Re: Physician referral dilemma

[Guest guest]

I can tell you exactly why this is happening and what you can do about it By

your description that relationship isn't permanent as no lease or Medical

Directorship is. The financial incentive for the physician is finite and the

income is too inconsequential. The bottom line is don't write them off. Keep

going after them in a respectful manner. I once waited three years for one of

those situations to run it's course but it did and we got in. The general feel

is not to bother but if you DO continue to bother, you will be remembered and

possibly rewarded. As far as the patients requesting your services, I totally

agree that you must always do that. It's an incremental process, builds patient

loyalty, reflects well on everyone, and costs you nothing. My rule is to avoid

people who always have a reason things may not (can't - urghhhh) work and spend

time with people who look for ways to make things happen. CONGRATS!! You're in

the right category. Keep up the great work!! Doug

Doug Sparks

Advanced Physical Therapy Concepts / APTC

www.aptc.biz

Physician referral dilemma

GlacierHere's one for the group. Any input would be deeply appreciated.

I run a private practice in a small town 15 miles from a city where there is the

largest orthopedic group in the state. Referral patterns with this group is

influenced by a " business relationship " with a clinic that leases space from

them. Some physicians have no problem referring patients to clinics near their

home while others will make the patient travel 3 days per week to go to their OP

clinic. Marketing to these guys is akin to talking to the wall and is frankly

not worth my time and effort. Historically I have been emphasizing to the local

community that they have the right to choose their provider - whether its me or

someone else - but that it should be their choice ultimately. This has worked

in many other situations with other physician groups - with the exception of the

orthopedic group mentioned above.

OK -so here is my question. What would you do to " empower " some of these local

patients - usually high school athletes and their parents to change this and

have them stay closer to home for better more personalized therapy services?

One thought that has crossed my mind is to have the patient give the physician a

card - " We support those who support us " . Or something like that to let

certain physicians know our discontent. I'm sure it would make me feel good to

do this but not sure if its too in your face. If we don't get the referrals - no

problem because we are not getting them anyways!

Any ideas out there with folks in similar situations?

Leo Credit PT MS

Gray Physical Therapy Center PA

PO Box 1047

6 Turnpike Acres Rd

Gray ME 04039

[Guest guest]

I can tell you exactly why this is happening and what you can do about it By

your description that relationship isn't permanent as no lease or Medical

Directorship is. The financial incentive for the physician is finite and the

income is too inconsequential. The bottom line is don't write them off. Keep

going after them in a respectful manner. I once waited three years for one of

those situations to run it's course but it did and we got in. The general feel

is not to bother but if you DO continue to bother, you will be remembered and

possibly rewarded. As far as the patients requesting your services, I totally

agree that you must always do that. It's an incremental process, builds patient

loyalty, reflects well on everyone, and costs you nothing. My rule is to avoid

people who always have a reason things may not (can't - urghhhh) work and spend

time with people who look for ways to make things happen. CONGRATS!! You're in

the right category. Keep up the great work!! Doug

Doug Sparks

Advanced Physical Therapy Concepts / APTC

www.aptc.biz

Physician referral dilemma

GlacierHere's one for the group. Any input would be deeply appreciated.

I run a private practice in a small town 15 miles from a city where there is the

largest orthopedic group in the state. Referral patterns with this group is

influenced by a " business relationship " with a clinic that leases space from

them. Some physicians have no problem referring patients to clinics near their

home while others will make the patient travel 3 days per week to go to their OP

clinic. Marketing to these guys is akin to talking to the wall and is frankly

not worth my time and effort. Historically I have been emphasizing to the local

community that they have the right to choose their provider - whether its me or

someone else - but that it should be their choice ultimately. This has worked

in many other situations with other physician groups - with the exception of the

orthopedic group mentioned above.

OK -so here is my question. What would you do to " empower " some of these local

patients - usually high school athletes and their parents to change this and

have them stay closer to home for better more personalized therapy services?

One thought that has crossed my mind is to have the patient give the physician a

card - " We support those who support us " . Or something like that to let

certain physicians know our discontent. I'm sure it would make me feel good to

do this but not sure if its too in your face. If we don't get the referrals - no

problem because we are not getting them anyways!

Any ideas out there with folks in similar situations?

Leo Credit PT MS

Gray Physical Therapy Center PA

PO Box 1047

6 Turnpike Acres Rd

Gray ME 04039

[Guest guest]

I would advise forming an alliance with the PT group. If you guys are 15 miles

away, then you should be more collegial and less adversarial. Talk to them

about the situation because odds are they will have patient's asking all the

time for names of someone closer. If they see you as a " small timer " (which is

how you want to sell it) then they will be likely to support you. As well, the

idea that you could make the docs mad is never a good idea. At this point it

sounds as if they aren't " stopping " or " discouraging " patients from going to

you, but never under estimate the ego of a doc if you get them offended. The

other thing is to go to the coaches in your local schools and talk to them and

the AD and tell them what you are seeing and market the idea that local clinic

attendance will be better for the patients in the long run. Also the same with

the local primary care docs, most people see an orthopod by referral from their

primary doc so tell them the same things. This may get them to advocate for you

when the patient says their ortho doc referred them to such and such clinic.

Good luck

Sac Spine & PT

Physician referral dilemma

GlacierHere's one for the group. Any input would be deeply appreciated.

I run a private practice in a small town 15 miles from a city where there is

the largest orthopedic group in the state. Referral patterns with this group is

influenced by a " business relationship " with a clinic that leases space from

them. Some physicians have no problem referring patients to clinics near their

home while others will make the patient travel 3 days per week to go to their OP

clinic. Marketing to these guys is akin to talking to the wall and is frankly

not worth my time and effort. Historically I have been emphasizing to the local

community that they have the right to choose their provider - whether its me or

someone else - but that it should be their choice ultimately. This has worked

in many other situations with other physician groups - with the exception of the

orthopedic group mentioned above.

OK -so here is my question. What would you do to " empower " some of these

local patients - usually high school athletes and their parents to change this

and have them stay closer to home for better more personalized therapy services?

One thought that has crossed my mind is to have the patient give the physician a

card - " We support those who support us " . Or something like that to let

certain physicians know our discontent. I'm sure it would make me feel good to

do this but not sure if its too in your face. If we don't get the referrals - no

problem because we are not getting them anyways!

Any ideas out there with folks in similar situations?

Leo Credit PT MS

Gray Physical Therapy Center PA

PO Box 1047

6 Turnpike Acres Rd

Gray ME 04039

[Guest guest]

Leo,

Take one of your athletes and do a " human progress note " to the referring

physician. Have in your head a 30-60 second " commercial " that will stick in

his head like-schedule within 24 hours of referral, or early and late hours,

or convenient appointment times, or toot your horn as to a

specialty-diagnosis you like to treat. Find out what your competition

offers and offer it better or offer something else altogether. Physicians

don't want to have to think about where they send their patients. Don't

forget to ask them for what you want. Find a way to help them. We tell

physicians to send all their patients to us and if we don't take their

insurance WE will find them a place to go. Find a way to make their lives

easier or their practice more manageable.

Connolly

PT Plus of Oak Creek

Physician referral dilemma

>

>

> GlacierHere's one for the group. Any input would be deeply appreciated.

>

> I run a private practice in a small town 15 miles from a city where there

is the largest orthopedic group in the state. Referral patterns with this

group is influenced by a " business relationship " with a clinic that leases

space from them. Some physicians have no problem referring patients to

clinics near their home while others will make the patient travel 3 days per

week to go to their OP clinic. Marketing to these guys is akin to talking

to the wall and is frankly not worth my time and effort. Historically I

have been emphasizing to the local community that they have the right to

choose their provider - whether its me or someone else - but that it should

be their choice ultimately. This has worked in many other situations with

other physician groups - with the exception of the orthopedic group

mentioned above.

>

> OK -so here is my question. What would you do to " empower " some of these

local patients - usually high school athletes and their parents to change

this and have them stay closer to home for better more personalized therapy

services? One thought that has crossed my mind is to have the patient give

the physician a card - " We support those who support us " . Or something

like that to let certain physicians know our discontent. I'm sure it would

make me feel good to do this but not sure if its too in your face. If we

don't get the referrals - no problem because we are not getting them

anyways!

>

> Any ideas out there with folks in similar situations?

>

>

>

> Leo Credit PT MS

> Gray Physical Therapy Center PA

> PO Box 1047

> 6 Turnpike Acres Rd

> Gray ME 04039

>

>

>

>

>

>

[Guest guest]

Leo,

Take one of your athletes and do a " human progress note " to the referring

physician. Have in your head a 30-60 second " commercial " that will stick in

his head like-schedule within 24 hours of referral, or early and late hours,

or convenient appointment times, or toot your horn as to a

specialty-diagnosis you like to treat. Find out what your competition

offers and offer it better or offer something else altogether. Physicians

don't want to have to think about where they send their patients. Don't

forget to ask them for what you want. Find a way to help them. We tell

physicians to send all their patients to us and if we don't take their

insurance WE will find them a place to go. Find a way to make their lives

easier or their practice more manageable.

Connolly

PT Plus of Oak Creek

Physician referral dilemma

>

>

> GlacierHere's one for the group. Any input would be deeply appreciated.

>

> I run a private practice in a small town 15 miles from a city where there

is the largest orthopedic group in the state. Referral patterns with this

group is influenced by a " business relationship " with a clinic that leases

space from them. Some physicians have no problem referring patients to

clinics near their home while others will make the patient travel 3 days per

week to go to their OP clinic. Marketing to these guys is akin to talking

to the wall and is frankly not worth my time and effort. Historically I

have been emphasizing to the local community that they have the right to

choose their provider - whether its me or someone else - but that it should

be their choice ultimately. This has worked in many other situations with

other physician groups - with the exception of the orthopedic group

mentioned above.

>

> OK -so here is my question. What would you do to " empower " some of these

local patients - usually high school athletes and their parents to change

this and have them stay closer to home for better more personalized therapy

services? One thought that has crossed my mind is to have the patient give

the physician a card - " We support those who support us " . Or something

like that to let certain physicians know our discontent. I'm sure it would

make me feel good to do this but not sure if its too in your face. If we

don't get the referrals - no problem because we are not getting them

anyways!

>

> Any ideas out there with folks in similar situations?

>

>

>

> Leo Credit PT MS

> Gray Physical Therapy Center PA

> PO Box 1047

> 6 Turnpike Acres Rd

> Gray ME 04039

>

>

>

>

>

>

[Guest guest]

Leo,

Our outpatient therapists are in a similar situation. If the

patients specifically ask to be seen by your therapists, then the

physician would be hard-pressed to send them elsewhere. However, you

would need to direct your marketing to the consumer rather than the

physicians.

Hope this helps.

-Curtis

[Guest guest]

Leo,

Our outpatient therapists are in a similar situation. If the

patients specifically ask to be seen by your therapists, then the

physician would be hard-pressed to send them elsewhere. However, you

would need to direct your marketing to the consumer rather than the

physicians.

Hope this helps.

-Curtis

[Guest guest]

Barrett - you hit it on the head! I agree with your honesty in that those

with a financial interest (or those who wish to think of these interests

first before clinical interests) will never be persuaded to change how they

refer. Two of my employees used to work directly with this group and they

have always said that Dr. X and Dr. Y " will never send us a patient " because

of that.- So far they have been correct. The other physicians in that group

seem to have the patient's interests first and we do get referrals from

them.

I do appreciate everyone's input. I feel better now because much of the

advice given has already been my focus. Marketing to the consumer has been

my primary vehicle. My practice is 3 years old and growing quickly - my

face and name are everywhere in town. We have the contract at the local

high school for sportsmedicine services, we support countless local

organizations, I give talks to all sorts of local groups, we donate time and

services for consulting at the local YMCA, I am the president of the local

business association - you name it I'm there. (Actually that has been one

of the most exciting aspects of opening my clinic). What I haven't done is

to develop a Referral for Services form. Thanks Lynn for your input on

this. I may use this instead of my sportsmedicine injury eval report -

which I am sure never gets read.

I guess when I typed that email I was part venting because I had heard that

Dr. X had a local football player in therapy at " his place " . This happened

despite my warning to this kid's dad that Dr. X was going to try to do that.

His dad told me that he was going to tell Dr. X that his son was going to go

to Gray PT. Well I guess Dr. X is quite persuasive. Yep, I may actually

get in this physician's face - not that I believe that it will change

anything, but rather for my own satisfaction.

Thanks gang!

- Original Message -----

To: <PTManager >

Sent: Wednesday, December 15, 2004 4:55 PM

Subject: Re: Physician Referral Dilemma

>

>

>

> Leo,

>

> I'm uncertain about the meaning of the card you imagine handing out.

> Who are " we " and who's " us " ?

>

> Aside from that, I'm not convinced you face a solvable problem with

> the physicians bent on making a profit from each referral to therapy.

> As a private practitioner for the past 25 years, it has been my

> experience that no amount of reason, competence or convenience for the

> patient will overcome the monetary rationale any doctor might have.

> This includes the bonds of close friendship and professional respect.

> I realize how awful this sounds.

>

> If getting " in their face " makes you feel better (and it may) go

> ahead. This won't make any difference either.

>

> Merry Christmas.

>

> Barrett L. Dorko, P.T.

> http://barrettdorko.com

> And http://rehabedge.com

>

> At 07:48 AM 12/15/2004, you wrote:

>

>

>

> GlacierHere's one for the group. Any input would be deeply appreciated.

>

> I run a private practice in a small town 15 miles from a city where

> there is the largest orthopedic group in the state. Referral patterns

> with this group is influenced by a " business relationship " with a

> clinic that leases space from them. Some physicians have no problem

> referring patients to clinics near their home while others will make

> the patient travel 3 days per week to go to their OP clinic.

> Marketing to these guys is akin to talking to the wall and is frankly

> not worth my time and effort. Historically I have been emphasizing to

> the local community that they have the right to choose their provider

> - whether its me or someone else - but that it should be their choice

> ultimately. This has worked in many other situations with other

> physician groups - with the exception of the orthopedic group

> mentioned above.

>

> OK -so here is my question. What would you do to " empower " some of

> these local patients - usually high school athletes and their parents

> to change this and have them stay closer to home for better more

> personalized therapy services? One thought that has crossed my mind

> is to have the patient give the physician a card - " We support those

> who support us " . Or something like that to let certain physicians

> know our discontent. I'm sure it would make me feel good to do this

> but not sure if its too in your face. If we don't get the referrals -

> no problem because we are not getting them anyways!

>

> Any ideas out there with folks in similar situations?

>

>

>

> Leo Credit PT MS

> Gray Physical Therapy Center PA

> PO Box 1047

> 6 Turnpike Acres Rd

> Gray ME 04039

>

>

>

>

>

>

[Guest guest]

Barrett - you hit it on the head! I agree with your honesty in that those

with a financial interest (or those who wish to think of these interests

first before clinical interests) will never be persuaded to change how they

refer. Two of my employees used to work directly with this group and they

have always said that Dr. X and Dr. Y " will never send us a patient " because

of that.- So far they have been correct. The other physicians in that group

seem to have the patient's interests first and we do get referrals from

them.

I do appreciate everyone's input. I feel better now because much of the

advice given has already been my focus. Marketing to the consumer has been

my primary vehicle. My practice is 3 years old and growing quickly - my

face and name are everywhere in town. We have the contract at the local

high school for sportsmedicine services, we support countless local

organizations, I give talks to all sorts of local groups, we donate time and

services for consulting at the local YMCA, I am the president of the local

business association - you name it I'm there. (Actually that has been one

of the most exciting aspects of opening my clinic). What I haven't done is

to develop a Referral for Services form. Thanks Lynn for your input on

this. I may use this instead of my sportsmedicine injury eval report -

which I am sure never gets read.

I guess when I typed that email I was part venting because I had heard that

Dr. X had a local football player in therapy at " his place " . This happened

despite my warning to this kid's dad that Dr. X was going to try to do that.

His dad told me that he was going to tell Dr. X that his son was going to go

to Gray PT. Well I guess Dr. X is quite persuasive. Yep, I may actually

get in this physician's face - not that I believe that it will change

anything, but rather for my own satisfaction.

Thanks gang!

- Original Message -----

To: <PTManager >

Sent: Wednesday, December 15, 2004 4:55 PM

Subject: Re: Physician Referral Dilemma

>

>

>

> Leo,

>

> I'm uncertain about the meaning of the card you imagine handing out.

> Who are " we " and who's " us " ?

>

> Aside from that, I'm not convinced you face a solvable problem with

> the physicians bent on making a profit from each referral to therapy.

> As a private practitioner for the past 25 years, it has been my

> experience that no amount of reason, competence or convenience for the

> patient will overcome the monetary rationale any doctor might have.

> This includes the bonds of close friendship and professional respect.

> I realize how awful this sounds.

>

> If getting " in their face " makes you feel better (and it may) go

> ahead. This won't make any difference either.

>

> Merry Christmas.

>

> Barrett L. Dorko, P.T.

> http://barrettdorko.com

> And http://rehabedge.com

>

> At 07:48 AM 12/15/2004, you wrote:

>

>

>

> GlacierHere's one for the group. Any input would be deeply appreciated.

>

> I run a private practice in a small town 15 miles from a city where

> there is the largest orthopedic group in the state. Referral patterns

> with this group is influenced by a " business relationship " with a

> clinic that leases space from them. Some physicians have no problem

> referring patients to clinics near their home while others will make

> the patient travel 3 days per week to go to their OP clinic.

> Marketing to these guys is akin to talking to the wall and is frankly

> not worth my time and effort. Historically I have been emphasizing to

> the local community that they have the right to choose their provider

> - whether its me or someone else - but that it should be their choice

> ultimately. This has worked in many other situations with other

> physician groups - with the exception of the orthopedic group

> mentioned above.

>

> OK -so here is my question. What would you do to " empower " some of

> these local patients - usually high school athletes and their parents

> to change this and have them stay closer to home for better more

> personalized therapy services? One thought that has crossed my mind

> is to have the patient give the physician a card - " We support those

> who support us " . Or something like that to let certain physicians

> know our discontent. I'm sure it would make me feel good to do this

> but not sure if its too in your face. If we don't get the referrals -

> no problem because we are not getting them anyways!

>

> Any ideas out there with folks in similar situations?

>

>

>

> Leo Credit PT MS

> Gray Physical Therapy Center PA

> PO Box 1047

> 6 Turnpike Acres Rd

> Gray ME 04039

>

>

>

>

>

>

[Guest guest]

Barrett - you hit it on the head! I agree with your honesty in that those

with a financial interest (or those who wish to think of these interests

first before clinical interests) will never be persuaded to change how they

refer. Two of my employees used to work directly with this group and they

have always said that Dr. X and Dr. Y " will never send us a patient " because

of that.- So far they have been correct. The other physicians in that group

seem to have the patient's interests first and we do get referrals from

them.

I do appreciate everyone's input. I feel better now because much of the

advice given has already been my focus. Marketing to the consumer has been

my primary vehicle. My practice is 3 years old and growing quickly - my

face and name are everywhere in town. We have the contract at the local

high school for sportsmedicine services, we support countless local

organizations, I give talks to all sorts of local groups, we donate time and

services for consulting at the local YMCA, I am the president of the local

business association - you name it I'm there. (Actually that has been one

of the most exciting aspects of opening my clinic). What I haven't done is

to develop a Referral for Services form. Thanks Lynn for your input on

this. I may use this instead of my sportsmedicine injury eval report -

which I am sure never gets read.

I guess when I typed that email I was part venting because I had heard that

Dr. X had a local football player in therapy at " his place " . This happened

despite my warning to this kid's dad that Dr. X was going to try to do that.

His dad told me that he was going to tell Dr. X that his son was going to go

to Gray PT. Well I guess Dr. X is quite persuasive. Yep, I may actually

get in this physician's face - not that I believe that it will change

anything, but rather for my own satisfaction.

Thanks gang!

- Original Message -----

To: <PTManager >

Sent: Wednesday, December 15, 2004 4:55 PM

Subject: Re: Physician Referral Dilemma

>

>

>

> Leo,

>

> I'm uncertain about the meaning of the card you imagine handing out.

> Who are " we " and who's " us " ?

>

> Aside from that, I'm not convinced you face a solvable problem with

> the physicians bent on making a profit from each referral to therapy.

> As a private practitioner for the past 25 years, it has been my

> experience that no amount of reason, competence or convenience for the

> patient will overcome the monetary rationale any doctor might have.

> This includes the bonds of close friendship and professional respect.

> I realize how awful this sounds.

>

> If getting " in their face " makes you feel better (and it may) go

> ahead. This won't make any difference either.

>

> Merry Christmas.

>

> Barrett L. Dorko, P.T.

> http://barrettdorko.com

> And http://rehabedge.com

>

> At 07:48 AM 12/15/2004, you wrote:

>

>

>

> GlacierHere's one for the group. Any input would be deeply appreciated.

>

> I run a private practice in a small town 15 miles from a city where

> there is the largest orthopedic group in the state. Referral patterns

> with this group is influenced by a " business relationship " with a

> clinic that leases space from them. Some physicians have no problem

> referring patients to clinics near their home while others will make

> the patient travel 3 days per week to go to their OP clinic.

> Marketing to these guys is akin to talking to the wall and is frankly

> not worth my time and effort. Historically I have been emphasizing to

> the local community that they have the right to choose their provider

> - whether its me or someone else - but that it should be their choice

> ultimately. This has worked in many other situations with other

> physician groups - with the exception of the orthopedic group

> mentioned above.

>

> OK -so here is my question. What would you do to " empower " some of

> these local patients - usually high school athletes and their parents

> to change this and have them stay closer to home for better more

> personalized therapy services? One thought that has crossed my mind

> is to have the patient give the physician a card - " We support those

> who support us " . Or something like that to let certain physicians

> know our discontent. I'm sure it would make me feel good to do this

> but not sure if its too in your face. If we don't get the referrals -

> no problem because we are not getting them anyways!

>

> Any ideas out there with folks in similar situations?

>

>

>

> Leo Credit PT MS

> Gray Physical Therapy Center PA

> PO Box 1047

> 6 Turnpike Acres Rd

> Gray ME 04039

>

>

>

>

>

>

[Guest guest]

I have been away and missed this one!

I will give a worthy piece of consideration:

Remember that geographic referrals are attainable. That is, those

patients from your neighborhood should not need to travel to get

their PT, if, in fact, your provide PT that is of comparable quality

to that which is provided in the Ortho-owned group. It may seem

ridiculous that a PT might actually be smart, talented, or even good

AND work in a practice that is not owned by a PT. It can happen.

Who knows? Maybe they might be an okay set of PTs. Then again, they

might not be very good. Who knows? How do you measure? Please

start a separate post to find the answer to that one.

Anyway, try and contact that PTs involved. Somehow get them involved

in the process. Chances are, based on your explanation, the MDs will

not be upset at patients seeking PT outside their network. They need

to realize that it is a factor of convenience for patients to get PT

and medicine in the same locale, but it is also convenient to get PT

close to home. You would like to be that PT close to home. Give it

a shot, it might work, it might fail. And the clinic up the street

might already be doing it.

Peace

Merry Christmas

Happy Holidays to all

Simonetti, PT, DPT, MTC

land

[Guest guest]

I have been away and missed this one!

I will give a worthy piece of consideration:

Remember that geographic referrals are attainable. That is, those

patients from your neighborhood should not need to travel to get

their PT, if, in fact, your provide PT that is of comparable quality

to that which is provided in the Ortho-owned group. It may seem

ridiculous that a PT might actually be smart, talented, or even good

AND work in a practice that is not owned by a PT. It can happen.

Who knows? Maybe they might be an okay set of PTs. Then again, they

might not be very good. Who knows? How do you measure? Please

start a separate post to find the answer to that one.

Anyway, try and contact that PTs involved. Somehow get them involved

in the process. Chances are, based on your explanation, the MDs will

not be upset at patients seeking PT outside their network. They need

to realize that it is a factor of convenience for patients to get PT

and medicine in the same locale, but it is also convenient to get PT

close to home. You would like to be that PT close to home. Give it

a shot, it might work, it might fail. And the clinic up the street

might already be doing it.

Peace

Merry Christmas

Happy Holidays to all

Simonetti, PT, DPT, MTC

land

[Guest guest]

I am glad to see your post suggesting contacting the PT's. I sub lease

from a group of neurosurgeons and when I get a patient referral, I am

the one who lets them know in no uncertain terms that they have the

right to decide where to go to therapy. If they would rather go to a

more convenient site, already have a relationship with a PT they trust,

or live farther away, I draft the prescription for the physician's

signature, get it signed and fax it to the facility for the patient.

Many times the patient is reluctant to tell the physician that they

would rather go somewhere else, and I feel I need to help so that they

do not have to face what they may feel is a confrontation with the

physician or their staff in getting a prescription to go somewhere else.

(after all, they did not tell them when they were face to face with

them) I keep a list of PT's that I trust in the outlying areas I can

suggest if the drive to me is too far or the other PT is just more

convenient. I am also in an excellent network of PT's that I can usually

find a provider more accessible for the patient.

It's almost a running joke with one physician, he wants to know why I

don't want to treat those out of town patients. I see no reason to make

them travel too far if there is a local PT that I trust. I also keep a

list of PT's on insurances that I am not a provider for.

Yes, talk to the PT's! You may find they can advocate for your patients

and assist in getting them to you. It is a win/win situation. After all,

there are plenty of patients out there.

Sandi Pomeroy, PT

Pomeroy Therapeutics

Dayton, Ohio

wrote:

>

>I have been away and missed this one!

>

>I will give a worthy piece of consideration:

>

>Remember that geographic referrals are attainable. That is, those

>patients from your neighborhood should not need to travel to get

>their PT, if, in fact, your provide PT that is of comparable quality

>to that which is provided in the Ortho-owned group. It may seem

>ridiculous that a PT might actually be smart, talented, or even good

>AND work in a practice that is not owned by a PT. It can happen.

>Who knows? Maybe they might be an okay set of PTs. Then again, they

>might not be very good. Who knows? How do you measure? Please

>start a separate post to find the answer to that one.

>

>Anyway, try and contact that PTs involved. Somehow get them involved

>in the process. Chances are, based on your explanation, the MDs will

>not be upset at patients seeking PT outside their network. They need

>to realize that it is a factor of convenience for patients to get PT

>and medicine in the same locale, but it is also convenient to get PT

>close to home. You would like to be that PT close to home. Give it

>a shot, it might work, it might fail. And the clinic up the street

>might already be doing it.

>

>Peace

>Merry Christmas

>Happy Holidays to all

> Simonetti, PT, DPT, MTC

>land

>

>

>

>

>

>

>

>

>Looking to start your own Practice?

>Visit www.InHomeRehab.com.

>Bring PTManager to your organization or State Association with a professional

workshop or course - call us at 313 884-8920 to arrange

>PTManager encourages participation in your professional association. Join and

participate now!

>

[Guest guest]

I am glad to see your post suggesting contacting the PT's. I sub lease

from a group of neurosurgeons and when I get a patient referral, I am

the one who lets them know in no uncertain terms that they have the

right to decide where to go to therapy. If they would rather go to a

more convenient site, already have a relationship with a PT they trust,

or live farther away, I draft the prescription for the physician's

signature, get it signed and fax it to the facility for the patient.

Many times the patient is reluctant to tell the physician that they

would rather go somewhere else, and I feel I need to help so that they

do not have to face what they may feel is a confrontation with the

physician or their staff in getting a prescription to go somewhere else.

(after all, they did not tell them when they were face to face with

them) I keep a list of PT's that I trust in the outlying areas I can

suggest if the drive to me is too far or the other PT is just more

convenient. I am also in an excellent network of PT's that I can usually

find a provider more accessible for the patient.

It's almost a running joke with one physician, he wants to know why I

don't want to treat those out of town patients. I see no reason to make

them travel too far if there is a local PT that I trust. I also keep a

list of PT's on insurances that I am not a provider for.

Yes, talk to the PT's! You may find they can advocate for your patients

and assist in getting them to you. It is a win/win situation. After all,

there are plenty of patients out there.

Sandi Pomeroy, PT

Pomeroy Therapeutics

Dayton, Ohio

wrote:

>

>I have been away and missed this one!

>

>I will give a worthy piece of consideration:

>

>Remember that geographic referrals are attainable. That is, those

>patients from your neighborhood should not need to travel to get

>their PT, if, in fact, your provide PT that is of comparable quality

>to that which is provided in the Ortho-owned group. It may seem

>ridiculous that a PT might actually be smart, talented, or even good

>AND work in a practice that is not owned by a PT. It can happen.

>Who knows? Maybe they might be an okay set of PTs. Then again, they

>might not be very good. Who knows? How do you measure? Please

>start a separate post to find the answer to that one.

>

>Anyway, try and contact that PTs involved. Somehow get them involved

>in the process. Chances are, based on your explanation, the MDs will

>not be upset at patients seeking PT outside their network. They need

>to realize that it is a factor of convenience for patients to get PT

>and medicine in the same locale, but it is also convenient to get PT

>close to home. You would like to be that PT close to home. Give it

>a shot, it might work, it might fail. And the clinic up the street

>might already be doing it.

>

>Peace

>Merry Christmas

>Happy Holidays to all

> Simonetti, PT, DPT, MTC

>land

>

>

>

>

>

>

>

>

>Looking to start your own Practice?

>Visit www.InHomeRehab.com.

>Bring PTManager to your organization or State Association with a professional

workshop or course - call us at 313 884-8920 to arrange

>PTManager encourages participation in your professional association. Join and

participate now!

>

[Guest guest]

Amy:

I know of several orthopedists who do and do not refer patients to

me. When recommending the ortho to the patient, I mention some of my

experiences, and this is one specific comment I use : " MD never refers

any of his/ her post-op patients to me, therefore I never see his/

her sucesses. " It is completely honest.

It is slightly better than the 'He dont refer to me so I aint

referrin to him' methodology which is pervasive, and a likely

accompaniment to future direct access.

Peace

>

>

> We have a similar situation here with a large orthopedic group.

> Initially all their referrals went to a " friend of the business "

and

> now they have there own rehab on site. I have had my patients tell

> me that a physician has refused to do their surgery unless they go

> to the ortho's rehab. Others have said, although not stated

> outright, that they were made to feel that if they did not go to

the

> MD's clinic that insurance would not cover them anywhere else. Of

> course this is not true. But the general public doesn't know this

> and they don't know of their right to choose. For most of the

> general public MD's are " gods " and nothing gets questioned because

> if the doctor said it, it must be right.

>

> We are an outpt. clinic and we see a lot of acute injuries before

> they have even been referred to ortho. When we know a pt. is going

> to ortho we recommend several good MD's for their type of injury

> first. Second, we prepare them for what might happen as far as the

> MD and rehab and their right to choose, regardless of what the MD

> says. Also, anyone who calls in with questions regarding our

clinic

> is informed of their right to choose. And we ask everyone to

spread

> the word. In the past we have compiled an alphebetical list of

> clinics in the area and sent them to all local physicians asking

> them to pass it on to their patients so they can choose the

provider

> that best suits them. Some are still using this list, others I'm

> sure have " filed " it elsewhere. I would have no problem filing a

> complaint against this practice if I could back it up but all my

> info comes second hand. I end up with the question of how to prove

> it.

>

> Amy

[Guest guest]

Amy:

I know of several orthopedists who do and do not refer patients to

me. When recommending the ortho to the patient, I mention some of my

experiences, and this is one specific comment I use : " MD never refers

any of his/ her post-op patients to me, therefore I never see his/

her sucesses. " It is completely honest.

It is slightly better than the 'He dont refer to me so I aint

referrin to him' methodology which is pervasive, and a likely

accompaniment to future direct access.

Peace

>

>

> We have a similar situation here with a large orthopedic group.

> Initially all their referrals went to a " friend of the business "

and

> now they have there own rehab on site. I have had my patients tell

> me that a physician has refused to do their surgery unless they go

> to the ortho's rehab. Others have said, although not stated

> outright, that they were made to feel that if they did not go to

the

> MD's clinic that insurance would not cover them anywhere else. Of

> course this is not true. But the general public doesn't know this

> and they don't know of their right to choose. For most of the

> general public MD's are " gods " and nothing gets questioned because

> if the doctor said it, it must be right.

>

> We are an outpt. clinic and we see a lot of acute injuries before

> they have even been referred to ortho. When we know a pt. is going

> to ortho we recommend several good MD's for their type of injury

> first. Second, we prepare them for what might happen as far as the

> MD and rehab and their right to choose, regardless of what the MD

> says. Also, anyone who calls in with questions regarding our

clinic

> is informed of their right to choose. And we ask everyone to

spread

> the word. In the past we have compiled an alphebetical list of

> clinics in the area and sent them to all local physicians asking

> them to pass it on to their patients so they can choose the

provider

> that best suits them. Some are still using this list, others I'm

> sure have " filed " it elsewhere. I would have no problem filing a

> complaint against this practice if I could back it up but all my

> info comes second hand. I end up with the question of how to prove

> it.

>

> Amy

[Guest guest]

That's a very good point . Though I love the prospect of direct access and

have used patient/employer demand in the past to help me get on closed insurance

panels, the physicians will likely refer to you in that environment because of

your response. The other quite humorous response you quoted will probably not

get patients referred anyway.

I've had more than a few conversations with our APTC members who are noticing a

general lethargy in the physician's views of the " hassle of dealing with

therapy " as they describe it. Like you, the therapists are friends and social

with the physicians. With candor one doc says that a particular therapist calls

him all of the time regarding patient care in situations that seem obvious,

another told the patient that what the physician prescribed is not really the

best way to go about their problem, and still another told the patient that the

physician had misdiagnosed. His conclusion was " I'd rather give them a home

program or send them for one visit to get a home program rather than put up with

the hassle of the down side " . He indicated that in most situations he sends

them straight home because he just saw them and doesn't see the need for another

evaluation by the therapist.

In all fairness most every physician said if he/she could find consistency and

cooperation with unobtrusive service they would be loyal to that therapist

because he/she truly believes in therapy. What may sound like a negative

overview actually tells us what the physician desires and that is a benefit. I

learned this information from a survey of some of our members when I heard

complaints that referrals as a whole had significantly dropped off though the

physicians did not have in-house therapy. This " physician therapy lethargy "

description came up 15+ times from members who spoke with physicians in social

settings. This might be a little off the subject but it should aid our

marketing approach. Happy holidays to everyone. Doug

Doug Sparks

Advanced Physical Therapy Concepts / APTC

www.aptc.biz<http://www.aptc.biz/>

doug@...

Re: Physician referral dilemma

Amy:

I know of several orthopedists who do and do not refer patients to

me. When recommending the ortho to the patient, I mention some of my

experiences, and this is one specific comment I use : " MD never refers

any of his/ her post-op patients to me, therefore I never see his/

her sucesses. " It is completely honest.

It is slightly better than the 'He dont refer to me so I aint

referrin to him' methodology which is pervasive, and a likely

accompaniment to future direct access.

Peace

>

>

> We have a similar situation here with a large orthopedic group.

> Initially all their referrals went to a " friend of the business "

and

> now they have there own rehab on site. I have had my patients tell

> me that a physician has refused to do their surgery unless they go

> to the ortho's rehab. Others have said, although not stated

> outright, that they were made to feel that if they did not go to

the

> MD's clinic that insurance would not cover them anywhere else. Of

> course this is not true. But the general public doesn't know this

> and they don't know of their right to choose. For most of the

> general public MD's are " gods " and nothing gets questioned because

> if the doctor said it, it must be right.

>

> We are an outpt. clinic and we see a lot of acute injuries before

> they have even been referred to ortho. When we know a pt. is going

> to ortho we recommend several good MD's for their type of injury

> first. Second, we prepare them for what might happen as far as the

> MD and rehab and their right to choose, regardless of what the MD

> says. Also, anyone who calls in with questions regarding our

clinic

> is informed of their right to choose. And we ask everyone to

spread

> the word. In the past we have compiled an alphebetical list of

> clinics in the area and sent them to all local physicians asking

> them to pass it on to their patients so they can choose the

provider

> that best suits them. Some are still using this list, others I'm

> sure have " filed " it elsewhere. I would have no problem filing a

> complaint against this practice if I could back it up but all my

> info comes second hand. I end up with the question of how to prove

> it.

>

> Amy

Looking to start your own Practice?

Visit www.InHomeRehab.com<http://www.inhomerehab.com/>.

Bring PTManager to your organization or State Association with a professional

workshop or course - call us at 313 884-8920 to arrange

PTManager encourages participation in your professional association. Join and

participate now!

[Guest guest]

That's a very good point . Though I love the prospect of direct access and

have used patient/employer demand in the past to help me get on closed insurance

panels, the physicians will likely refer to you in that environment because of

your response. The other quite humorous response you quoted will probably not

get patients referred anyway.

I've had more than a few conversations with our APTC members who are noticing a

general lethargy in the physician's views of the " hassle of dealing with

therapy " as they describe it. Like you, the therapists are friends and social

with the physicians. With candor one doc says that a particular therapist calls

him all of the time regarding patient care in situations that seem obvious,

another told the patient that what the physician prescribed is not really the

best way to go about their problem, and still another told the patient that the

physician had misdiagnosed. His conclusion was " I'd rather give them a home

program or send them for one visit to get a home program rather than put up with

the hassle of the down side " . He indicated that in most situations he sends

them straight home because he just saw them and doesn't see the need for another

evaluation by the therapist.

In all fairness most every physician said if he/she could find consistency and

cooperation with unobtrusive service they would be loyal to that therapist

because he/she truly believes in therapy. What may sound like a negative

overview actually tells us what the physician desires and that is a benefit. I

learned this information from a survey of some of our members when I heard

complaints that referrals as a whole had significantly dropped off though the

physicians did not have in-house therapy. This " physician therapy lethargy "

description came up 15+ times from members who spoke with physicians in social

settings. This might be a little off the subject but it should aid our

marketing approach. Happy holidays to everyone. Doug

Doug Sparks

Advanced Physical Therapy Concepts / APTC

www.aptc.biz<http://www.aptc.biz/>

doug@...

Re: Physician referral dilemma

Amy:

I know of several orthopedists who do and do not refer patients to

me. When recommending the ortho to the patient, I mention some of my

experiences, and this is one specific comment I use : " MD never refers

any of his/ her post-op patients to me, therefore I never see his/

her sucesses. " It is completely honest.

It is slightly better than the 'He dont refer to me so I aint

referrin to him' methodology which is pervasive, and a likely

accompaniment to future direct access.

Peace

>

>

> We have a similar situation here with a large orthopedic group.

> Initially all their referrals went to a " friend of the business "

and

> now they have there own rehab on site. I have had my patients tell

> me that a physician has refused to do their surgery unless they go

> to the ortho's rehab. Others have said, although not stated

> outright, that they were made to feel that if they did not go to

the

> MD's clinic that insurance would not cover them anywhere else. Of

> course this is not true. But the general public doesn't know this

> and they don't know of their right to choose. For most of the

> general public MD's are " gods " and nothing gets questioned because

> if the doctor said it, it must be right.

>

> We are an outpt. clinic and we see a lot of acute injuries before

> they have even been referred to ortho. When we know a pt. is going

> to ortho we recommend several good MD's for their type of injury

> first. Second, we prepare them for what might happen as far as the

> MD and rehab and their right to choose, regardless of what the MD

> says. Also, anyone who calls in with questions regarding our

clinic

> is informed of their right to choose. And we ask everyone to

spread

> the word. In the past we have compiled an alphebetical list of

> clinics in the area and sent them to all local physicians asking

> them to pass it on to their patients so they can choose the

provider

> that best suits them. Some are still using this list, others I'm

> sure have " filed " it elsewhere. I would have no problem filing a

> complaint against this practice if I could back it up but all my

> info comes second hand. I end up with the question of how to prove

> it.

>

> Amy

Looking to start your own Practice?

Visit www.InHomeRehab.com<http://www.inhomerehab.com/>.

Bring PTManager to your organization or State Association with a professional

workshop or course - call us at 313 884-8920 to arrange

PTManager encourages participation in your professional association. Join and

participate now!

[Guest guest]

Doug,

Amen to that! Many of the problems we have in establishing consistent

referral sources have been brought on by other therapy providers, or by

ourselves, by misreading the needs of (or worse yet, neglecting the needs

of) those referral sources.

To make things optimal these days we spend a lot of time with the question

" what's it like to be in his shoes? " Those who can understand others'

perspectives are immensely useful in creating procedures---not only between

docs and therapists, but between therapists and patients, managers and

staff, etc. (They the best sort of humans, I think!)

In a previous work situation, we once had to fire a therapist who had a very

poor understanding of such things. The last straw was a phone message he

left with our most loyal orthopedist along the lines of " you blew this

diagnosis but not to worry, I've informed the patient in time to prevent

disaster. " (Turned out the therapist was wrong anyway).

We can (and must!) have these discussions with ortho and other referrers,

but not without recognizing the obvious social/personal/professional

dynamics.

Dave Milano, Director of Rehab Services

Laurel Health System

32-36 Central Ave.

Wellsboro, PA 16901

dmilano@...

Re: Re: Physician referral dilemma

That's a very good point . Though I love the prospect of direct access

and have used patient/employer demand in the past to help me get on closed

insurance panels, the physicians will likely refer to you in that

environment because of your response. The other quite humorous response you

quoted will probably not get patients referred anyway.

I've had more than a few conversations with our APTC members who are

noticing a general lethargy in the physician's views of the " hassle of

dealing with therapy " as they describe it. Like you, the therapists are

friends and social with the physicians. With candor one doc says that a

particular therapist calls him all of the time regarding patient care in

situations that seem obvious, another told the patient that what the

physician prescribed is not really the best way to go about their problem,

and still another told the patient that the physician had misdiagnosed. His

conclusion was " I'd rather give them a home program or send them for one

visit to get a home program rather than put up with the hassle of the down

side " . He indicated that in most situations he sends them straight home

because he just saw them and doesn't see the need for another evaluation by

the therapist.

In all fairness most every physician said if he/she could find consistency

and cooperation with unobtrusive service they would be loyal to that

therapist because he/she truly believes in therapy. What may sound like a

negative overview actually tells us what the physician desires and that is a

benefit. I learned this information from a survey of some of our members

when I heard complaints that referrals as a whole had significantly dropped

off though the physicians did not have in-house therapy. This " physician

therapy lethargy " description came up 15+ times from members who spoke with

physicians in social settings. This might be a little off the subject but

it should aid our marketing approach. Happy holidays to everyone. Doug

Doug Sparks

Advanced Physical Therapy Concepts / APTC

www.aptc.biz<http://www.aptc.biz/>

doug@...

Re: Physician referral dilemma

Amy:

I know of several orthopedists who do and do not refer patients to

me. When recommending the ortho to the patient, I mention some of my

experiences, and this is one specific comment I use : " MD never refers

any of his/ her post-op patients to me, therefore I never see his/

her sucesses. " It is completely honest.

It is slightly better than the 'He dont refer to me so I aint

referrin to him' methodology which is pervasive, and a likely

accompaniment to future direct access.

Peace

>

>

> We have a similar situation here with a large orthopedic group.

> Initially all their referrals went to a " friend of the business "

and

> now they have there own rehab on site. I have had my patients tell

> me that a physician has refused to do their surgery unless they go

> to the ortho's rehab. Others have said, although not stated

> outright, that they were made to feel that if they did not go to

the

> MD's clinic that insurance would not cover them anywhere else. Of

> course this is not true. But the general public doesn't know this

> and they don't know of their right to choose. For most of the

> general public MD's are " gods " and nothing gets questioned because

> if the doctor said it, it must be right.

>

> We are an outpt. clinic and we see a lot of acute injuries before

> they have even been referred to ortho. When we know a pt. is going

> to ortho we recommend several good MD's for their type of injury

> first. Second, we prepare them for what might happen as far as the

> MD and rehab and their right to choose, regardless of what the MD

> says. Also, anyone who calls in with questions regarding our

clinic

> is informed of their right to choose. And we ask everyone to

spread

> the word. In the past we have compiled an alphebetical list of

> clinics in the area and sent them to all local physicians asking

> them to pass it on to their patients so they can choose the

provider

> that best suits them. Some are still using this list, others I'm

> sure have " filed " it elsewhere. I would have no problem filing a

> complaint against this practice if I could back it up but all my

> info comes second hand. I end up with the question of how to prove

> it.

>

> Amy

Looking to start your own Practice?

Visit www.InHomeRehab.com<http://www.inhomerehab.com/>.

Bring PTManager to your organization or State Association with a

professional workshop or course - call us at 313 884-8920 to arrange

PTManager encourages participation in your professional association. Join

and participate now!

[Guest guest]

Doug,

Amen to that! Many of the problems we have in establishing consistent

referral sources have been brought on by other therapy providers, or by

ourselves, by misreading the needs of (or worse yet, neglecting the needs

of) those referral sources.

To make things optimal these days we spend a lot of time with the question

" what's it like to be in his shoes? " Those who can understand others'

perspectives are immensely useful in creating procedures---not only between

docs and therapists, but between therapists and patients, managers and

staff, etc. (They the best sort of humans, I think!)

In a previous work situation, we once had to fire a therapist who had a very

poor understanding of such things. The last straw was a phone message he

left with our most loyal orthopedist along the lines of " you blew this

diagnosis but not to worry, I've informed the patient in time to prevent

disaster. " (Turned out the therapist was wrong anyway).

We can (and must!) have these discussions with ortho and other referrers,

but not without recognizing the obvious social/personal/professional

dynamics.

Dave Milano, Director of Rehab Services

Laurel Health System

32-36 Central Ave.

Wellsboro, PA 16901

dmilano@...

Re: Re: Physician referral dilemma

That's a very good point . Though I love the prospect of direct access

and have used patient/employer demand in the past to help me get on closed

insurance panels, the physicians will likely refer to you in that

environment because of your response. The other quite humorous response you

quoted will probably not get patients referred anyway.

I've had more than a few conversations with our APTC members who are

noticing a general lethargy in the physician's views of the " hassle of

dealing with therapy " as they describe it. Like you, the therapists are

friends and social with the physicians. With candor one doc says that a

particular therapist calls him all of the time regarding patient care in

situations that seem obvious, another told the patient that what the

physician prescribed is not really the best way to go about their problem,

and still another told the patient that the physician had misdiagnosed. His

conclusion was " I'd rather give them a home program or send them for one

visit to get a home program rather than put up with the hassle of the down

side " . He indicated that in most situations he sends them straight home

because he just saw them and doesn't see the need for another evaluation by

the therapist.

In all fairness most every physician said if he/she could find consistency

and cooperation with unobtrusive service they would be loyal to that

therapist because he/she truly believes in therapy. What may sound like a

negative overview actually tells us what the physician desires and that is a

benefit. I learned this information from a survey of some of our members

when I heard complaints that referrals as a whole had significantly dropped

off though the physicians did not have in-house therapy. This " physician

therapy lethargy " description came up 15+ times from members who spoke with

physicians in social settings. This might be a little off the subject but

it should aid our marketing approach. Happy holidays to everyone. Doug

Doug Sparks

Advanced Physical Therapy Concepts / APTC

www.aptc.biz<http://www.aptc.biz/>

doug@...

Re: Physician referral dilemma

Amy:

I know of several orthopedists who do and do not refer patients to

me. When recommending the ortho to the patient, I mention some of my

experiences, and this is one specific comment I use : " MD never refers

any of his/ her post-op patients to me, therefore I never see his/

her sucesses. " It is completely honest.

It is slightly better than the 'He dont refer to me so I aint

referrin to him' methodology which is pervasive, and a likely

accompaniment to future direct access.

Peace

>

>

> We have a similar situation here with a large orthopedic group.

> Initially all their referrals went to a " friend of the business "

and

> now they have there own rehab on site. I have had my patients tell

> me that a physician has refused to do their surgery unless they go

> to the ortho's rehab. Others have said, although not stated

> outright, that they were made to feel that if they did not go to

the

> MD's clinic that insurance would not cover them anywhere else. Of

> course this is not true. But the general public doesn't know this

> and they don't know of their right to choose. For most of the

> general public MD's are " gods " and nothing gets questioned because

> if the doctor said it, it must be right.

>

> We are an outpt. clinic and we see a lot of acute injuries before

> they have even been referred to ortho. When we know a pt. is going

> to ortho we recommend several good MD's for their type of injury

> first. Second, we prepare them for what might happen as far as the

> MD and rehab and their right to choose, regardless of what the MD

> says. Also, anyone who calls in with questions regarding our

clinic

> is informed of their right to choose. And we ask everyone to

spread

> the word. In the past we have compiled an alphebetical list of

> clinics in the area and sent them to all local physicians asking

> them to pass it on to their patients so they can choose the

provider

> that best suits them. Some are still using this list, others I'm

> sure have " filed " it elsewhere. I would have no problem filing a

> complaint against this practice if I could back it up but all my

> info comes second hand. I end up with the question of how to prove

> it.

>

> Amy

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