#55 - Medical Collaboration for the Private Practice DC with Dr. Alex Frantzis, Part 1

Factor spelled FA k t R stands for Functional and Kinetic Treatment with Rehabilitation. Over the past decade, this unique approach to treating pain and dysfunction has been utilized by healthcare providers on six continents, serving as a framework that guides clinical decision making and patient visits around the globe on a daily basis. With this podcast, our goal is simple to bring the best and brightest in clinical education to the forefront and empower practitioners with cutting edge, evidence based content that improves patient outcomes and inspires healthcare providers to continually evolve their approach to treatment. In each episode, we will feature a training or interview with some of the top minds and healthcare in a short format that is easy to digest, with actionable information that you can implement into practice right away. Let's get started. Hi, everyone, Welcome to the Factor Podcast. I'm your host, Jessica Riddle. If this is your first time tuning in, welcome and thanks for listening. If you're in private practice, as many of our listeners are, then you've probably struggled at one point or another with self doubt or even been held back by limiting beliefs, or maybe even inseemingly insurmountable obstacles. They keep you from clearly defining your big, hairy, scary, audacious vision for your business. And when you convince yourself that these obstacles are indeed insurmountable, it's easy to give up on your big vision to instead focus on the low hanging fruit and lower your goal posts a little bit. I've been there, and I've even been talking a lot about this on LinkedIn lately about how recently I've been smacked in the face with a big, hairy, scary vision for factor that I now have no choice but to chase down relentlessly until I make it a reality. So at this point you're probably hasking yourself what any of this has to do with medical collaboration. Well, for those of you in the private practice space, expanding your opportunities to collaborate with local medical providers can be a great strategy for expanding your practice and taking your business to the next level, creating both a referral source for new patients and a network of colleagues that you can trust to provide your patients the best care possible, thus expanding your influence and the positive impact on your community. And who better to talk about this then. Doctor Alex Francis, a board certified chiropractic orthopedist who owns several integrated health centers throughout Northeast Ohio. A two thousand and eight graduate of Logan University, doctor Francis began his first multidisciplinary clinic soon after graduation, growing to three locations and employing a team of providers including a board certified orthopedic surgeon, general practice medical doctor, physicians, assistants, physical therapists, and massage therapists. In twenty thirteen, he became staff privileged with a local hospital in Cleveland and has operated an established office in the hospital since twenty seventeen, working with specialty teams such as primary care, general surgery, vascular surgery, and pedietry. Most recently, doctor Francis has expanded to integrate with an urgent care facility offering chiropractic care as part of their model, managing neuromuscular skeletal conditions alongside various other healthcare specialists. In today's episode, we will discuss the medical model and how medical referrals work, discuss best practices in approaching medical providers for opportunities to collaborate and co manage cases, and the importance of addressing mental health care as a component of chronic pain and pain management. This two part training will provide you actionable steps that you can take to begin establishing relationships with medical providers in your area, along with some guidelines and best practices for overcoming misconceptions about what you really do and establishing yourself as a trusted provider on your patient's healthcare team. Let's cue the intro music and get started. Thank you very much, Jessica, So everybody that's here, thank you everybody that's watching the recording when this comes out, I appreciate you guys taking the time to give me an hour of your time to kind of talk about my specialty and what I do very well. So one of the things that I'm I'm involved in is I'm a DC once a Logan, I'm a Logan grad So one of the things that I've managed practice. I graduated two thousand and eight. Kind of talked a little about my history. I graduate from Logan two thousand and eight. Since that time, I was an associated original. Initially I moved into private practice kind of on my own with my partner. But since day one, I've always been in grated setting. I start off in my private practice with the usual standard massage therapy, physical therapy, all that that kind of blossomed into a fully integrated practice with an we had at any given time, we had a pain management specialists in MD. I've had physicians assistance, I've had orthopedic surgeons in my office and built a model based on that. Moving from that in my private practice, I ended up going into a hospital setting. I was asked back in twenty thirteenth initially to be staff Pological Local Hospital here in Cleveland, Ohio, and since that time, I have expanded beyond private practice. I do have three private practices that I have associates, and I've expanded into hospital setting and actually today the last few months, I've been seeing patients in urgent care. I'm actually at the urgent care today seeing patients. And I've been doing this for a couple of months. So I've always been outside since graduating, I've always been in some kind of integrated setting. I've always had a network of medical professionals that I've worked with. So I really want to take some time to kind of help don this talk with students before so students, sure, but even some of the more seasoned cairos and providers out there and how to collaborate in a medical setting eventually leading to maybe an integrated practice private practice. I also run a group on Facebook about hospital based chiropractic. There's some of us out there, but trying to help build the medical community for patient base and understanding how to work with other providers. So this first life my biography. I'm originally from Toronto, came of bachelor's degree, went to Logan. I do ACU councer certified anyway, and I'm also we used to be known as the northpedic Diplomat but now is known as the International Cudory Neuromuscular Medicine. So that's kind of what my background is like. Jessica says, I've been in an integrated setting since basically day one of private practice. I've always had some kind of other professional either in office or part of my network, and then that grew into the hospital I'm in now, that grew into the urgent care where we have variety of specialties. So hopefully you guys can get some information here on what I've been able to do successfully. We're very few of us have failed or can't figure out how to get our foot in the door. So everything that we're discussing here is stuff I've done in private practice at one time or another. A lot of this stuff is early on. What I did in practice at helped build my network. And so the preface I want to say before we start all this is I understand the reservations. I understand some of us went to different Cairo schools where we were taught medical models bad or the big, big bad MD who's going to give drugs, performed surgery necessarily. This is why we're different. And unfortunately we learned in Kiro schools, we actually never learned how to play nice with other providers. So I've spent the last thirteen fourteen years trying of figuring out and I found this system that worked for me. It's not hard, it doesn't have to be hard, but building that network really benefits you as a practitioner. But more importantly, it benefits your patient base. It benefits your every day Miss Smith that comes in with a little back pain, that needs something beyond what we can do, and it really helps build a network of patients that are reliant on you, that love you that see you for everything, but I understand that you have their best interests at heart. So today's presentation is what worked for me and stuff I've seen has been the easiest with my personality. I know there's other providers that offer advice on how to integrate. There is no right answer, it's right what's right for you and your personality. So moving into that, like I said, there's many different approaches to do this. There's no right there's no right answer, there's no wrong answer. But the important thing is it doesn't have to be hard, it doesn't have to be uncomfortable, it doesn't have to be challenging. And once you understand the providers you're working with, once you understand where they're coming from and their mentality, this is actually a very simple procedure. So, like I said, many different approaches. Each one can be effective getting your foot in the door. But find what works for your personality. Find what works for you. Could we bring them lunch, could be just stopping by saying hi, and I'll get into a few stories of what's kind of guided me. And it's funny because before this presentation, I actually want of my patients here if they were care she's a primary care MD. I've known for a couple of years now. She's seeing me for a shoulder issue and I asked her, I'm like, hey, I'm doing this webinar today as a medical professional, what's the one thing that you want to see when you're working with not just cairos but other providers. And she mentioned communication. Just talk to me I'm sending you a patient, or communicate with me, let me know what's going on. And that's really what I base a lot of my approach to is communication with other providers. Communicating with their patients is obviously important, but communicating with other providers it can be it. It could seem like a daunting pass from but it's really not. We learn a lot about how to keep people and get our foot in the door, but the bigger thing is is keeping that referral, the referral network going and keeping those referrals coming. I've heard countless stories from professional from cairos that refer to a specific provider. They're doing great for a couple of months and then that turns to disappears. So another approach is not just getting a foot in the door and starting the referral process, but building it and building that trust and building that referral network to longstanding relationship. We a lot of us fail. Let that so understanding that we want to also not just worry about getting patients in the door getting referrals into our system. We also want to make sure that we keep that and we build that relationship. It's we had to nurture it. It's like it's like planning a garden. You want to really build that. So the headaches a lot of people have is we have no idea what to do. In my slides, I make little I put little things like funny little comments, but realistically, with our profession, we have such a wide array of how we practice. I like to say, I don't know what the cairo down the street is doing, let alone what an MD is gonna think I'm doing, or a nurse practitioner or whatever the case is. Like, you have to learn how to educate, and unfortunately, there's people have their set beliefs. People have they're always a kyroy's a quack, or he does this, or he does that. There are some hurdles you have to overcome, but you also have to understand where these providers are coming from and what I mean by providers, I mean mds, deos, nurse practitioners, PA's, pts, dentist, dietary, all that kind of blending together. And people may have the preconceived notions of what you do. You try to educate, You try to teach them what you're doing, and there's there's different ways of doing it. But you really have to understand where your audience is coming from, where these people are coming from, and these providers are coming from. So before you can get into really building a network and understanding where they're coming from, you also have to understand what you want out of this. You know, what kind of network do you want? Do you want a big network or small network? And I'm a firm believer and unfortunately, having referred to work with a lot of different providers with all of different specialties, you have to also understand who you refer to is also reflection on you as a provider. If I'm sending to doctor Smith and he is a hotshot orthopedic surgeon who doesn't spend time with his patients, is kind of arrogant, that does reflect on you. You have to also understand if you're going to build your network, you want to make sure it's providers that are similar to you that you can relate to. And again, how big a network wants to be. I have a relatively small network, providers that I've worked with or I rely on on a regular basis. Some people want to do a large network that's not necessarily conducive to the way I practice, and for most cairos it's not so in In my network, I have my set go to I have a podiatric surgeon that I work with that works with me. We're trained in feet. I just don't do feet. It's just for personal reasons. I just don't do feet. I also have an northopedic surgeon who does spine and extremities. He's kind of my go to earth of guy. When what I'm doing is not working and what he's doing is not working, we can kind of bounce patients back and forth. I have a family practice. I have a couple of pas that I work with that are fantastic general practice internal med. I get at a couple of mds that work with that are internal med that can co manage some stuff with me. I also have a cardiologist that I work with. Cardiologist that I work with. It's fantastic. He's my archive. There's an issue, or there's a cardiac issue that I'm obviously not comfortable dealing with. I have somebody can work with. That we'll get into later and later slides kind of understanding when to implement different providers and specialties and all that. The one thing I always tell everyone who asked me these questions is don't be intimidated. These providers are no better than you are as a cairo getting over that hurdle of the big bed MD. They're scary, they're they're intimidating, they're not. There's a few arrogant womens out there, but for the most part, don't be afraid of these providers. There's no reason to be. I call it inferiority complex. There's no reason to feel inferior. Like I see my physicians. Since I work with I seem orthopedic surgeon, I see the cardiologies that their own way pools, and having that mindset of equality really does make a difference when you approach these people. Don't be afraid. A lot of the fear, though, is based on rejection. We get afraid of being rejected or we get this is a whole as a person, we don't want to necessarily put ourselves out there to be rejected. You're gonna get rejected. You're going to approach providers that don't want to work with you. They're gonna have the preconcy cairos or quacks. I see it every day in the hospital, and I move on. If you don't dwell on those who reject you, it's not worth the time or the effort. Concentrate on nurturing relationships with other providers that are open to what you do. If you waste your time on trying to convince the primary care things sure quack that you're not a quack, it's gonna just destroy you. It's not worth the effort. It's not worth it. You work with people who want to work with you, are open to you, and understand that those are the people you want to nurture those relationships. Do you want to build those relationships? And the people that don't want to work with you, that don't want to, who think whatever they think, it's not worth your time and efforts. So you really want to concentrate on that small network providers that compliment you, who reflect well on you, and you want to do it in a very understanding way. You might get rejected. You might they might tell you know your Cairo, I have no need for you. Like, all right, cool, move on to the next one. There's thousands of metical providers out there, and you might get rejected by some of them. But there is those few that will work with you and will promote you, and will work well with you and give your patients a care that they need that you can't give them because outside your scope, it's outside your specialty that you can really grow your practice. You can grow your patient care with a very few other providers that you don't need. So I understand, don't don't dwell on the rejection, don't dwell on any of that. So one of the things I tell people is you need to understand what they're thinking. Okay, so you have to understand medical professionals. They have the same concerns we do. They have the same worries as we do. When you're in private practice. My concern and private practice was always the same as we're going to get my patients from Are my patient's going to like me and follow along treatment plans? Am I going to be able to get them better? And are they going to be those kinds of patients that I can build on. It's not treating patients for years upon years, but patients know if they have if they're low back flares up, they know they can come and see me and they know I can get them better. I'm going to send them on their way, but I know I had that revolving door patient base that are loyal to me, that will come back for their aches and their pains. Mties have the same concerns. They worry about their patients. They worry about understanding, keeping their patients coming. They worry about if I refer a patient to doctor Smith, the cardiologist, is that patient going to come back to me? Or is he going to steal that will steal my patient. That's a concern that we have as providers, Like if I send a primary care, is that primary care going to tell them don't send to the Cairo. He's a voodoo doctor. If you're listening to this podcast and you've yet to attend a Factor Rehab Live course, I have a special offer just for you. I realize that sometimes you need to kick the tires a bit to learn more about a course, especially one that offers a certification track before you go all in and register. So here's a special offer I think you'll really like. Doctor Riddle, our director of Education, has put together a free one hour webinar that provides a foundation for why having a system in your rehab is so important. See, a Factor is a system, not a technique, so learning more about the why, behind the what and the impact it can have on your patient care is a crucial first step in determining if becoming Factor certified is right for you. And to sweeten the deal, we're offering Continuing Education credit for completing this online training absolutely free. Yes you've heard that correctly. Free CE credit is available and a number of US states for chiropractors, as well as for massage therapists, athletic trainers, and physical therapists. To learn more and get your free CE while learning more about how Factor can impact your patient care, visit the free Factor webinar link in our show notes. Now back to the show. They have those same concerns that we do, and private pact especially, we all are trying to do the same thing. We may have different approaches what we're doing, but they have the same concerns. It's funny because I did assume call a couple of months ago, and some of you may have seen somebody may not. With doctor David Purse, he's a general surgeon. He's our packs for years upon years, and he's now a friend of mine. We work well together. He used to be the president of the hospital on Matt He used to be president of a Cleveland clinic hospital, which is one of the largest healthcare systems in the country and in the world. And doctor person I went on this webinar. We have this conversation and he's a general surgeon and he goes one of my biggest concern is if I see miss Smith for a colonoscopy or for a GI issue, is she going to come back to me later on? In life like that, you would think a surgeon who has referrals coming out, they worry about that one patient that they see they build a relationship with, are they going to come back to us? So those concerns go back and forth across all specialties. When you do finally get meeting with these providers and you start geting your foot in the door, you're always gonna get the same questions. It might be a different variety of questions asked differently, but you always get these same kind of questions. One of the questions we have, one of those hills we have to kind of battle, is the concern of what you're doing is evidence based. So we'll get more into evidence based. And I know, looking at the chat previously, I know we have some life people and I know Sherman and Logan and National and we all have different kind of same education, but different philosophies. So one thing they want to know is evidence base. Is what you're doing evidence base? Is there what some efficacy to what you're doing? Is there some logic or research to what you're doing? Is actually evidence based? The other the other factor they really care about communication. And I told a story about my primary my primary provider that I saw today as a patient for a shoulder issue. When I asked a question, what advice would you give other practitioners, She's like, the three c's communication, communication, communication. If I'm sending you a patient, don't just send me what results of a test. I want you to call me or send me a letter and tell me what's going on. Like I want to be in the loop. I want to know what my patient's doing. So when I follow up with them. I can ask them, hey, how's your low back paint? How's you need a shoulder? Communication is key, and it was before talking to her, I thought that's what all providers do because that's what I see, and she goes there's a lot of newer mds anddos and all that stuff that they don't they don't communicate. I want to see communication. I want to know what's going on with my patient. Priory for you a patient, I want to know what you're doing, but I want to know what I can do to help you and help facilitate that. And it's wonderful because when I see my patients like my patients and I'm co managing with somebody, it's nice to have the MD, the PA, the nurse practitioner or the whoever be like, hey, even following up with your therapy with doctor frances Is, if you even seeing doctor Francis, like like you told like he told you, And they'll be like, well, yeah, maybe sometimes they miss a few. They reinforce that, well, you need to follow that treatment plan. You need to follow what he's doing. If you have any semblance of getting wanting to get results, you have to follow it. It's nice having another healthcare professional backing you up one of the frustrating things that bother me in practice. I tell a patient we're going to do this many visits over this amount of time, and they disappear and then they bitch they don't get better, And having that other provider behind you sitting there and saying, are you following with doctor Francis, are you following with doctor Samith, are you doing a therapy? Are you doing actually as he did, or whatever the case is. It's nice having that reinforced because it helps with your compliance indirectly. And I do the same with them too. If I'm seen a primary patient, so referl from a primary care doct I'm doing the same thing. Hey have you seen doctor Smith? Have you seen are you following up like you should be? Well? Now you should really get in for your diabetes art attention, whatever the case is. So understand that. And that goes into the third point of the slide, which is co management. Are you going to come manage these conditions with them? And we'll get more into that later. So let's talk about evidence based. So the one precursor to this is if I see a safety pin from any of you providers, please just stop. Okay, we're not that's not evidence based. So we talk about evidence based. We're not talking about technique necessarily. I'm a firm believers. I don't care what technique you do. I see. I see value in most techniques out there. I'm not an active ator guy. I'll do some diversivators. I call it on some patients that I can't manually adjust. I see value in Godstead even though I don't do Godstead gonstead MPI I'm logan, so logan basic. I see some value and diversified is kind of my stick. And I do a little airt and some soft tissue and that if you exercise. But it's not a technique thing. Evidence base is not necessarily a technique thing. Now that there are some weird techniques out there that have no intrinsic value, but we're not talking about technique here. We're talking about is what you're doing have some kind of evidence to support it, and it doesn't necessarily just have to be like double blinded studies. But is there some advocacy to what you're doing? The key I tell people and all cairos I've ever worked with students providers is a treatment you're doing appropriate and safe? Okay, if you have a hypparticipation with synosis of they are like, like older patient, you shouldn't be cranking on their neck. You should have some of the tools to go there. So is it what you're doing evident, appropriate and safe for that patient? Length of the treatment? Will you overtreat? And that's a huge issue for a lot of people, a lot of Cairo stigma. I hear it in the urgent care. Oh, you're going to see them three times a week for fifty two weeks. I'm like, no, no, no, no no. I'm a firm believer in trials of care and do a trial care see at works and benefici the patient. Go on. If it doesn't benefit the patient, change something up, get a console, figure out what's why it's not working. My mentality is six state visits, I should see some kind of functional improvement. And that's what these providers want to do. They want to see that you're not going to do the same thing over and over again and not get any improvement. So they want to know what you're doing is reasonable. And my reason is you can see a patient twenty five times, but at regular intervals are you monitoring progress? And I'm looking for objective improvement. And when I deal with other providers and they're like, well, you're a cawer, you're going to see in three times a week for fifty two weeks, my response jokingly is like, you know what, I might do that, but at at regular intervals am I going to see improvement? Is it going to change? Are they functionally getting better? And that's what they want to see? Okay? And no, I will not see a patients three times or fifty two weeks. I'm just saying that there is no six visits eight business. Everybody is different, but what you want to see is there's some kind of objective improvement. Please again, no safety pits, Let's not go there. The one thing I do want to mention going back to the appropriate it's safe, there's also a time when your treatment is not going to be safe for that patient. It's not going to be appropriate. You've got to be able to pick up on those flags and be like, well, working with this patient may not appropriate, and you should express to the primary cares that I want these patient visits. I want to see these patients. I want to get these people better. But I don't think it's safe for me to proceed. I think there's something else going on that might be the problem. And if I don't order imaging, order the testing, I'll send it back to the primary to do it. So you want to make sure what you're doing, obviously is appropriate and safe for that patient. And I feel like a lot of Cairo's, a lot of our profession kind of get worried about numbers and maybe dabble in areas they shouldn't be dabbling in. But you want to make sure it's appropriate and safe. Communication, Okay, communication is key. Communication, communication, communication, medical writers. What's wonderful about the medical profession is they already have a built in They have this communication system already ingrained in their psyche from medical school, internship, residency of communication. This system is already built into how they work, so for you to take a step into the system is ridiculously easy. They understand communicate, so they have protocols they follow, They have certain expectations when they work with providers about communication. You stepping into this as a simple process. Okay, it could be a letter, could be effects could be a phone call, it could be a text message. If you if you have a relationship a lot with the orthopedic surgeon I'm working with. I've been texting him all morning about patients I've been seeing that I've referred to him, He's referred to me, and we have a hypo compliant text messaging and like hey, miss Smith, or he'll call me like we have that relationship. Where as soon as he's done seeing one of my patients or patients he's referred to me, he'll give me a call and be like, hey, Alex, this is what I found, this is what's going on. What do you think? And we'll go back and forth. So we're always communicating. After I see one of his patients out, at the very least shoot him off an email or attacks or a column. By that time, I'd be like, hey, I saw this patient. This is what I'm thinking. Are you good with it? Do you want me to do something else? Are you thinking something else? And we'll try to get on the same page, kind of direct care to what we think is appropriate. The one thing we'll get into is early on in practice, I had these these letters that I use. I called the three letter approach. I know other people who promote working with medical professionals wants you to send reefs or send studies instead. JAMPT published a study and low back pain, or the American Family Physicians send them these studies. I'm gonna tell you right now, nobody in clinical practice gives a crap about those studies. They just don't. And I'm sorry to say that. And I think it's a wonderful profession to get more research out there promoting what we do. I'm a huge fan of what the American Association Family Physicians did years ago. I use that every day. I'm a huge proponent of it. But please, for the love of God, to not send these providers journal articles, because it's going to sit in somebody's desk until ends up in the trash and no one's going to read it. You want it, especially providers in busy clinical practice. Short and sweet, Okay, avoid Cairo talk. Don't start talking about well, definitely, don't talk about sublixations in terms of our sublixation because as a completely different meaning in the medical profession. But avoid Cairo talk. Avoid what we means lingual between us. Don't do it. Okay, They're not trained like we are. They don't understand the language like we do. Family practice general surgery. They're not advert they don't know what we're doing. Okay, so avoid Cairo talk, avoid profession specific language in these letters, stay away from research. Use these communications as a very short introduction, a short communication of Hey, this is what I found, this is what i'm doing, Thanks for the referral. Keep it simple, keep it at under three paragraphs, and I don't even say keeping a less than that, And my examples are basically one long paragraph and a quick thanks for the refral kind of situation. The other thing I want you to really concentrate on these communications is a thank them for the referral, because that shows you're professional, you're courteous, you're respectful, but also reassure them that you're going to work with them to get their patient better. Okay, you're not working against them. You're not taking these patients for your own. These aren't your patients. You are treating these patients, but their doctor Smith's patients. So when you get a referral in, you want to thank them and you want to make sure they understand that, yeah, miss Smiths is going to come still see you for follow ups and her med checks and all that stuff. I still want them to see on a regular basis. They have appointments with you. I wanted to make those appointments, okay. And you're going to work with them to get them better. Okay. You might do most of the heavy lifting, but you're still going to work with them to get them better. Working with them may only be them seeing the patient and being Okay, keep seeing doctor X for your treatment because it's working, but they're still working with them. And keep it in the mentality you're co managing. You're not controlling the narrative. You have a partner in crime that's going to help you get that patient better. Okay. In the letter you want to or your communication, your findings, what your plan is for me, It's a trial of care, six eight visits, and my expectations are and thank you for referral and instructions that I want them to follow up with you. Okay, So we definitely need that. Nobody wants to read a book. Keep it short and sweet, okay, don't use Cairo talk. Nobody cares. Nobody cares about sublixation complex. Nobody cares. What they care about is getting your patient better and making them look good. Okay, So understand that. Keep them in the look what's going on, and that's really really what they care about. Okay. So that's the three letters that I use, and we'll go into examples of that here in a second. So the three letter approach, okay, there should be at least three letters. When you have a patient referred to you, there should be at least three letters. Okay, And we're going to talk about you using your patient base to refer and then the three letters also work as well. So you want an initial introductional letter, Hey, doctor Smith, thanks for the referral. I saw miss Sally issues. Great, this is what I found. This is what I'm going to do as my trial of care. I told them to follow up with you if there's any change as any issues, or follow up any schedule to care. Simple to the point and easy. Okay. At some point, please, for the love of God, you should be doing a revaluation on your patients something, okay, measuring functional doing functional outcome assessments, doing an exam, doing an email somewhere after your trial of care to monitor functional improvement. That's a perfect opportunity to send another letter. Hey, doctor Smith, this is where we're at. These are the functional improvements I have. This is what I'm going to do for the next trial of care. Just want to keep you in the loop. And then a release letter. Okay, the release letter should basically say, hey, doctor Smith, patient responded great, We've love some residual issues. This is what they are. I told them to follow up with you and they can come see me if they have any other issues. I told them follow up with you regularly to keep you in the loop. If there's any changes, they should follow up with you. And that's it. Okay, this is simple. This is template letters that you change names, you change conditions, You kind of keep in simple. In general, if the provider has any questions, they will call you and they will reach out. The beautiful part about these letters is now you've gotten your name in front of these providers three times for one patient. So if you get ten patients from this provider every six months, they are now seeing your name across their desk at thirty times. That's what they want to see. They want communication, and from a marketing perspective, the more your name is getting in front of them, the better off. It's going to be. Like it's just name recognition that's really key. So understanding communication. And the wonderful thing is is that communication is or ingrained into them. They want the communication. That's what they're used to with other specialists. We are mescal they're a muscular medicine specialist. We do it wonderfully well. So they see us as another specialty, which I take as a compliment. But are those are the things they want to see, that's what they're used to. They don't care if you're a Cairo, they don't care if you're a cardiologist orthotic surgeon. But if you communicate with them, they will flog you with referrals because they see that's what they're used to and that's what they want. Once they see that referral network is there and you're you're stepping into communication paradigm, they know and they respect. It makes the process a lot easier. You're just you're putting your name into an already well oiled machine and what's ingrained into them. Okay, So understanding that approach really makes a big difference. And like I said, it's a text message to the email. It's these letters you're going to see here shortly that really don't take a lot of time out of your practice. That really don't take a lot of time to help introduce you and get your name in front the providers. And it's already a system they're accustomed to. Okay, it's already a system they were trained on. They went through residency seeing and that's what they do, and that's a system that they know. And these letters work for orthopedic surgeons. There were cardiologists because even a specialist, this is what they know. When a cardiologist sees a patient, they get a referral from primary care, they see a patient, they send a communication back saying, hey, doctor Smith, I saw your miss Sally for the heart the aphid that I'm saying, this is what I'm gonna do for treatment. I'm going to monitor her, appreciate the referral. This is already something that they see every day, that specialists do. There's no reason you can't implement this. We're not reinventing the wheel. It's simple communications. It's a text, it's it's a letter, it's this is all it is so understanding that really makes the difference. And it's not discovering fire here. And this is a whole new mentality. This is a system they already have implemented and brained in them that you're just stepping into and building off of. So Jessica, if you don't mind sharing, this is the letters that we're talking about. So next three slides, we're going to make these letters available in the file section. So this is the first letter. This is the introduction letter. You can definitely use these letters for yourself obviously, or use my name and my reputation. But these are the letters I'm talking about. These are the letters I want to see. It's short and sweetened to the point. If you start getting involved in pages upon pages upon pages of letters, no one's going to read it. Okay, no one's going to take the time. If you send them research, no one's going to care. So using these letters and these approaches is something simple. It's easy. Provider sees it. It's going to take them fifteen seconds to read it. They're going to look at it, read it, and be done with it. And they're going to see your name. They're gonna understan where you're coming from. Don't start talking about extension, biased and all these don't just keep example low back being shoulder pain. This is what I'm thinking. This is my kind of working magnosis and go from there. These letters should be pretty standard. You're doing a trialcare with everybody from the most part. The only thing that should change is a patient name obviously, and you're you're treating, and if your approach should vary a little bit. You don't have to worry about getting into modalities and I'm going to do therapeutic. Actually, numerous sculary education rant needling don't worry about about that too much. They don't care. They care about the patient's going to get better, and if it doesn't get they don't get better. They want to know there's a plan B, and there always should be a plan B. So this is our first letter. This is an initial letter to be able to download, to definitely download it. And then obviously the reevaluation letters somewhere in the middle of your treatment plan, or there could be multiple reevaluation letters too. If you're doing six block kind of treatment plans, this is after six visits, you do another six another after six visits, and should be at least three letters. But obviously you can kind of use these as more and this is our finally, our release letter, and the release letter. What I'd like to point out is I also told although they can be referred back to us and see us. If there's a flare up, they can definitely go back to the primary referring source. Say hey, go back to your primary, go back to whatever first. They'll send them back to you in ninety nine percent of the time if they go to the primary first and a good job the first time I need discommunication, guess what they're setting right back to you afterwards. That's it for today's episode. Be sure to tune in to episode fifty six, where we wrap up part two of our training and discuss the easiest way to effectively communicate with medical providers and the best tools that you can use to build professional relationships with multiple providers and specialists in your local area. You won't want to miss it. Episode fifty six drops in two weeks. Earlier. In today's episode, I mentioned that I've recently clarified a big, hairy, scary vision for expanding factor, and after working with healthcare providers across the globe for the past decade, I feel like I have a pretty good pulse on the biggest needs of our community. But I never want to make assumptions and miss the mark. If you were alive during the era of clear Pepsi and green catchup. Then you know exactly how bad things can go when companies make assumptions and radical changes that are not exactly what their audience was looking for. So, in the spirit of making sure we're heading in the right direction, can you do me a quick favor if you could head to the show notes and click the link on the Factor survey. It contains just five simple questions to help us zero in on exactly what you need most from our team. It'll take you less than a minute to complete, and I will be ever so grateful to have your feedback and input. And as a thank you gift, I'll send you a cultivated playlist of our best Factor podcast episodes that provide content custom tailored to your submissions. That's all for today. We'll see you next time. Hey guys, if you like what you heard today, I encourage you to visit our website at Factor hyphenstore dot com that's spelled fak tr hyphenstore dot com to find out more information about all that we have to offer. We have a variety of online offerings as well as our hands on Factor Rehab System course scheduled in cities around the globe. Be sure to also check out our event calendar and bookmark any of these upcoming live webinar dates coming up in the near future so you can join us live. And of course, the biggest compliment we can receive is for you to help us spread the word to your friends, colleagues, and classmates. You'll find all the important links, as well as info about our sponsors in the show notes, so be sure to check those out.