Most chiropractors welcome new patients and understand that the best new patients are often referrals.  The real cream of the crop, therefore, are patient referrals from Medical Doctors, Attorneys or other professionals your patients already view as “experts.”

We value these patients who are already convinced of our credibility (as with other referrals) but even more so due to the fact that their medical doctor sent them.  Plus, the potential leverage with MD referrals is much greater than the average patient referring in another patient.  Sure, most people have more than a handful of friends they can refer in; but an MD may be sitting in his/her office all day long seeing patients for musculoskeletal problems for which they can offer little help.  Statistically speaking, back pain is the #2 reason for a doctor visit, so that’s a lot of potential referrals from one good MD.

OK, so you get the point.  MD referrals are grand.  Cultivate them.  Now here’s the interesting twist on this scenario.  Medical Doctors – with an actual MD degree – may not be the best choice for inter-professional marketing.

Check out the latest stats below:

  • 49.1% of all office-based physicians are in practices employing “physician extenders,” according to the National Center for Health Statistics.
  • The most common “physician extenders” are nurse practitioners (NPs), certified nurse midwives (CNMs), or physician assistants (PAs).
  • 5 million prescriptions per day are written by Physicians Assistants
  • Physician Assistants are predicted to grow by 39% through 2018 and represent the 3rd fastest growing U.S. occupation, according to the Bureau of Labor & Statistics
  • MD’s in family practice are dwindling:  in 1997, more than 2300 MD’s graduated and entered family practice; by 2003 that number dropped in half; by 2020, the shortfall of general practice physicians is expected to reach 40,000.

What does that mean for chiropractors?

1. Do not only target MD’s in your efforts to win new patient referrals.  As stated above, at the present levels, half the time they are not even seeing the patients, so they won’t be the ones to refer. In the future, general practice MD’s will be even more rare.

2. Educate yourself about Physician Extenders. There are some that do not even realize that Physician’s Assistants can write a prescription (5 million people per day know different). But like CNM’s or NP’s, they are not doctors, so to address them as “Doctor” demonstrates a basic ignorance about their profession that you want to avoid if you are seeking to gain their confidence.

 

 

3. Communicate directly with the provider.  Ask your patient who they see at the XYZ Clinic or Dr. ABC’s office.  Don’t just assume that they are seeing the MD.  Then communicate directly with the provider, who may often be a physician extender.  In some clinics, patients are “assigned” a doctor of record (MD) but they will tell you that they never see that person.  So, don’t bother to write letters and woo them.  Go directly to the professional to whom they are seeing and with whom you now share a common bond (your patient). Write clinical letters and reports to the physician extender instead of the MD.

 

4. Treat them with respect.  Physician extenders are not MD lackey’s whose primary job is to hold surgical tools or do the dirty work that MD’s don’t want to do. They conduct physical exams, diagnose and treat illnesses, order and interpret tests, counsel on preventive health care, assist in surgery, and write prescriptions. In many practices, most of the responsibility of talking to pharmaceutical reps and learning about the latest drugs is delegated to the physician extenders. So, they don’t have a lot of time on their hands and have definitely heard the sales pitch before. Offering to take them to lunch is not a novel idea, as they may routinely have lunch scheduled several days per month with drug reps.

 

5. Put Your Sword Down. Some chiropractors still  view the medical profession with sword in hand, ready to do battle.  Certainly, there is some prejudice that still lingers between the medical profession and chiropractors.  With physician extenders, however, you will be pleasantly surprised that most of this is absent.  For starters, most of these professionals are younger (average age of a P.A. is 41) so they were never part of the “old guard” mentality present in the 60’s, 70’s or 80’s. They also tend to graduate younger than MD’s due to the fact that they do not spend extended time in residency. That combined with the future growth of the profession will ensure that the scales will be tipped towards younger PA’s, CNM’s and NP’s for quite some time.  Use this as an opportunity to build relationships with your younger colleagues who may be more open-minded towards all that chiropractic has to offer.

 

6. Refer Directly to Physician Extenders: Despite their varied duties and responsibilities, physician extenders typically do not get the lion’s share of new patient referrals of their own. Many times this goes to the MD(s) that own the clinic or who have the name recognition. Here’s your chance to be different. Refer patients to the physician extender instead of the MD.  They will appreciate your referrals and your communication, which will help open the doors to a mutually beneficial relationship in the future.

 

Hopefully, you can use these principles to increase your referrals with physician extenders and build your practice and improve our profession simultaneously!