Dr. Jay GreensteinCEO, Sport and Spine CompaniesChair, VCA Insurance Committee

Chair, VCA Public Relations Committee

Goals of Session

• Gain an Understanding of Current Needs

• Gain an Understanding of Current Processes

• Discuss Key Factors in Reaching Out

• Develop Take-Home Strategy to Meet Current Needs

• Overall Do’s and Don’ts

Why do you want to reach out?

What Mechanisms in Your Practice Are Currently In Place to Build MD Relationships?

Benefits of Reaching Out

• Improve the Public’s Health– Access to Potential Patients to Provide Most

Evidenced –Based Solutions

• Improve Practice’s Reputation– MD “Stamp of Approval” – “My PCP sent me here

and said you were the best.”

• Improve Practice’s Financials– More new patients grows the practice.

Step 1: Be Prepared BEFORE You Reach Out

• Do you have the infrastructure needed for increased volume?

• Have you defined your – Practice Style (Wellness, Acute, Rehab?)– Intake Process from HealthCare Providers

• Scheduling• Insurance Logistics• Referral Logistics

– Follow Up Process• Initial and Re-exam narrative process• Referral Logistics

Step 2: Understanding the Needs and Expectations of the MD Community

Step 2: Understanding the Needs and Expectations of the MD Community

• What are MD’s looking for?– Outstanding outcomes AND customer service

– Communication: Written and Oral

– Discharges

• Is this congruent with your practice mission?

• Can you and your staff meet those needs?– If not, what are the competency gaps that exist and

how do you “Close the Gap”?

• HOT – Current Referral Sources – what are you doing to maintain the relationship?

• WARM – MD’s of Current Patients not currently sending – what are you going to do to in order to initiate building a referral relationship?

• COLD – The MD’s office next door who you don’t have any patients with but would like to establish a relationship – how are you going to cold call?

Step 3: Hot, Warm and Cold Leads

HOT

HOT

• How are you maintaining and growing this relationship?– Clinical communication?

• Narratives• Clinical Power Point Presentations• MD Flash Presentations developed by the VCA PR

Committee

– Relationship building?• Lunch and Dinner Meetings• Social Networking• Social / Charitable Events

HOT

• Pay Attention to Your HOT Referral Sources!

WARM

WARM

• How are you developing this relationship?– Clinical communication?

• Narratives

• Clinical Power Point Presentations

• MD Flash Presentations developed by the VCA PR Committee

– Relationship building?• Lunch and Dinner Meetings

• Social Networking

• Social / Charitable Events

WARM

• Step 3a: – Mine your patient data and find patients’ MD

information

– Send narratives (Initial, Re-exam, Final)

– Follow up with phone call to ensure receipt

– Ask for a lunch meeting or even 10 minutes of time to discuss clinical cooperation• What are your differentiating factors?

• How can you help his/her patient population?

Differentiating Factors?

• Top 3?

– 1.

– 2.

– 3.

COLD

COLD

• Step 3a: – Send practice brochure– Follow up with phone call to ensure receipt

OR – Walk in and…

– Ask for a lunch meeting or even 10 minutes of time to discuss clinical cooperation• What are your differentiating factors?• How can you help his/her patient population?

Final Steps: Action Algorithm - Warm

Doctors’ Response to Request for Meeting

Thanks the MD for their time and hang up

Utilize VCA Flash Presentation or Prepare New Presentation

Wait for Next Patient and Send Narrative and Try Again

When Discharge for current patients occur, send final report;

Send MD Flash Presentation Ask Patient to discuss outcomes with MD

Send all Re-exam Reports Be Prepared for MD Common Questions

Be Prepared to Ask Your Questions to MD

Be Prepared and bring along appropriate marketing materials so he can give your

information to his patients

NO YES

Final Steps: Action Algorithm - Cold

Doctors’ Response to Request for Meeting

Thanks the MD for their time and hang up or leave office

Utilize VCA Flash Presentation or Prepare New Presentation

Send Note Thanking MD or Office Staff for their time and send flash of MD Presentation or pertinent clinical literature

Be Prepared for MD Common Questions

Be Prepared to Ask Your Questions to MD

Be Prepared and bring along appropriate marketing materials so he can give your

information to his patients

NO YES

Act quickly if you get a referral(Send Narrative, Thank You

Note etc.)

At the Event

Common MD Questions

• How do you treat “X”?– Answer Hints: Needs to be evidenced-based.

• Do you manipulate the cervical spine?– Answer Hints: Most likely concerned about CVA’s; Utilize J. David

Cassidy’s publications/testimony

• What insurance’s do you take?– Answer Hints: Also find out what they take to make sure it’s

congruent. Explain how you handle carriers you are not a provider for.

• How long do you treat patients for?– Answer Hints: Concerned about lifetime care

• How soon can you get patients in to see you?– Answer Hints: Concerned about long wait times to get into PT/Ortho

practices. Ensure your infrastructure is set up to get patients in quickly

Valuable Questions for MD’s

• What % of your practice is currently NMS?– Answer Hints: If it’s above “0”, you have opportunity.

• What is your typical referral pattern of NMS patients?– Answer Hints: Most likely it’s not to you, but be sure not to

respond negatively to their existing pattern

• Are there any patients that don’t respond that you would consider sending to me based on the fact that _______________ (differentiating factors)?– Answer Hints: Assuming they say yes, find out who the key

person is who actually writes the referral.

Tracking mechanism

• How are you tracking your referrals?

• How are you tracking when and if your reports have been sent?

• How are you tracking whether or not an “event/interaction” has been effective?

Competition?

• Other DC’s?

• PT’s?

• MD’s?

– X-factor

DC’s

• Challenge: Many DC’s are marketing to the same population of MD’s

• Solutions:– There are plenty of patients to

go around– DC styles (like MD’s) are

different and MD’s can find multiple DC’s to refer to based on patient needs

– Always find ways to help your colleagues if you can!

PT’s

• Challenge: Part of the typical medical model referral pattern

• Solution:– Utilize differentiating

factors related to your individual practice and expertise

MD’s• Challenge: PCP to Ortho is a very common referral pattern• Solutions:

– Build relationships with local Ortho’s– Explain how you may be able to save the patient a step unless

it’s a surgical candidate

MD’s – X Factor

• Challenge: PCP have been trained to medicate

• Solutions:– Communicate that you can have an

impact even during the “early medication phase”

– Use the clinical literature to discuss how Chiropractic outcomes can be both cost effective and efficacious clinically

– Explain how you may be able to prevent chronicity because you address function, not just symptoms.

Overall Do’s

• Always Keep Trying to Build Relationships

• Give GREAT clinical care that is evidenced-driven

• Document!!!

• Communicate regularly with Physicians

• Know your stuff!

• Enlist patients to communicate their satisfaction with you back to their MD’s.

Overall Don’ts

• Don’t criticize existing referral patterns or MD practice processes

• Don’t criticize other providers of any type

• Don’t drop the ball on your communication with your MD’s

• Don’t use Chiro-centric lingo• Don’t ever quit trying to build

relationships so you can help more people!

Questions?