Working closely with local medical physicians and ancillary professionals is a surefire way to boost your referrals and establish your reputation as the authority in conservative care. Building strong relationships will take time and energy, but the outcome is well worth the effort. It’s one that benefits you individually, as well as the entire chiropractic profession. Here are the essential steps to increasing your MD referrals:

Create a Healthcare Provider Database

Start to build your healthcare provider database within ChiroUp for simplified communication with the providers in your community.

Provider information can be collected from web searches and phone directories. A staff member can enter the essential data in ChiroUp by navigating to Admin ⇢ Healthcare providers. Need more help on this step? Check out this tutorial.‍ 

Begin your list by selecting professionals with whom you have an existing relationship and those who your patients utilize. Be sure to include physicians listed on your local hospital websites.

Focus your attention on family practice, internal medicine, Ob/Gyn’s, pain management, neurosurgeons, and orthopedic surgeons – in that respective order. Each time a patient mentions a provider’s name, add them to your list, as this will give you a logical reason to contact that provider. Be sure to include the physician’s fax number and medical specialty so that you can automate subsequent communication and marketing.

Consistently update your healthcare provider database by asking all new patients “who is your primary provider?”

Reference: Austin-McClellan LE, Lisi AJ. An overview of the medical specialties most relevant to chiropractic practice and education. Journal of Chiropractic Education. 2020 May 29. Link

Deliver Initial Reports for Every New Condition

Medical physicians place their reputation on the line whenever they refer a patient. Providers need to see a pattern of excellence in everything they do, including thorough and standardized documentation. Unfortunately, when it comes to SOAP notes, busy physicians will generally not take time to read your multi-page initial note; however, they will appreciate a brief personalized summary. Which, lucky for you, is automated in ChiroUp.

Healthcare provider initial visit summaries can be created simultaneously with your patient’s lay condition/exercise report. To generate this report, you will simply select (or enter) the patient’s healthcare provider, indicate if the patient was referred, then preview and edit if desired. The MD initial report will print when you deliver your patient’s lay report. Reports are branded to your clinic and include the provider’s information for expedited delivery.

*The primary action step for this task is to implement a system to ensure that every new encounter triggers a condition report AND a healthcare provider summary for the patient’s MD - regardless if the patient was referred or not.

💡Pro Tip: Although not technically required by US law, most offices include a signed acknowledgment on their intake paperwork that you will be communicating with the patient’s primary physician and other providers. See this FAQ‍ for more details. 

Deliver Release Reports for Every Patient

Sending a release report to the patient's primary provider is just as critical as the initial report. Here’s why:

Regardless of our professional degree, MDs and DCs all have failed cases mixed into our many clinical successes. Unfortunately, since the successes don’t need to seek additional care, we primarily see each other’s failures – distorting our perception of the other’s value. (Check out this past video for more on this topic)

Consistently relaying your positive outcomes improves medical perceptions and referral patterns. ChiroUp has a 10-second solution for delivering a release report: When your patient completes care or reaches MMI, navigate to the Communication tab in the patient’s account, then select Release report, and enter the # of treatments and % improvement. Release reports should be generated for every patient, regardless if they were referred by their physician or not.

Click here for a tutorial of this process to see how easily it can be done.

You will want to implement a system for sending release reports when a patient is released or reaches MMI:

• Providers may choose to personally generate and fax these reports immediately following the release visit.
• Providers may choose to relay the necessary outcome metrics to a staff member who will generate and fax the report.
• Many providers choose to store ChiroUp MD release report request cards in their treatment room for relaying information, or as a reminder to complete the report later. These forms may be printed and laminated for reuse. Click here for the full sheet version.

Schedule Face-to-Face Lunch Meetings

One of the best ways to establish a relationship with other providers is through face-to-face meetings. Like you, physicians have limited availability so their lunch break is generally the most convenient time to meet. Scheduling lunches with physicians in your area is a multi-step process:

a. Personally request a meeting

Some chiropractors choose to mail merge a version of the lunch request letter with your ChiroUp healthcare provider database and send an invite to every MD describing why you would like to meet. This step is often skipped since the letter will go unanswered in more than 90% of cases.

Regardless if you choose to send the introductory letter, the key step involves visiting the professional’s office and requesting to bring in lunch for their clinic providers and staff. You can do this yourself or task a friendly/outgoing staff member.

See our script to schedule a professional lunch for ideas. Although this visit may seem intimidating at first, you will be surprised at how you will learn to enjoy asking to bring gifts.

Use the lunch checklist to note the number of guests (including all staff) and be sure to ask about any food allergies or preferences.

b. Prepare

Once you have a date and time, make sure to block your clinic appointment schedule to allow adequate time for set up, lunch, and clean up. It is not unusual for the professional to be running an hour behind, so plan for ample time. For a noon lunch, plan on being unavailable from 11:30 a.m. until 2 p.m. Be sure to confirm the lunch meeting details with a call to the office one day in advance.

Prepare your materials in advance of the lunch. The following assets are essential:

• Business cards (including extra cards for the front desk)
• Laminated insurance provider list

Additionally, you’ll want to bring one piece that can help stimulate discussion:

• A ChiroUp condition reference and lay condition report (start with something simple and familiar like Lumbar facet syndrome or Cervicogenic headache)
• Your ChiroUp patient satisfaction and clinical outcome data
• ChiroUp Clinical evidence synopsis
• ChiroUp Musculoskeletal treatment pyramid handout
• ChiroUp Indications for referral handout

If you pick up lunch yourself, add some “cushion” time to the schedule – restaurants are sometimes unreliable. Catering is a better option. Finding one restaurant that consistently provides good food and service and sticking with them for the whole season is a great idea.

On the day of your lunch, be sure all necessary items are delivered, including refreshments, utensils, napkins, serving utensils.

Follow-up correspondence- newsletters

Mailing a periodic newsletter highlighting your expertise will help establish “presence of mind” and create an opportunity to reach out regularly. Newsletters should be delivered via direct mail 6-12 times per year.

Here are four samples from the ChiroUp Forms library for inspiration:

• MD Newsletter 1
• MD Newsletter 2
• MD Newsletter 3
• MD Newsletter 4

Don’t want to invest several hours writing a newsletter each month? ChiroUp Premium subscribers enjoy professionally written, evidence-based, monthly M.D. newsletters that inspire trust and stimulate referrals.

Follow-up correspondence- Notes and cards

Reaching out during special occasions is another way to keep in touch with all physicians and specialists who refer. Consider sending periodic handwritten communication:

• MD relationship Thank You – This is the magic note that consistently triggers referrals. Don’t send it more than once per year.
• MD Thanksgiving Thank You – Thanksgiving is an opportune time to say thank you, plus the cards stand out from the inevitable pile of subsequent Christmas and Holiday cards.
• Birthday Cards - sent to those with whom you have developed a stronger relationship.
• Annual summary of outcomes for referred patients.

Follow-up connections- Subsequent visits

Keeping your practice fresh in the professional’s mind is very important. This can be achieved by visiting their office to drop off some post-it pads or pens and a small unique treat* for the staff two to four times per year (plate of cookies, chocolate-covered strawberries, fresh fruit basket, etc.)

Dropping off a small item is also an opportunity to schedule subsequent lunch meetings. It is recommended to schedule lunches one to two times per year with each office. For subsequent lunches, be sure to print out and provide your ChiroUp patient outcome statistics along with the MD outcome statistics summary letter to remind the MD that their referred patients responded well.

*Be certain that you are aware of, and do not violate, State or Federal "anti-kickback" (AKS) and Federal Stark laws that regulate health care gifting and prohibit any form of remuneration that could be construed as payment in exchange for referrals of business. Anti-kickback laws prohibit giving anything more than "nominal" gifts. Unfortunately, "nominal" is undefined by AKS law; however, the OIG has defined "nominal as gifts that are not cash or cash equivalents, and they have a retail value of less than $15 individually or an aggregate value of $75 per year per patient. This advice is for informational purposes only- to alert subscribers of potential pitfalls. Providers should consult with a healthcare attorney for legal advice.

Follow-up connections- Shadow and socialize

Asking a physician to shadow them in their office for a few hours is an excellent way to make a deeper professional connection. During the visit, avoid the temptation to provide unsolicited counsel. You are primarily visiting to learn, not teach. Don’t hesitate to provide answers to clinical questions, but stick to what you know, and don’t be afraid to admit when you don’t.

Don’t forget the mantra “Buds refer to buds.” Seek and create opportunities to cultivate a more personal connection with your referral network through social outings, charity events, continuing education classes, golf tournaments, etc.

Marketing to Ancillary Professionals

Your list of ancillary professionals could include dentists, massage therapists, health clubs/gym managers, private coaches, personal trainers, or health food store, owners.

All of the previous steps can be used to start building relationships, securing face-to-face meetings, and enhancing referrals from ancillary professionals.

💡Pro Tip: An additional way to build relationships is to host a professional education class for a specific group of providers. Personal trainers might be interested in a class entitled “Keeping your Runners Injury Free” – where you describe the prevention and management of common running injuries. Creative providers will be able to find a topic of interest for mostly any allied professional group.