Creating a successful cross-referral system with physicians

The emergence of the alternative medicine phenomenon has produced a number of unexpected yet critical professional challenges that oftentimes impede the intended benefits of joining physician and acupuncturist in an integrated clinical environment. The two professions link people with sharply different standards and expectations for performance, responsibility, education and reliability. With that there is routinely found a significant gap between the educational cultures and communication styles of physicians and acupuncturist, often exacerbated by their not being recognized or openly discussed to treat the same problem . Based on my previous experience, this gap will eventually lead to many debilitating issues that can severely impede acupuncturist’s chances for growth in their community practice. Let me give you an example. I am a fellowship trained acupuncturist with sub-specialty in spinal disorder. I came from an environment where physicians and acupuncturists always collaborate in treating same condition. Since my practice has been solely dedicated to treating patients with various types of spinal issues, it is always my best interest to refer my patients to appropriate radiologists, orthopedist or PM&R physicians to get an accurate diagnosis and not to wrongfully harm my patients by neglecting any importance conditions such as neurological damages. In November 2011, 39 years old male patient walked into my practice about 3 months ago with excruciating back pain which has been worse after a business trip to Korea. Pain was not tolerable and this patient was barely able to walk. Nor this patient had a history of back pain or trauma, did he visit any office previously. Of course, I explained the benefit of doing acupuncture and herbal medicine at initial consultation; however, I strongly felt I needed to refer this patient for radiographic image just to make sure if I can continue treating his condition. Result came back with multi-level degenerative disc disease, foraminal enchroachment at L4/5 and straightening of lordotic curve on lumbar spine. After receiving this report, I made it loud and clear to him that I will go ahead and do integrative approach in treating his condition, not only for the benefit of his condition, but also to protect my liability. Yes, I made my own oriental diagnosis: qi/blood stagnation and kidney yang deficiency; however, in many cases, it becomes very difficult to persuade my patient with this type of severe pain condition. So, I further explained to my patient that if there’s no improvement or worsening of symptoms, I may have to refer you out for another serious of diagnostic testing including L-Spine MRI and EMG/NCV in 2 weeks. To make long story short, this patient took MRI and came up with diagnosis of right paracentral protrusion at L4/5 contributing an impingement of L5 nerve and needed to take few days of anti-inflammatory medication to subside his condition. Fortunately, EMG/NCV testing came negative. Followed by 10 weeks of acupuncture and herbal medicine treatment along with assistance of a group of physicians, he was successfully able to recover from his condition fast enough to go back to his work. On his final visit, he stated that he was fully satisfied with the outcome. This patient mentioned three important things. First, he was happy to prevent from going a comprehensive spinal surgery. Secondly, he was impressed by a collaborative effort with a group of physicians to accelerate his condition without having any conflict between each other. Thirdly and foremost, he has become a fan of acupuncture with trust and confidence and now referring his significant others as well as friends at work. Based on this case, it is worthwhile to stress out how important it is to create a successful cross-referral network when we are approaching our own patient. We have to understand that there are things we can do; yet, there are things we are limited to offer. It is not only to build a solid practice model, but also to gain good reputation from patients and other healthcare professional. I go out often for lunch or dinner with physicians and it is amazing how many doctors are constantly looking for an acupuncture referral for their own patients. Needless to say, physicians can be one of the best marketing tools you can utilize for your practice.