Academy of Chiropractic Personal Injury & Primary Spine Care Program

Quickie Consult 1137
Marketing 140 G

From the Desk of Dr. Mark Studin
Academy of Chiropractic

Preamble: Many of the issues I bring to you are very small, yet each issue is just that, an issue. If you take care of the small issues, then you will be able to build and more importantly, focus on the bigger issues...a larger practice and more family time. -Mark Studin 2006

"How do I start getting referrals after I did all the work"


Dr Studin: We've had a preliminary conversation a little while ago and this is the follow up. And let me recap to make sure I understand. You've been in the program for a while. You've almost trauma qualified. You have one more course to go. You've done a lawyer seminar, which was somewhat successfully had about 30 lawyers show up. You've got about four or five direct referrals, but no follow up work. You've lectured of the lawyers seminar, you send out your emails to the lawyers with the bimonthly flyers and your CV and you're on the US directory, but you're really not getting the referrals you want, and then we went through of why your area is challenging. So here is the issue and here's your solutions. Your solutions are you've done the hard work, you've read the consults, you've listened to the podcast, I assume. now we've got to put it together for you. So you have five places that we've expanded your platform to get referrals, lawyers, medical primaries, medical specialists, urgent cares and emergency rooms. Now we're going to forget emergency rooms because it's a very long-term process in a very political process. And you're going to use the medical specialists, the surgeons, the pain management doctors, preferably the neurosurgeon as your advocate because that's how it's going to work. let's handle that first. Now you have an electronic medical record for your reports?

Guest Dr: Yes.

Dr Studin: So are you sending every one of your reports to the medical primaries for evals and re-evals?

Guest Dr: Not currently.

Dr Studin: You need to do that. And, and if they have a specialist involved that as well. Now, which EMR system do you use?

Guest Dr: Uh, currently I'm using medic fusion, which is a web base the EMR. I was using Tyro touch, but it took me forever to get my notes done and I was spending hours the weekend because it was just too slow because the server base.

Dr Studin: What is the suggested method right now in the most efficient method: is to used the transcription service and the transcription service is where you get templates that I actually created, a new patient takes 16 minutes, a re-eval take 60 minutes and the SOAP note takes about 15 seconds. And what happens is when you do that, you bet number one, you get oversight and She gets $20, eval and re-eval $3 is soap though. Now that can be expensive in an office. So what we suggest to get started is for all of your PI cases to do that, and your non PI cases use the same templates she gives you, but go off of paper, don't get them transcribed. Or You could work off of your current Chiro fuser or whatever you like because it's not a great system that you're working with and it just isn't, but this will also save you a boatload of time. And that if you go on the consulting page, number 17, evils and re-evals done for you. But this way you don't have to stress and get kept in keeping up with all of your notes. Someone else does that and the automatically done and put it in your inbox. That's what all of our more successful offices utilize.

Guest Dr: Is there a software that you know?

Dr Studin: No, you do paper and she uses a software motif, which is a, a cloud based program that she has that for over a decade. Dr. Owens has been customizing to mimic our templates. I mean you can't even buy it right now, it's $20 an eval on a re-eval, $3 a soap note. how much time are you saving? you could take that time and you know, put it towards production. But again, it gets expensive for every patient. Just there with, for Pi cases to start with and the rest of the evils and re-evals because that's what you're going to get to the primaries. Then you get oversight. If you're missing an item for compliance issue she'll look at it and say, you're missing that. You've got to get it in and she'll communicate with you. So that's a big suggestion. Number two, how many MRIs do you order a month on average, Right now? Take a guess.

Guest Dr: not a lot like five.

Dr Studin: so you're doing about five a month and that's fine. You need to get a surgeon and neurosurgeon in your community and that's critical. That is poor to the success of your practice. You need to call that neurosurgeon and tell them the following. I am a trauma trained doctor. I do things a little bit differently than most other chiropractors. I screen my patients when I order MRIs. I to send splice MRIs. I want at least two and a half millimeters in the cervical, three and a half lumbar, at least two or three clean slices through the dish dock, catching bone, if there's any cord or root compression, cervical or lumbar, you get them immediately. If there's an abutment, I see if there's enough space on the opposing side, I checked to see if there's motor deficits. If there is, then the rough to you immediately short of that. It's a waste of your time. So when I refer a case to you, 98% of them are going to be surgical. We screen that. I was trained with neurosurgeons to be a neurosurgeon without a scalpel, meaning all the triage I'm able to do, but you don't know me right now, but I just want to let you know, this is what we do. Anything shortest surgery, we treat chiropractic, not with physical therapy for spine. and by the way, you could take any article you want out of the green book, the science and Chiropractic and their stuff, Kyra versus PT, etc, But you can tell them, I need a neurosurgeon to work with because we're building our trauma portion of the practice. And when I refer a patient to you, if they are not surgical, they come back to me. If it's fine, no PT because PT has failed for spine and here's the literature that shows you that. Okay you can take one of the articles in there and pull up some of their supporting, index the peer reviewed literature to share with them. This is what I do. But over time I expect this to have a relationship and if I have a question I need to know I could call you and work with you, I'm seeing a lot of other things and I'm going to need some with the Chitchat with to determine if I need to manage them. Don't use the word treat the see if I need to manage them or you need to manage it.

Guest Dr: How do I get this? Is this a face to face meeting? With the neurosurgeons?

Dr Studin: Yes. Those that control the referrals Control the game. How much is your malpractice a year?

Guest Dr: $40,000. Roughly.

Dr Studin: How much is the neurosurgeons? I know $363,000 to $600,000

Guest Dr: are you serious?

Dr Studin: It's $363,000 if there are no malpractice claims against them, if he has two malpractice claims, even if that innocent, it's close to $600,000 a year. Who needs the referral more? You or him? He can't survive without you. This is Dr Studin, I'm calling to speak to doctor neurosurgeon. I have cases to refer, but I need to sit down meeting with them, it'll take 10 or 15 minutes. I'm happy to do it in your office over a cup of coffee. You let me know where when, but until I get the meeting, I can't have a referral because I need to know how the doctor functions. I have questions. That's it. Those that control the referrals, control the game. Then you do the same thing with a pain management doctor and the same thing with a neurologist, those and in orthopedics for extremities. Those are the four specialists you're going to need. You have the same conversation with them. Do you want to talk about how your trauma train, when you went to MRIs, you're well credentialed in that you read your interpret your own images. You do thin slice, you don't accept bullshit of slices of going through the bone and the disk. Aaron Smith and Cedar Park, Texas. I want you to call Aaron by the way. Aaron sat with his first orthopedic surgeon about a year ago, maybe year and a half ago. He like you was lost. What do I do? Where do I go? How do I function? He expected a five minute meetings. 45 minutes later we walked out with about eight referrals because the orthopedic surgeon said, I love chiropractic. I just haven't found one smart enough to work with. And all they did was talked about MRI slices. Biggest it's about managing your case now when you do that and then you start working with attorney, I have a relationship with doctor, neurosurgeon, doctor orthopedic surgeon. We have a great relationship. We communicate on cases. We Co-manage. Now all of a sudden the relationship changes. When you're dealing with attorneys, you want to meet with them. You don't want to send stuff to them cause you're not going to get anything from it. It's going to enhance your reputation. It's going to give you a name recognition. It'll give you zero referrals. You've already experienced that. So what you want to do is have a breakfast meeting with them, but not for formal credits. Listen, I'd love to sit down with you. You can put a little flyer together, invitation that's the regency house. And okay, we're going to be discussing low speed crash and serious injury. And You bring two educational fliers and the research behind that. And you put a little flyer together, RSVP called Dr Studin, here's my fax, here's my email, here's my phone number, RSVP. And you send that out to 10 and if you don't get any responses, you send it to another 10 and you might want to come up with a series of topics in a series of dates, what's good for you, and you keep sending it until you get like three to show up. Then you have your meeting and you do it again and you could rotate your topics, but your goal is not to get a referral. Your goal was to get them to invite you to train their staff. That's your goal. You want to be on the inside looking out, not the outside looking in. That's your goal, but you're going to work and as your relationships with the medical specialists grow, your relationships with the lawyers are going to grow. Then you stand the chance with urgent cares in hospitals, but not until then. On a couple of podcasts I talk about hospitals and emergency rooms. Go find them and listen to them. They're really good. And the other thing you haven't been doing enough is calling me or talking to me. You're not yet credentialed. You're almost there, But you're the real deal. I've got to finish your qualification. I've got to conclude what we're doing with you and you have one more course stroke. Is that the last one?

Guest Dr: Yup.

Dr Studin: You're still in the old career path. The old qualifications. You haven't done concussion and EMG, which is in the new qualification. So, I will grandfather you in the old one, but no, within three years you have to take those two additional courses. To maintain the qualification, and you're going to want to take the courses anyhow you're going to be in New York in October It's nonnegotiable. And you should do object boat day in the Hamptons. The jet boat days are important because you and I not only spent 10 hours together, you're also going to be on the boat with seven or eight other people. And most of them have been where you are.

Guest Dr: I've been wanting to come to that for the last couple summers.

Dr Studin: we hang out in the Hamptons; we go water cafe hopping and go tubing if you want. It's just beautiful hanging out at the beach. and you've heard of the Hamptons, correct?

Guest Dr: Yeah.

Dr Studin: Everything you heard is a lie if you've been there?

Guest Dr: No, I haven't been there.

Dr Studin: It's all a lie. Everything you've heard, it's actually better. We have a lot of fun, but we, everyone walks away richer and seeing the picture a little bit more. I mean, you and I just kind of talk all day long and everyone talks about their practice and business all day. We're going to put you together. You're going to be a powerhouse in your community. And by the way, if you're listening to this podcast, you want to call Aaron, you can call him also. He doesn't care. Everybody can call him. When you're there, I'm going to have people call you to, you will be there. It's a little bit of a process, but this is what you need to do.

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