Working with the Medical Community Without Losing Our Identity


:dropcap_open:B:dropcap_close:uilding a working relationship with the medical community is a wonderful way to reach patients and create a referral network that will continue for the life of your practice.  If done properly, chiropractic can stand as a separate and distinct treatment option.  Many doctors erroneously think that you have to “change” chiropractic for us to be accepted into the medical community.  In my personal experience nothing could be further from the truth, but there are steps to be taken for the process of building the relationship properly.  Understanding the barriers is the best way to start. 

communityandidentity2The first major barrier to building medical relationships is your ability, as ridiculous as it may seem, to convey your diagnostic skills to the MD.  The first family practice resident that I had in my office for the chiropractic elective at the State University of New York at Buffalo School of Medicine and Biomedical Sciences actually said, “I am surprised at the level of detail in your initial examination.”  Medical providers do not receive any exposure to chiropractic practice; therefore the default reasoning is chiropractic care is sub-par.  While we know this to be untrue, it is the reality nonetheless.   I have said it before and I’ll keep saying it, the medical community does not care at all about your technique.  They refer based on trust and clinical reputation.  They need to be able to trust that you will be able to take care of their patients. Can you and your office handle complex cases and manage patients in a collaborative environment? Does the medical community in your area know?
The next barrier to building medical relationships is continuing to display your clinical skills through reporting.   Reporting is a critical part of building a relationship with health care providers.  Without it you are a NON-PLAYER, pure and simple.  Your report is critical and many chiropractors have trouble understanding what to write and when to do a report.   It is important that you touch the report only once, therefore your initial note should be in a format that can be used for insurance reimbursement, compliance, reporting to the MD and, if necessary, reporting to the lawyer.   The initial report and each re-evaluation should get sent via fax.  To keep this streamlined my office staff will take the report that is printed from my EMR and fax it to each of the providers or professionals that are CC’d at the bottom.  For example, the original would go into the patient’s chart, a copy would be sent to the primary care physician, the medical specialist, the insurance carrier (this is sent with the billing automatically) and the lawyer.  We didn’t spend any money on stamps, the reports get there immediately and we have a delivery confirmation so we can prove they were received.  That is extremely efficient and I should point out that I do not do a separate progress note and a letter to the MD, the progress note IS the report. Touch it once and be done with it.  

:dropcap_open:I have said it before and I’ll keep saying it, the medical community does not care at all about your technique.:quoteleft_close:
Lastly, all this can be done without compromising who we are and what we do.  Our single biggest problem and the reason we only treat 8% of the population is we don’t effectively report what we do.  When we don’t communicate effectively, all that we are left with are other providers’ assumptions on what chiropractors are thinking and doing.  We rely on the patient going back to the MD and telling them what is wrong with them, and you know how accurate that can be!  The language in our reports is critical to building relationships; we are not “becoming” them any more than they are “becoming” us.  There is a place for discussion of chiropractic principles, vertebral subluxation and who we are as a profession.  Please understand that none of those things can be discussed until the medical community that you want to work with trusts you as a doctor and clinician.  That is how we win.

Dr. Owens has established the nation’s first chiropractic elective in a Family Residency Program with the SUNY at Buffalo School of Medicine and Biomedical Sciences.  He has developed and credentials chiropractors to teach courses approved for CME credit to the medical community.   He can be reached at 716-228-3847.

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