Greasing Referrals

[MetroPain]

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Wondering what others think about obtaining referals:

talked to a young surgeon today who said straight-faced that although being 9 years out in a large private practice group, his group is indirectly involved in "greasing" the hand that sends referrals.

examples: out-right illegally paying potential players, "leasing" office space, etc.

how does one maintain an ethical practice without playing the "game"? is there any way around this "greasing" problem without offending anyone and still remaining financially sound?

 

[Doctodd]

lots of hard work....it takes a couple of years, but the service you provide (hopefully a good service) will speak for itself.

T

 

[Tenesma]

there is an issue with greasing...

1) if word gets out then patients will assume that your reputation is not all that

2) the referring doctors will be referring to you because of greasing not because they necessarily respect what you do - and they will quickly change loyalty to whoever greases better

3) therefore - solution - don't grease, just be ethical and do the best job possible and over time your reputation will generate referrals ...

 

[Mister Mxyzptlk]

This is similar to the situation in the drug rep thread. You have to decide how much the money means to you.

Some pain docs will go to the office of a good referral source to see patients and pay "rent". Some PM&R and neurologists will do EMGs at the referring doc's office as well. Some of the radiology centers around here will place a "scheduler" in your office if you have high enough volumes (ostensibly to relieve your staff of the onerous burden of scheduling the studies) and of course they will also pay "rent" for the space their employee uses.

I don't care to get referrals from people like that and I don't believe in buying friends. For one thing it means you are dealing with unethical people who will not hesitate to screw you if they can make a buck. It's also damaging to one's reputation. IMHO it makes you look desperate for referrals and it also can tarnish you by association with questionable characters. Lay down with dogs, get up with fleas.

I think Doctodd summed it up in terms of how to handle it. Most doctors don't tolerate sleazy behavior. Your practice will evolve to the point where you will be getting plenty of referrals from people who think like you do.

 

[MetroPain]

thanks for the advice. i definitely agree with everyone that your practice should speak for itself and although it may take a while, you are running your practice in an ethical fashion.

 

[Xardas]

Wondering what others think about obtaining referals:

talked to a young surgeon today who said straight-faced that although being 9 years out in a large private practice group, his group is indirectly involved in "greasing" the hand that sends referrals.

examples: out-right illegally paying potential players, "leasing" office space, etc.

how does one maintain an ethical practice without playing the "game"? is there any way around this "greasing" problem without offending anyone and still remaining financially sound?

Why anyone would risk any type of activity that can lead to potential prison time after putting in the years to go through medical school and residency is beyond me.

 

[Tenesma]

there is a fine line between greasing (buying referrals) and creating a cordial, courteous environment to generate business....

do you know what has generated the MOST business referrals is actually becoming friends with the referral sources --- go jogging with an orthopedic surgeon, play tennis with the big-shot internist, arrange play-dates with your kids and their kids... if people like you AND respect you that is even better...

I also ALWAYS inquire about their clinical interests --- one PCP told me he'd love to do more acupuncture (he was trained but just never developed the volume to do it more consistently) - so i refer patients to him for acupuncture

one PCP told me loves lipid physiology --- so I recommend him to any of my patients on cholesterol agents as a potential "cholesterol consultation"...

one ORTHO guy hates seeing shoulders but loves hips -

one PCP bought a device for hemorroidectomies and I mention his name every time i see hemorrhoids on an initial intake ROS part of H&P...

there are many ways to generate business/referrals and potentially friendships without having to sell your soul...

 

[Mister Mxyzptlk]

do you know what has generated the MOST business referrals is actually becoming friends with the referral sources --- go jogging with an orthopedic surgeon, play tennis with the big-shot internist, arrange play-dates with your kids and their kids... if people like you AND respect you that is even better...

Very true, but since I'm a couch potato I try to develop all the diseases they treat and see them as a patient. Since I have Munchausen's it is a double bonus. I love it when work and hobbies dovetail like that. It's a little tough faking dysmenorrhea in order to get those gyn referrals.

I tried to arrange a play date with a doctor's kids but the parents called Child Protective Services and I got hit with a 100 yard restraining order and they threatened to put me in the sex offender's registry. I recommend that if you want to try this you should have some kids.

 

[Spine Specialist]

http://blogs.wsj.com/health/2007/11/27/why-a-device-maker-paid-docs-85-million/





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[Mister Mxyzptlk]

ANS was doing this for a while, paying people to use their stims. I wasn't part of it so I'm unclear on the details. I think it was under the guise of evaluating new products or something. According to the grapevine they were paying one of my colleagues $1,000/case.

 

[ampaphb]

ANS was doing this for a while, paying people to use their stims. I wasn't part of it so I'm unclear on the details. I think it was under the guise of evaluating new products or something. According to the grapevine they were paying one of my colleagues $1,000/case.

The US Attorney who spoke at NASS in October made clear that those kind of arrangements are exactly of the sort they are focusing on for criminal prosecution