I spent literally hours wading through the Study and its more than two dozen referenced research projects, which, I assume are written the way they are written (like a government study), to justify the research moneys granted to the researchers. But, be that as it may, the Research Project brought to light some interesting points that should be of interest to any of you who work with MDs or who are planning to.

The greater part of the project and its many parts consisted mostly of surveys of MDs and DCs, which were done either face to face or by mail.

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Here are some of the points of the Study that got my attention:

From the beginning, the Study acknowledges, “With the increasing popularity of chiropractic care in the United States, inter-professional relationships between conventional trained physicians (MDs and DOs) and chiropractors (DCs) will have an expanding impact on patient care. The objectives of this study are to describe the intra-professional referral patterns amongst DCs, describe the inter-professional referral patterns between DCs and conventional trained medical primary care physicians (MDPCPs), and to identify provider characteristics that may affect these referral behaviors.”

In simpler English: As chiropractic grows in popularity in the US, they want to know how chiropractic is impacting “conventional medicine” and vice versa.

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The Results Section of the Study stated: “Of all DCs contacted, 452 (40.7%) participated in the study. Close to 8% of DCs reported that they never send a case report when referring a patient to another DC, while 13% never send a case report to a MDPCP. About 10% of DCs never send follow-up clinical information to referring doctors.
(Emphasis added)

Again, that’s 13% of the DCs, (who admitted to it), “never send a case report to a primary care MD.” And “About 10% of DCs never send follow-up clinical information to referring doctors.”

Results from another section of the study indicated it was a 2-way street: “This tendency toward informal ‘lay referrals’ was revealed to be reciprocal in our companion survey of MDPCPs, which showed that MDPCPs were much more likely to suggest that their patients contact a chiropractor on their own rather than to initiate a formal referral. The lack of a direct formalized referral relationship between DCs and MDPCPs has implications for efficiency, quality, and patient safety in the health care delivery system. For example, there is empirical evidence suggesting that allowing patients to contact other physicians on their own is likely to break continuity of care. ”

Again, in English: MDs tend to just tell their patients that they might try a chiropractor, instead of referring them to a particular chiropractor, thus resulting in patients becoming dropped balls and not getting the care on their own that a little tighter control and better communication between doctors would have provided.

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In other words, if I were to interpret the Results, Conclusions, Discussions, etc., etc., etc. of this rather complicated Research Project, and reduce it all down to something we can work with, I would have a tendency to conclude that what the Study really tells us is something we all probably already knew: The communication between DCs and other DCs and especially between DCs and MDs, could be much, much better.

And the level of communication could be improved, at the very least, on a professional level, simply by doctors sending appropriate documentation to the primary care physician and vice versa, if for no other reason but as a professional courtesy.

Ultimately, the patient’s health should be the primary concern, not any petty riffs between the chiropractic and the medical professions. Despite the fact that many MDs have sold out to Big Pharma, the fact remains that most MDs are good people who do want to help their patients.

So, if you missed our first series of Newsletters on how to get MD referrals, you should take a look at them. And just to quickly summate:

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1. Take your usual notes during the initial visit.

2. Obtain the name and address of the patient's general practitioner.

3. From the notes, generate a comprehensive, well- written, professionally presented initial report.

4. Send the report to the general practitioner, with opening and closing comments that explain that you are sending the report as a professional courtesy and to give the doctor the opportunity to ask you any questions about the patient, what you found, your treatment plan, etc.

5. There must be no hint of solicitation in the report or cover letter.

6. Follow up on any response.

7. If the MD/DO refers a patient following a report on an existing patient, make sure you send a similar report of the newly referred patient's initial visit and progress reports.

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Report Master Version 6 takes the work out of the Narrative and SOAP Note writing process, so you'll have more time to do the things you would rather be doing, and still maintain the necessary quality in your reports that most MD/DOs demand.

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