you let your MD know the great results that you got and oftentimes patients will do will do exactly that. And let the MD know. You can also pick the phone up and call the MD if the patient has responded well, this is a great opportunity to educate the MD, set up a meeting with the MD. And I teach these, these strategies, these calls in my course.

And then of course your discharge note from acute care, make sure that you respond to the MD that yes you have in fact, discharged the patient that you referred, or she referred you for the headaches. And now you are recommending maintenance care, uh, on an as needed basis or whatever your recommendation is that at that point. So that is the proper way. And the improper way to handle MD referrals. We tend to spend so much time on how to make the initial MD connection to get that patient in the office. And although that is a very important part of the process and a very important step that I do teach as well, knowing how to properly handle the referral is equally as important. Just like we said, in the beginning, every action that we take in life or with an MD referral has the potential to greatly impact your practice and patients lives for years to come. And I will end with this quote from Sean cubby. We are free to choose our paths, but we can’t choose the consequences that come with them, but you can choose wisely. Thank you

For watching everybody. And don’t forget to tune in next week for our Facebook live for ChiroSSecure’s Empowering Women in Chiropractic. Thanks everyone. Join us each week as we bring you the best in business growth, practice management, social media, marketing, networking leadership, and loves more. If it’s about women in practice and business, you’ll hear it here. We hope you enjoy this week’s Facebook live event. Please like us on Facebook comment and share. We look forward to seeing all of you next week for another episode of empowering women in chiropractic. Now go ahead and hit the share button and tell your friends and colleagues about the show. Thank you for watching. Have a beautiful day. This has been a ChiroSecure production. [inaudible].

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