Compliant documentation: A way to aquire new patients

Published: 2009-11-01 21:48:10
Author: Ted A. Arkfeld | Chiropractic Economics | April 2008

Compliant documentation can help you acquire patients. To illustrate, here is a true story:

Approximately six years ago, I relocated from Phoenix to a small northern Michigan town with a population of about 5,000. During my first few weeks of practice, I sent an introductory letter describing my credentials to every family practitioner and specialist in town and the surrounding communities. The letter was also an invitation to lunch for a personal meeting.

Days turned into months without any replies. The other chiropractor who had been in practice in this small town for more than 20 years told me, “None of the medical providers in this town want to meet with a chiropractor, and they definitely are not going to be referring patients.”

When I practiced in Phoenix, I enjoyed excellent relationships with medical doctors from all specialties. So, I decided to try a different tactic in my new Michigan community.

The next week, I asked every patient who came to my clinic for his or her primary-care physician’s name and address. Then, when I did a re-evaluation of a patient, I sent a copy of my report to the patient’s medical provider.

I followed this procedure with every new patient who came to the clinic. Two months later, I received a phone call from the only physiatrist in town. He asked if I would take a referral from him on a difficult case of unknown muscle pathology. I stated it would be a pleasure to take on such a challenging case and I would be in constant contact with him.

The case turned out to be multiple thoracic subluxations with myofascial trigger points. I sent the referring doctor a copy of the initial evaluation summary and all re-evaluation reports, including the discharge examination report approximately six weeks later.

In succeeding months, other medical providers from various specialties began making referrals.

What caused the change in medical-doctor behavior? Compliant documentation — concise, complete, legible documentation written in language the medical community uses and understands.

MDs are used to reading E/M initial and re-evaluation reports from other providers. They are especially accustomed to seeing orthopedic and neurological reports, along with physical-therapy notes.

Since chiropractors do orthopedic and neurological tests on patients, it makes sense to use language MDs feel comfortable reading.

To get referrals from MDs, follow these steps:

1. Take a good initial exam. This exam should include four components:

• A history. This should include the onset, mechanism of injury (if possible), and chief complaint. Include a review of problem-pertinent symptoms, past medical history (surgeries, fractures, traumas, and serious illnesses), and family history.

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