Physician referral dilemma

[Guest guest]

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]

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]

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]

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