William E. Morgan, D.C.

In the twenty years that I have been in chiropractic, our market share has changed little. When I was a recent graduate, approximately 15% of the U.S. population was under the care of chiropractors; today that percentage is roughly the same, in spite of a disproportionate increase in the number of chiropractors.

We should not be satisfied with reaching such a small portion of the population with the benefits of chiropractic. But how can we reach the other 85%? If slick advertising schemes or flashy health fair spinal screenings were the answer, then chiropractic would have no doubt reached deeper into the bulk of the population. But these methods have not worked; in fact, unprofessional practice promotion is one of the main reasons that inhibit patients from seeking chiropractic care. People do not want a doctor who is trying to sell them something. They want a trusted professional.

We can reach more patients who need chiropractic by building bridges with those who manage the care of these patients: their medical doctors. This is not to say that we need to become the lapdog of the medical profession, but rather that we should collaborate our care for our mutual patients. For most of my career I have collaborated with the medical profession in treating my patients, and I have found it rewarding by professional and material perspectives.

Establishing a working relationship with a progressive MD may seem like a hard process, but virtually all of your patients have a medical doctor, so start establishing a working relationship with their doctors through professional communication about your shared patients. "Dr. Pelkey: Today, our mutual patient, John Allyn reported with an unusual skin growth on his upper back. I have referred him to you, his medical doctor, for an evaluation of this condition. D. Jones , D.C. " This type of sensible interaction will help to lay the ground work for a broader working relationship. Eventually you should meet with this doctor and share what you have to offer to his or her other patients. Consider this: if you were able to have ten medical doctors referring just one patient every three days, your practice would begin to flourish.

In exchange for these referrals, MDs would desire communication and involvement in decision making. After receiving a referral from a medical doctor, send a consultation letter back to the MD within a day or two. This letter should not be an exhaustive narrative, but rather a brief summary of your findings along with a sensible treatment plan. Be sure to thank the doctor for the referral, and avoid using chiropractic jargon. Periodically provide the MD with updates, and finally, when the patient's condition is stationary, send the patient back to the doctor with a summary of care.

One of the biggest complaints that medical doctors have about referring to chiropractors is that chiropractors never release the patient. To overcome this complaint, involve the MD in prescribing ongoing chiropractic care. Send a recommendation like the following: "This patient's condition is now permanent and stationary, but I feel that she would benefit from periodic chiropractic care to help maintain his/her current level of activity and pain relief." If you have a good relationship with the MD, he or she will make the referral for continued care. This type of teamwork is gratifying because the patient is satisfied that his/her doctors are communicating, the medical doctor is satisfied because he/she is involved in the decision making for care, and the chiropractor is content because he/she validated by the referral process.