John Smith was injured when the vehicle in which he was a passenger was rear-ended by a pickup truck. After being taken by ambulance to the local hospital, he followed with chiropractic treatment for his injuries by calling Don Doctor, whom he was referred to by a friend. Having never been in an accident previously, he didn't know what course of action to follow. At his second office visit, he asked Doctor if he knew any good personal injury attorneys.
As a chiropractor with many years of experience, Doctor had professional relationships with several competent personal injury attorneys. Responding to the patient's request, Doctor recommended Larry Lawyer, a personal injury specialist with many years of experience. Lawyer had previously referred Paula Patient, a young lady who had been in another vehicular accident. Doctor was successfully treating Patient, who was responding well to his treatment regime.
Is there anything "wrong" with the above "arrangement"?
Whatever your perspective on referrals from and to doctors and lawyers, this "approach" is used countless times every day. Since it is illegal for attorneys to pay doctors for referrals and equally illegal for doctors to pay lawyers for referrals, the "trading material" routinely consists of referrals running in both directions.
In previous articles written for DC many years ago, under a former column written by this author called "The JD and the DC: A Winning Combination," much space was devoted to referrals under a program similar to what is outlined above. This "system" was affectionately known as the "mutual admiration society," in which doctors referred to lawyers they admired and lawyers referred to doctors equally admired without any commitments on either end to match "one for one" the referrals running in both directions.
Notwithstanding, the unwritten "rule" was that the referrals should, generally speaking, balance equally.
Times have changed. With the advent of managed care, Lawyer found that he was able to substantially outrefer Doctor. After running a "count," Lawyer discovered he had referred five patients to Doctor, who was able to refer only one client in "return." Lawyer became upset and searched for other doctors who could match his referrals.
Despite assurances being given by each new doctor with whom he established the "society," the five-for-one scenario was repeated over and over again. Lawyer became frustrated and began to refer to primary care physicians instead of doctors of chiropractic. He bowed to the pressure exerted by certain insurance carriers that MD care is somehow "better" than the treatment provided by doctors of chiropractic.
Unfortunately, this result is increasingly common.
Steps the DC can utilize to mitigate the problem might consist of educating the attorney's staff (in person in the office with hands-on demonstrations) as to the value of chiropractic care in treating victims of trauma, the development of a close working relationship with the attorney and assisting him in providing detailed and persuasive reports at reasonable cost and, when necessary, granting reasonable lien reduction requests as circumstances require.
The bias against doctors of chiropractic still exists in the mindset of personal injury attorneys. If the ol' one-for-one can no longer be utilized as an incentive for the attorney to refer, the doctor of chiropractic might adopt a more personalized approach to keep the referrals flowing from attorney to doctor.
