How To Build Referral Relationships with Medical Providers: Episode 236

Welcome to the Health and Wellness Practitioners podcast. I am your host, Dr. Danielle Angela. In this show, I and my guest experts will talk about everything from getting your practice started to developing your clinical skills, growing your practice your way, and of course, dealing with the real stuff like burnout and work life balance. Whether you've been practicing for decades or just started your journey, you'll find something here for you. So take a deep breath and enjoy the show.

Why You Should Build Referral Relationships with Medical Providers In Your Area

Welcome back to the Health and Wellness Practices Podcast. I am your host, Dr. Danielle Angela. In today's episode, I am sharing with you another how-to from Aligned Women that I recorded in either 2019 or perhaps 2020. And this how-to, as I mentioned in last week's episode, is all about how to build relationships with medical providers in your area. This how-to is my secret sauce. Y'all <laugh> this how-to is so effective. If you want to receive referrals from medical providers, you've got to listen to this episode. And why would you wanna receive referrals from medical providers? Let's face it, hospitals, large networks, the pharmaceutical industry, they have way bigger budgets than we do in our small businesses to market and advertise, right? So people are hearing about different types of medications. They're seeing pharmaceutical commercials on TV pretty much all day. And so they might be going to their MDs looking for help with certain conditions or sets of symptoms, and also not feeling satisfied with the results or the outcomes from the care that they're seeking there.

Not because they're not happy with their medical doctor, but because the medical doctor just simply doesn't have good solutions for these types of complaints that they're seeing. So who does? We do, right! Because we get to the root cause of people's complaints, conditions, and symptoms. So if you know that your ideal patients or clients, if you know that the people that you can best serve are sometimes going to their medical doctors and talking to them about the symptoms that they have, but you can help them get to the root cause of those symptoms, then why not build these relationships so that the MDs in your area know that you can help with these things that they don't have good solutions for. Okay, before we dive into this how-to, I'm gonna give you a few disclaimers just like we did in last week's episode, which by the way, if you haven't listened to last week's episode, it is about how to get more referrals to your health and wellness practice. And I highly recommend listening to that one as well. These two episodes really go hand in hand with each other if you want to receive more referrals to your business. 

Okay, so the disclaimers.  

#1 is that you will hear my kids in this episode. They were apparently running around and laughing and giggling and making noise while I was recording this, how two in my office and they were little. Well, here's the thing. If you've followed me on social media since around the time that I started a line woman back in like 2000 15, 16, 17, you were seeing my kids in my live videos all the time, you know that they've been a huge part of why I started this business. So of course they've been by my side through the whole thing. And while I've been running this online business, I've been doing it from home. My children also live there. If hearing my kids in the background of this episode is not okay for you, this is probably not the best podcast for you to listen to. <laugh>, there are probably lots of episodes where you hear children in the background, okay? 

#2 I talk specifically to women in chiropractic in this episode about using the strategy that I'm teaching. But I want you to know that no matter what type of health wellness profession you practice, this strategy can work for you. You may feel like you are not smart enough, you may feel like you don't have enough clinical knowledge or whatever it might be. I promise you, this strategy can work for you. You can learn anything <laugh> you, you can learn anything. It's beyond your scope of practice per se, but you can increase and expand your scope of knowledge at your own free will. You can Google stuff and figure it out. So don't think that because I'm using the word chiropractic or chiropractors that this won't work for you. It will. 

Lastly, I refer to a template letter. This template letter, y'all, is my secret sauce. It is the thing that has allowed me to get in the door to get my name, my clinic's name, my colleagues' names in front of orthopedic surgeons, neurosurgeons, athletic trainers, athletic directors at universities in high schools that we have been trying to build relationships with for a long time. So if you want to get access to the template letter, I'll send it to you for free. Just DM me on Instagram. I'm @DrDanielle Angela, you can find me there. I will send back to you the template letter. You just gotta promise me that you'll actually use it. Okay? All right, let's dive into the how to. This is gonna be a good one and I want to hear your takeaways at the end.

Benefits of Building Referral Relationships with MD’s 

Hello Aligned Women. Dr. Danielle here. I am bringing you the February, 2020 how to and this month we are talking about how to build relationships with MDs. I'm going to teach you a very specific form of communication with medical providers, not just MDs, but anyone in healthcare that you may want to build a referral relationship with. And I want you to know that what I show you in this how-to is really specifically designed to get you the best outcome possible. Listen, I'm giving you a template letter in this month's, how to, so this video may be short, but the template letter I have used since 2007, and I used it in a clinic where we were often co-managing rehab and post-operative rehab for patients that were having  acl repairs, knee replacements, dislocation reductions, all kinds of orthopedic musculoskeletal injuries. And we wanted to be able to provide the care for these patients in the clinic that I worked in and not have them sent to a physical therapy clinic. Not because we didn't want them to go to physical therapy, but because we wanted to be able to manage the care in our clinic and specifically because we wanted the students that were interns in our clinic to get the exposure to these types of cases.

So it was really key for us to communicate clearly and precisely with medical providers so that they felt confident that we could handle both the pre-operative and the post-operative rehab for these patients, and that they did not refer the patients out of our care. Now, you may not be managing pre and post-surgical rehabilitation or things like that in your practice, and if not, that's okay. But what you will get here in this how-to will still work for you, and I'll tell you why in a little bit. Alright? So let me first be clear with this how to, what I'm talking about is not a suggestion that you refer all of your patients to an MD <laugh>, or that you refer all the patients that have systemic conditions to an md. You need to know the red flags and the yellow flags, maybe even the orange flags of when to make a referral to a medical doctor.

How Your Patients Will Benefit From You Having Referral Relationships with MD’s

But that's not the point of this how-to. What I'm teaching you again is to help you be strategic in your communication with MDs. It's not about going into their office and dropping off your business cards or brochures or whatever, because most oftentimes, the actual care providers, the PAs, the nurse practitioners, the MDs, they never see those things because the front desk staff or the office manager takes them and puts them in the trash. All right? So what I'm teaching you will help you create documentation that will hopefully be seen, it should be seen, by the medical care providers because it actually becomes part of the patient's file in their office. So why would you want to build relationships with MDs in the first place? Well, this is important for a lot of reasons. We know that the ACA in 2018 reported again that the utilization of chiropractic care was roughly 10% across the United States, and that number has been pretty stagnant for many decades now. If we wanna see that number improve, then we need to get strategic about how we are going about building our practices. And of course, having the trust of medical providers knowing that they can refer their patients to us and that we will manage their care appropriately is key in that process.  Keep in mind that when you and your patient's medical doctor are on the same page with that patient's care, it can only lead to the best outcome for the patient. Studies have shown that a patient's satisfaction with a medical or other kind of healthcare office is primarily about their perception of how well the team members in that office work together for the patient's best interest. It's not about how the office looks or whether they liked the doctor or if the doctor was nice, but their perception of how well the team members in that office work together for the patient's best interest.

Now, if you expand your team to include people that are outside of your practice, but that you are partnering with or working with in an unofficial capacity, that can only then lead to the same type of satisfaction that patients experience with the team members in your office. And of course, if patients are more satisfied with their experience in your practice, that could also lead to improved long-term outcomes for the patient's care. Now, for your practice, building relationships with medical providers is key because again, we don't want medical providers referring patients out of our care. In other words, we wanna minimize the chances that when a patient goes to their medical doctor and says, I'm under chiropractic care for this, and the medical doctor says, chiropractic care is dangerous, you should stop going. We don't want that to happen. We want more medical providers to understand that what we do is actually safe and effective, and that they can feel confident that we are doing what is best for the patient, always. So imagine if two to three MDs in your area were referring more patients to your practice. If they were seeing primary care patients presenting with headaches and low back pain and neck pain, whether it's acute or chronic, and they're saying, go to a chiropractor instead of here's this opioid. Imagine the impact that has on the patients, the people in your community, yes, and also on your practice. Additionally, patients might be more likely to carry out their treatment plan if their medical doctor has said, go to this chiropractor, or is at least on board with the care that you're providing,  in agreement with the care that you're providing the patient in your practice. Okay? 

Obtaining Permission From Your Patients 

Lastly, I just want to  also shine a light on the fact that when you are building relationships with medical providers, and especially if you were to just start seeing referrals from medical doctors into your practice.  Imagine what that would do for your confidence as a care provider. Imagine what that would do for your confidence as a business owner, and it can only help you feel good to have those medical doctors referring to your practice when you feel good, your practice grows. All right? So before you get started with sharing information about your patients to their medical providers, you need to be sure that you obtain the patient's permission. This means a couple of things. First, most likely in your HIPAA documents, you have included a disclaimer that tells a patient that you are potentially going to share information with their other care providers and they're signing that, dating it and releasing you to. They're authorizing you to share that information. But I also strongly encourage you to double check that documentation as well as get a verbal authorization from the patient in a direct one-to-one conversation with them and document that verbal authorization from the patient in, in your chart notes as well. So here's an example. This is what I often say. If I have a patient that's responding pretty well to care and I hear from them, they have a medical doctor in the area, I wanna know that medical doctor. I want their medical doctor to be on board with the care that I'm providing the patient.

Maybe they've even seen their medical doctor about the complaint and the medical doctor said, I don't know. Here's this medication, or let's take some x-rays if it doesn't go away <laugh> soon. The medical doctor essentially didn't know what to do with it, right? And what they could have done was refer that patient to you. So now on visit 4, 5, 6 with a patient who's responding really well to chiropractic care who has had chronic headaches, I would probably be saying to this patient at this point.  “You know, Sarah, you mentioned that you have a long history of being a patient in Dr. Hansen's office and that you had gone to her about the headaches that you were having, but she really wasn't sure what to tell you or what to have you do. And look now after just a couple of weeks, you're feeling a lot better. Would it be okay with you if I sent a letter to her office to let her know what my findings were during your exam and what we came up with as a treatment plan and how you're responding to care so that she is on board with the care that you're being provided here?”

I've never had a patient say, no. It's possible, of course.  Every single time I've had this conversation, the patient always says, yeah, that sounds great. And from that point, then I just say, “okay, so I have your permission to send your medical doctor a letter? That's okay with you?” and the patient says yes, then I proceed with a written letter. And this letter template is included on page seven of your handout for this month's how to, on page five, I've given you a breakdown of what to be sure you include in the letter.

What To Include In Your Referral Communication 

Now, I wanna be clear that as you include these things that I have bulleted out for you that you don't include much else. In fact, it's best to keep this letter that you send short and focus on the patient and not focus on you. The medical doctor is looking at this letter and it's dated. It has a patient's name. It then has their medical history essentially with the exam findings and your treatment recommendations and the patient's response to care. So this letter now becomes a part of the patient's file once you've sent it to their medical doctor's office. And in the interaction with the patient, hopefully at some point the medical doctor actually sees this letter and says, oh, okay, cool. So you have seen this chiropractor and it's going like this, and so you've had a significant change or improvement from that care that you've had there. And the patient's like, yeah, it's really been helping me. And the medical doctor can't argue with that too much at least. So, keep it focused on the patient. 

What not to include in your referral communication

Don't include information about yourself other than thank you for the opportunity to refer or to co-manage this patient with you. And that's about that. You really don't need to elaborate about your credentials or anything else about you in this letter. Okay? So again, page seven, there's a sample letter included for you. I want to just reiterate the point from page six. 

When You Should Not Communicate With A Patient's MD

Are there any patients you should not send this communication to their MD for? Yes. Any patient who doesn't authorize you to share this information, don't send a letter to their medical provider, <laugh>. If they don't authorize you to release this information, don't share it.

And just also remember that sharing this documentation, even though you're going to write it in medical terminology and you're gonna keep it focused on the patient, this letter written this way, I cannot promise you or guarantee you that it will protect you from any backlash or that it will prevent any MD from ever saying to a patient that that patient's to stop chiropractic care. However, I haven't seen that happen. I've only seen positive outcomes from it. If I had concerns, I'd be sharing them with you for sure. All right, so you can review the template letter, you can take that letter and make it your own.  I wouldn't tweak it too much. So honestly, I would keep it really simple. 

The years that I worked in the sports and rehab clinic at a chiropractic college, I found that we sent multiples of these every week, probably on an average week, like five to 10 letters a week, every week, for patients that we were co-managing with an MD for one reason or another. We oftentimes didn't hear communication back from the medical provider ever <laugh>. But in the cases where we repeatedly sent very concise, specific, clear letters, written in medical terminology to medical doctors that we shared, many common patients with, that medical doctor eventually started calling and saying, Hey, I noticed that you guys have been sending documentation on a lot of our patients. What are you doing there? They would call us and ask us what we were doing and what we were doing that was working. Could they come see our clinic? That's a whole different ball game than if you were knocking on their door or you were walking into their office, asking them if you can show them what you do and teach them what, what you do. Okay? So keep that in mind. 

Consider Your Phase Of Business When Building Referral Relationships with MD’s

All right, a couple more things before I wrap up this video for you. Consider your phase of business here. If you are in a dream up phase right now, meaning you don't have a practice open, but you're getting ready, what you're learning here obviously isn't immediately actionable for you, but this is really good stuff for you to know because when you get into the startup phase. After your practice is officially open for business, you're going to want to be working on building relationships with medical providers in your area, because that's one of the key marketing tactics, building relationships. Then as you move into the ramp up phase and beyond, you might feel really pressed for time. So, carefully consider if implementing this strategy is really necessary for your practice right now and what it would mean for your practice, what it would mean for you if you did carry out this process consistently. Remember, this is a suggestion that I've used a lot myself, hundreds of times, and it's a suggestion that has worked for many other people over the last few years. But it's a suggestion. It isn't a have to, it's a how to. Okay? 

How To Implement This Process

So how do you implement this moving forward? If you decide that this is a strategy you want to implement, you've gotta be consistent with it. So that means that in Asana, or some other tasks management software, you need to put this task in so that somebody, you or someone else on your team is checking in on maybe a weekly basis. For example, someone should check to see who we need to send a letter to each week.  Who do we need to send documentation for? What patients are on our radar that have been new recently that have had a significant outcome and we wanna share that with our medical provider?  I would encourage you to at least evaluate if each new patient in your practice is a patient that you would want to contact their medical provider for. And then of course, also patient-centered reactivations into your practice as well. 

 

How To Move Through The Fear Of Building Referral Relationships with MD’s

Okay, so I'm gonna shift gears. I'm gonna take off my clinical hat and put on my coaching hat and I'm gonna give you some journal prompts because I know that this topic is something that might bring up some fear for you. You might be thinking, I don't know enough to talk to medical providers, or I might say the wrong thing, or they're gonna think I'm stupid. Or what if they think I'm doing something wrong? I want to encourage you to explore those feelings and fears. If now feels like the time for you to do that, I've given you some journal prompts to help you get started.

Remember, this is not a have to, it's a how to. It's a suggestion. It's a possibility for you, not a must do if you feel like this is in alignment for you. 

Now, to get started working on this, first consider, do you feel any fear about building relationships with MDs? And if yes, just identify those fears, write them down, what are they? And then consider where did those fears originate from? Like what's the source? Where do they come from? And if you get super woo about this, maybe the origination of those fears doesn't necessarily feel like it's even something that happened in this lifetime. Maybe it was generational, it was passed down to you through your DNA or ancestral or from a past life. Are you ready to release that fear? If so, what would make it possible for you to do that? Then what is likely the worst case scenario if you put yourself out there and start building relationships with medical doctors? What is the worst case scenario? Identify the worst case scenario and ask yourself, what would I do if this happened? What would I do? And then also identify the best case scenario. What is the best case scenario? And knowing the worst case scenario in what you would do in that event versus the best case scenario may help you to see, does this feel like something that you want to work through right now, even though it might feel a bit scary to you? 

Okay, so usually at the end of our how-tos, I include some additional resources for you. In this, how-to, we don't have a specific past training or other resource that I felt like really related to this topic per se, although maybe a bit the January 2020, How-To on Creating Patient-Centered, Aligned Treatment Plans.

So this month's How-To homework is really, really simple. Same as last month. It's really simple. It's to begin implementing this method of communication with MDs and other medical providers and share with us your insights. What did you learn? What challenges came up? You can share your insights in our private online community. So that is our How-To on building referral relationships with MDs. Before I wrap up, I just wanna reiterate the points here that what I'm teaching you seems really, really simple. It is simple, it is really simple. But if you are really consistent with it, really consistent, then this can work even as simple as it is. All right? So go, get to work if you feel like this is something that you're ready to implement and let us know how does it go, what, what comes up for you as you, as you put this into place. Okay? 

How To Get A Copy Of The Referral Letter Template

So that was the How-To on Building Referral Relationships With Medical Providers. I hope that this how-to is insightful for you.  I am willing to bet you've never been taught how to build referral relationships with MDs this way. So go get busy implementing what you've learned and then hit me up on Instagram @DrDanielleAngela, and let me know how it is working for you. Again, if you want the template letter that I mentioned, I'll send it to you for free. Just DM me there on Instagram @DrDanielleAngela, let me know you want it, you heard about it on the podcast, and I will send that PDF right over to you. No strings attached. 

KNOWN

If you want more support, more guidance and more direction, more structure around getting more new patients or clients to your practice without spending all day posting on social media without spending hours tinkering with your website, trying to optimize it, trying to get it to rank number one in Google. If you want to get more new patients or clients without wasting thousands of dollars on social media ads. If you want to get more new patients or clients without standing at health fairs or screenings and the nights and weekends, taking all the time away from your family, I have an amazing solution for you. It is my new grip coaching program that is coming up in March. It is called KNOWN. KNOWN is all about becoming known as the go-to expert in your, your local and or global community so that people are sending you referrals to your practice. You don't have to do all these things that you were told to do to grow your business that you don't actually want to do in the first place. If you know that you want to help more people, if you know that you're good at what you do, if you know that you have a mission, you have a calling to serve more, to make a bigger impact in your community, known is for you to learn more. DM me on Instagram @DrDanielleAngela. 

Okay, friends, I am loving being back on this podcast with you. I'm loving hearing all of your feedback. I'm loving seeing you share on social media. Keep it going, keep it up. I'll see you back here next week for another new episode of The Health and Wellness Practitioners Podcast. See you then. 

Hey, thanks so much for joining me for today's episode. If you love this podcast, then be sure to join our free community, The Health and Wellness Practitioner Group over on Facebook where you can continue the discussion and get to know other people in the community as well. We're a group of chiropractors, naturopaths, acupuncturists, midwives, doulas, massage therapists, mental health therapists, counselors, nutritionists, and the list goes on. So come and join us. Get to know other people, both personal and professional relationships. You can finally group by heading to drdanielleangela.com/community  and request to join the group. I’ll see you there.