The Rate Limiting Steps to YOUR Growth

I had a VERY interesting day at the office today which involved an MD that has never referred to me and the 2nd year medical student that was with her…This was a great opportunity to build a relationship since the MD learned from the 2nd year student and I got the patient!  It could not have unfolded more perfectly. The full-length consultation on this topic will be much more detailed and in particular, will show you how to use the concepts in the MD Relationship Program to build long lasting relationships in the medical community.  More specifically, I will detail why after I saw the patient, I IMMEDIATELY called the MD, had a 3 minute conversation (she actually said WHOOPIE!) and faxed over my CV (13 pages, its MUCH larger now) with the initial report…

Looking back to your undergraduate days, you may remember sitting in chemistry class discussing chemical reactions. (That may be a good or bad memory for you!)  One of the fundamental parts of the chemical reaction is what is called the “rate limiting step.”  This is the SINGLE item that will govern not only the speed of the reaction, but whether or not the reaction occures in the first place.  If you have an adequate supply of the “rate limiting step” it flies; if you don’t it is DEAD.

Working with MDs is no different and re-evaluating where you are in the program is critical for long term success.  In the MD Relationship Program, the “rate limiting step” is your reporting.  This is SUCH an important issue thatthere will be an in depth consultation later this week on this very topic.  Many of you have worked hard to start to improve your Documentation and Reporting, however, this is a process that should continue to evolve.  Many of the MDs that I currently work with have told me on multiple occasions, “IF YOU WANT TO BE A SPECIALIST, THEN ACT LIKE ONE,” and that includes sending out a report that shows clinical competency along with the unique abilities of the chiropractor.  This is your “rate limiting step” and is required to be in the game.  When done properly and efficiently, it will boost your referrals and collections.

I have spoken to many of you in the past and we have gone back and forth with your reporting.  The new year is here and this is a terrific time to evaluate what we are all using to communicate chiropractic to the medical community.  For those of you that have not gone through this process with me, please send me a copy of your initial, re-evaluation and release from care reports.  These can be faxed to 716-239-4371.  If you have done this in the past, I want to be able to work with you to ensure that the changes were made and your office is at the next level. 

You cannot compromise on reporting as it will determine the level of your success.  Healthcare is changing and no matter what you tell yourself, please understand that I see what works and what doesn’t.  To get on the field you have to be reporting to MDs, otherwise you will be sitting in the nosebleeds wondering how everyone else got there…

Please read this article.  This is important foundational information for meeting and working with MDs.  NOTE: You MUST, MUST, MUST discuss with the MD that NONE OF THESE PATIENTS HAD COMORBID CONDITIONS (disc, radiculopathy, radiculitis, diabetes etc.).  Currently, there are NO STUDIES that have included COMORBID conditions.  That is the precise reason that correlating research studies to the clinical environment can be very difficult.  That is the problem with clinical guidelines.  When was the last time you had a lower back patient that had no other co-morbid conditions?

When working with the medical community, diagnosis is critical.  That is how you are able to clinically justify prolonged care when needed.  Without a proper diagnosis and correlation of clinical co-morbid conditions, you have no idea what is going on with the patient.  The information on co-morbidity is what helps you to define your prognosis.  Therefore, it goes diagnosis, prognosis and treatment plan. According to

Prognosis (Greek πρόγνωση – literally fore-knowing, foreseeing) is a medical term to describe the likely outcome of an illness. When applied to large populations, prognostic estimates can be very accurate: for example the statement “45% of patients with severe septic shock will die within 28 days” can be made with some confidence, because previous research found that this proportion of patients died. However, it is much harder to translate this into a prognosis for an individual patient: additional information is needed to determine whether a patient belongs to the 45% who will succumb, or to the 55% who survive.[1] A complete prognosis includes expected time, function, and a description of the disease course such as progressive decline, intermittent crisis, or sudden, unpredictable crisis.

Researchers focus on large groups of people making it easier for them to draw conclusions.  Being a doctor requires drawing a conclusion from a single patient which takes focus and proper reporting.  This is why you are a doctor and not a technician.

The script for calling MD offices to get started with the program has been updated in Consultation #5, “A Familiar Model.”  It is at the end of the consultation.  Please make sure that you review this with your staff or marketing person.

There was a research article mentioned in in the paragraph above.   What you should do is print it out and provide a copy to all the medical providers that are patients in your office.  I have medical residents, nursing staff, MDs and mid-level providers that are patients.  Handing these outcome studies with your address stamped on EVERY page is a great way disseminate chiropractic research.  Remember, this is about building advocates in your community.  There is no better way than to hand research to the people that can understand it!  This was published in 2010 in The Spine Journal.


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