Academy of Chiropractic Personal Injury & Primary Spine Care Program

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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.

“How to Break Into Hospital Emergency Rooms for Referrals”

“You have to go to A before you go to B” Mark Studin 2018


Everybody in the chiropractic profession wants direct emergency room referrals. Some believe it is an untapped, everlasting source of personal injury referrals while others don’t care and want every other type of patient. Both of the above scenarios are accurate and those doctors who have broken into emergency room referrals have realized that it’s “game over” for the balance of their careers should the relationship perpetuate.

The challenge is how to “break in” and get yourself either on staff in the hospital or become the immediate referral for “everything spine” short of fracture, tumor or infection. Historically, most hospitals have had a relationship with a chiropractor in the past as many of your predecessors have been very aggressive. The problem is that these chiropractors did the “ol chiropractic one step to step level of bullshit” and got “laughed out” of the facility. This has been reported to me by too many hospital administrators, inclusive of the chief medical officers who reported that in conversation with these doctors of chiropractic that their knowledge base was inferior for spine and the treatment protocols were unsubstantiated.

If we fast-forward to today’s marketplace, hospitals once again are realizing that chiropractors are a strong solution to both their utilization and financial problems. However, the hospitals have gotten smarter and realize that all chiropractors are not alike and strongly desire the “credentialed chiropractor” who can triage the traumatically induced musculoskeletal cases and ease the burden of both the medical specialists and emergency room physicians. With that being said, how do you go from being in your private clinic to being in the hospital system and be the prime recipient of their referrals.

There is one group in New York that believes if you refer enough into the system and make them enough money, that in turn they will refer to chiropractic. That system has failed spectacularly. The hospital will continue to say whatever needs to be said to the chiropractic community and give them just enough short of making the referrals. This is a great business deal for the hospitals. Take everything and give nothing but false hope.

We will NEVER do that. 

Initially, Dr. Owens and myself felt it best for you to communicate with the chief financial officer and let them know of the MRIs, surgeries and other ancillary services that you would keep within the hospital system should you get the immediate referral (preventing outside referrals) as well as referring all of your ancillary services into the hospital system. This turned out to be a poor choice because there were too many barriers that needed to be broken down and there wasn’t enough in it for the administrator.

What has yielded the best results nationally, is a combination between the spine surgeons and the primary care community. The spine surgeons need someone to screen their nonsurgical cases as they lose money during those evaluations (even if they get paid in full) and the MD primary care providers need both the education on spine for collaboration with the mechanical spine diagnoses as well as a bridge to the surgeons. Therefore, one of the prime reasons for creating the CME lectures to medical primary care providers is for you to become their educator and bring with you a surgeon who has a vested interest in having these primary care providers refer to them directly. This puts you in the middle of the primary care provider and spine surgeon, who will now want you to screen these patients to “weed out” cases. That is a huge win for the spine surgeon, who will strongly urge the primary care providers to work through you. This is also a strong wind from the hospital as all of the procedures will be kept within the hospital system along with all ancillary services needed.

In addition, most medical primary care providers have hospital privileges and once they recognize you as being clinically excellent in managing mechanical spine issues they will be in a position to introduce you, along with the spine surgeon to the responsible parties in the hospitals to begin your journey of getting the referrals from the emergency department. In short, you first need to create a relationship with medical specialists (which I teach you how to do), then you need to create a CME lecture to medical primary care providers and from there you work on leveraging the hospitals to get them to realize that you are their solution as well.

1.      Create relationships with medical specialists
2.      Become a Trauma Team Member
3.      Teach a CME course to medical primary care providers
4.      Have the medical specialists and medical primary care providers communicate with both the emergency department chairman and the chief medical officer of the hospital
5.      Talk to either Dr. Owens or myself to go to the next level


Adjunct Associate Professor of Chiropractic, University of Bridgeport, College of Chiropractic
Adjunct Post Graduate Faculty, Cleveland University-Kansas City, College of Chiropractic
Adjunct Professor, Division of Clinical Sciences, Texas Chiropractic College
Graduate Medical 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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