New patient referrals to our clients: 797,412 Referrals as of 12/14/2018
#1 Program and Office Infrastructure 
Quickie Consult #1

Preamble: Many of the issues I bring to you are very small, yet each issue is just that, an issue. If you take care of the small issues, then you will be able to build and more importantly, focus on the bigger issues...a larger practice and more family time.

The interesting thing about the Internet is that it allows things to be observed that may not otherwise be observable.  One of my daily observations is that I get to see WHEN YOU WERE LAST ON THE SITE!  The MD Referral Program is about just that, building relationships.  To be successful at building relationships, you have to be consistent and getting busy is not an excuse.  You have to have infrastructure built into your practice to handle new business and not having it is the death blow to practice growth.  I discussed this in length in an earlier consultation, but it seems it needs reviewing.  You MUST have a marketing system set up to work WITHOUT you!  (If you are starting out, it needs to be you, but the system has to handle growth.)  If everything is dependent on you, your practice will reach maximum capacity in a very short time.  This program is designed to be managed by your staff WITH your overseeing it.

If your staff is having issues, then GET NEW STAFF.  You are the boss, doctor, CEO and ruler which doesn’t give you the ability to abuse people or take advantage of them, but it does give you the ability to build a business whose parts are running while you are treating and making money.  The only thing that MAKES money in your office is related to patients. The only things that TAKES money is EVERYTHING ELSE.  Doctors that do not understand that will struggle for years.  I have the ability to work with your staff or marketing person; take advantage of that opportunity.  Do not lose ground…As the doctor and the leader, this is what you need to do…

- Get the MD database created

- Build your binders

- Delegate the marketing to a staff member or if your are new, do it yourself

- Visit the site and read the consultations

- Visit the site and customize the fliers

- Get that research to the medical community

- Do it and do it consistently

If you need help, I will help you. The only thing that I am interested in is your success…I have 7 new direct MD referral patients (NF or WC) scheduled in my office Monday to Wednesday this week.  Week after week it gets bigger and better.  The best thing is that I am not doing ANYTHING with the MD Program now except sending notes and talking on the phone.  My staff handles EVERYTHING…When my NP level doubles to 14, I am able to handle that with NO problem…CALL ME…
  

Quickie Consult #2 


Preamble: Many of the issues I bring to you are very small, yet each issue is just that, an issue. If you take care of the small issues, then you will be able to build and more importantly, focus on the bigger issues...a larger practice and more family time.

Long term practice growth and ensuring that you are in control of the flow of your patients’ care requires building SOLID relationships in your community.  The more advocates you have the better; you need people talking you up.   When we really sit down and look at it, we all know that a focused effort is much more effective than a scattered one.  That holds true for referring people OUT of your office as well.  Doctors that think “spreading” referrals out is a good idea, just don’t get it.   Here is an example.  If you have a family chiropractic practice, statistics show you will refer approximately 3-8% of your patients for MRIs.   If you see the national average of 120 visits per week, you will have about 30 unique patients in a given week or 30 UBV (unique patient visits; some are seen three times per week, twice or only once).  With that being said, you would, therefore, refer out about 0.9 to 2.4 MRIs.   If you have a trauma practice, your utilization rate will be higher.  If you are spreading out those referrals to multiple facilities, it is all white noise!  The companies do not even know you exist.  Over time, you will have built very few solid relationships and none of the professionals in the area will know who you are or what you do.  Remember, it takes a long time and a focused effort to build solid clinical relationships.  This concept is true for surgical, pain management, neurology or any other multidisciplinary referral.  Whoever you are building relationships with, it is CRITICAL that you find the BEST and only refer to them!  Now, understand that this is a two way street and you need to receive referrals back.  I have broken many referring relationships because patients came out of my office to another professional’s with nothing in return.  A few years ago, I referred to a neurosurgical office that then sent my patient to their physical therapist!  I did call the surgeon and asked them nicely why he did that…His answer was that he was not aware the patient couldn’t see the chiropractor and the physical therapist at the same time.  Whether he did it on purpose or not (I assumed it was a fib), he never got any more of my patient referrals. 

The correct process requires you to call the MD, go by his/her office and interview him/her (without his/her knowing it).  On the phone you say, “This is Dr. Owens. I would like to stop by and meet Dr. Smith. I have patients to refer and am looking for the BEST neurologist.”  Here are the magic words again: I HAVE PATIENTS TO REFER…The best MDs to do this with are the MDs that are starting a new practice or are new members to a larger group.  When they have practiced for 40+ years, they could care less about more patients!  If fact, they may be more interested in you taking patients away.  This new MD now goes on your grid for the binder and the fliers.

Next, make sure that you concentrate on the clinical necessity of referrals and when warranted, send patients over.  This is no different than working in a hospital or multidisciplinary clinic except you are all in separate clinics.  In fact, in most hospitals, SUPPORTING other providers and testing centers is actually part of the evaluation process and can determine whether the MD continues to stay on!  The concentration of referrals shows both loyalty and that you have a busy clinic.  Doctors and lawyers are more likely to send patients/clients to a busy doctor than one that is begging for patients.  Remember, promote yourself and your expertise by concentrating your referrals to the best clinicians in the area and stick to them.  Help build them by making introductions and teaching them how to refer to you.  If you are doing the MD lectures, use them to build relationships within that group.  It is easier to build stronger relationships than it is to constantly start new ones…FOCUSED REFERALS = MORE REFERRALS.


Quickie Consult #3

Preamble: Many of the issues I bring to you are very small, yet each issue is just that, an issue. If you take care of the small issues, then you will be able to build and more importantly, focus on the bigger issues...a larger practice and more family time.

"Reporting Your Impression of a Case to the MD"

I just had a great conversation with Dr. Rob Shortell in CT about reports going out to the MD.  His main question had to do with what to include or not include when reporting to the MD.  We spoke for about 15 minutes and he asked REALLY good questions.  Based on my talking with doctors of chiropractic from all over the country, one major issue that we all struggle with is REPORTING TOO MUCH!  When I say too much, I mean too much of the stuff that the MD does care about.  Remember, you are immersed in chiropractic and understand the minutia of our art.  The MD doesn’t know the first thing about it and because of negative propaganda, most MDs are worried that chiropractic care is going to hurt their patients!  We know that it is untrue and quite the opposite of medical procedures, especially if you include patient satisfaction or malpractice premiums as proof.

Therefore, instead of going through the points in written format (BORING!), what I decided to do was get Rob on the phone tomorrow at 1 PM and redo our conversation.  It will be recorded and posted for everyone that is thinking the same thing.  This is going to be a huge help and will assist you in getting your brain around what do to and what not to do.  Once it is recorded, I will send an email out to everyone; that should be around 3 PM EST.  One of the more pressing points had to do with how to report a patient with spinal instability at C5-6 observed on flexion-extension films with no MRI or positive ortho/neuro testing, but a pain level of 6/10 that is constant!  What would you do???

Take care and keep promoting what we do in the medical community.  The better we get at interacting with them, the stronger we become!

Quickie Consult #4

Preamble: Many of the issues I bring to you are very small, yet each issue is just that, an issue. If you take care of the small issues, then you will be able to build and more importantly, focus on the bigger issues...a larger practice and more family time.

Being the BEST clinically is NON-NEGOTIABLE and is MANDATORY.  MDs are concerned with PATIENT SAFETY and then EFFECTIVENESS, in that order.  If you have not done so, get your CV in order.  This will show you where you are defiicient in course work.  Then take the $ that you have budgeted for continuing education and take the classes that will elevate your position in the healthcare community.  You continuing education MUST correlate with your practice goals for you to be perceived as EXPERT.  Everything in this program is done for a reason.

My CV is what goes out in the MD binders when my office makes the initial contact.  I have an email list for every doctor and lawyer that I work with that my staff uses to send CV entry updates as well as a new copy.  Here is an example of an email that gets sent:


I have added the following to my CV.  The updated version is attached.  Please shred any prior versions.

Instructor, Acute Care Guidelines of the New York State Workers Compensation Board, Clinically correlating the causal history, examination, imaging, advanced imaging, electrodiagnostic testing, prognosis and treatment plans of the injured and implementing care within the guidelines as outlined by New York State. Creating diagnosis driven metrics of care in relation to the patholophysiology of the bodily  injury. New York Chiropractic Council, East Elmhurst, NY, 2010

Consistency is a MUST, day after day, week after week, month after month, year after year.  Staff training is critical to making sure that this is done properly and regularly.  Sitting with your people for 15 minutes to teach them will translate to thousands of new patients over the course of your career.

Quickie Consult #5

Preamble: Many of the issues I bring to you are very small, yet each issue is just that, an issue. If you take care of the small issues, then you will be able to build and more importantly, focus on the bigger issues...a larger practice and more family time.

There has been a new link added to the MD Relationship Program Web site at www.teachchiros.com.  The title is "What’s New" and it is located on the left-hand tool bar at the bottom.  This link does not require you to log in and will assist you in staying current with content.  In 2011, you will see a significant increase in content and practice building information.  Please check this section regularly for a quick look at updates.  You will continue to receive e-mail announcements as well.  This will be particularly helpful when using staff or a marketing person to visit MD offices.  Your instructions should be for them to check the "What's New" section on a daily basis.  More consultations will be posted about working with staff and learning to properly delegate tasks. 

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This information is for the MD Relationship Program members ONLY. It is not to be shared, e-mailed, copied or mailed to any other party without express written permission from the MD Relationship Program. The information contained below is governed by US copyright law and intellectual property rights and privileges. If you are receiving this information and are not part of the MD Relationship Program, you are receiving this in an unlawful manner and may be subject to legal ramifications. 

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PLEASE TAKE NOTICE: © Copyright CMCS Management, Inc - Dr. Mark Studin 2015 - This information is intended for educational purposes only. Any review, retransmission, dissemination or other use of, or taking of any action in reliance upon is prohibited.