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From the Desk of Dr. Mark Studin
Academy of Chiropractic
Preamble: many of these issues are small, yet each issue is just that… an issue. If you take care of the small issues, then the larger issues often take care of themselves and you can focus on the larger issues… a larger, more profitable practice and more family time.

“When NOT to Take a Referral”

“Be careful what you ask for… Sometimes you get it and it’s not what you want” Mark Studin 2017

I received this from a doctor yesterday that I will keep anonymous. 

This same scenario has played out in so many states. In the past, Texas was the most egregious with the lien regulations in the state, but I now seeing this play out in multiple other states. Caveat Emperor!

What makes this so incredible, is the lawyer actually put this in writing, which can be the foundation for this lawyer to be disbarred and exposes the lawyer to practicing medicine without a license, a felony in all states.
In this case, the lawyer created a relationship with a pain management MD that injects EVERY patient in many areas repeatedly and orders multiple MRI’s on every patient regardless of clinical presentation. The role of the chiropractor is to treat the patient in a prescribed format with a mandatory referral at a prescribed time. The lawyer does a fair amount of advertising and then feeds the chiropractor who MUST be in “lock-step” with the lawyer or gets threatened and then thrown out of this network (get rich quick scheme).

Below are the lawyer’s comments to one of our doctors who refused to refer to his pain management doctor as he had previous BAD experiences in treatment to many of his former patients. My comments follow the lawyers demands and threats:

I must tell you that I am super pissed off. I told you a hundred times I don't want to work with your pain management specialist and what do you do, refer a client that I got to you your pain management specialist!!!! That makes no sense, are you purposefully trying to piss me off. I have my system and it made me a multi-millionaire at age 39 and I am going to use the same system here, as it works. 

If you do not want me to manage care and make referrals to the docs I want, then we should not do business together. I am going to do this for maybe 5 years or so and I am looking to do it right before I retire again. 

Need to know if you are going to continue to call me out for playing doctor because that is what I do and that is why I get the best settlements.  

So, let me know, there are plenty of other guys in town that will let me take the reins and run with it, and if you really, morally or whatever do not want to do that, then fine, I understand.

I responded when the doctor asked me my opinion of what the lawyer wrote to him:

That rant has made me proud to know you… I am happy to call you an ethical doctor and human being as you earned it helping people, not just get rich… Do not lose this email… You probably will need it in the future 

The response from our doctor:

Please know this, without your help I would not have had the confidence to walk away from this source of referrals. I know I don't need him.

I know the other docs he mentioned will sell their souls for him. And, they may have to pay the price for his style.

It's amazing to me that there isn't an ounce of science that says when to send to a pain management doctor. His style dictates EVERYONE of his patients have to get shots. Now he has a pain management doctor that thinks ALL patients need to be injected.

Today he told 2 patients I sent him that he didn't want their case any longer because he has no time for sprains and strains.

My comment: The pain management doctor doesn’t think every patient needs multiple shots and the lawyer has changed his medical decision making. The MD has simply signed on to GREED. These are the people we all read about in the newspapers who are investigated, indicted and jailed. Yes, some get away with it and the lawyer spent a few years in another state and then moved to state #2. It’s only a matter of time when the system catches up to them and I HOPE that it happens very quickly because it makes it bad for the rest of the honest doctors.
Lastly, there are SOME lawyers (please believe that most lawyers do not want to risk their licenses, savings and freedom for a get rich quick scheme) who are dirty. Almost all want to do well within the rules and once you cross that line with the lawyer, THEY will own you for the rest of your life because you knowingly did the wrong thing and they “gotcha!” 

If you find yourself in this type of relationship, gracefully… but quickly… terminate the relationship and never look back. This is the most expensive type of referral you can ever get. AS it says in the () above, it can cost you your license, savings and freedom. 

I am very proud of this doctor who walked away. He is an example of what is good.



Adjunct Assistant Professor of Chiropractic, University of Bridgeport, College of Chiropractic
Adjunct Professor, Division of Clinical Sciences, Texas Chiropractic College
Educational Presenter, Accreditation Council for Continuing Medical Education Joint Partnership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences

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