Meeting with local PCPs

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tmvguy03

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I’m meeting with some local PCPs at their clinic over lunch to expand my referral base. I haven’t met these guys yet. I’m going straight from my clinic over lunch and am wondering what is the etiquette for what to wear? I wear scrubs and a white coat in clinic, should I wear that or change into a suit? I thought a suit might look like I’m a rep or something. Thanks
 
I usually just wore scrubs because I didn't really have time to change. My scrubs had my name and practice logo on them though, so they looked a little more formal. If you want to change I wouldn't go beyond dress pants and a button up shirt without a tie. I feel like a suit would make them think you just cared about money. No physician that I have ever met doing advertising to my office or when people came into the places I rotated at as a med student ever wore more than the above.
 
I’m meeting with some local PCPs at their clinic over lunch to expand my referral base. I haven’t met these guys yet. I’m going straight from my clinic over lunch and am wondering what is the etiquette for what to wear? I wear scrubs and a white coat in clinic, should I wear that or change into a suit? I thought a suit might look like I’m a rep or something. Thanks

You're a specialist. Act and dress what like one. I'd wear shirt and tie at a minimum.
 
You're a specialist. Act and dress what like one. I'd wear shirt and tie at a minimum.
Dress to your area though - east coast city, yeah, suit and tie is probably appropriate. Where I am that would just get funny looks and could be interpreted as being business/money focused. Jeans and a plaid shirt would be better received in my area.
 
I’m meeting with some local PCPs at their clinic over lunch to expand my referral base. I haven’t met these guys yet. I’m going straight from my clinic over lunch and am wondering what is the etiquette for what to wear? I wear scrubs and a white coat in clinic, should I wear that or change into a suit? I thought a suit might look like I’m a rep or something. Thanks

Sports coat. No tie.
 
Scrubs. Lose the coat, it screams midlevel.

Agreed.

Nothing worse than an NP in the grocery store wearing a white coat.

Wear scrubs. Nobody cares what you're wearing. Form proper sentences and just be yourself. Everything else is BS.
 
Agreed.

Nothing worse than an NP in the grocery store wearing a white coat.

Wear scrubs. Nobody cares what you're wearing. Form proper sentences and just be yourself. Everything else is BS.


You wear scrubs to work, you wear scrubs to medical things including lunches and office visits. You do not wear scrubs to dinner, on planes, or out in public.

Benefit scrubs: feel amazing, super stretchy. Hot if I need to walk at lunch and forget my shorts. (see above: do not wear scrubs in public).
 
If you're meeting the docs, its business casual in my area. Scrubs are for the OR, white coats are for the clinic (sometimes). If you're giving a presentation or meeting office staff, suit and food.
 
Family doc here. In my area we are fairly casual. Had a pain doc new in town a few years ago come and see us with his partner. Think he bought us some sandwiches. Nice guy and came across as such. Can't even remember what he wore.

2 biggest things that get my business:

1. You're nice to my patients
2. They don't come back to me all narc'ed out. Bonus points for no opiates at all but I'm pretty good at setting realistic expectations before dishing them your way.
 
Be a normal person providing a worthwhile product (ethical and competent medical care in this case) and you're good. Wear scrubs bc who cares...
 
I’m meeting with some local PCPs at their clinic over lunch to expand my referral base. I haven’t met these guys yet. I’m going straight from my clinic over lunch and am wondering what is the etiquette for what to wear? I wear scrubs and a white coat in clinic, should I wear that or change into a suit? I thought a suit might look like I’m a rep or something. Thanks

Anything. I work with a very large multi-specialty clinic with three quarters of the docs internists and primary care. Many of them wear jeans and flannel shirts. Some wear khakis, blue/white shirts and a tie.

They will not care what you are wearing, as long as you are fully clothed.

Keep in mind that many PCP referrals are garbage, relative to referrals from neurosurgeons/orthopods. Be very clear about the type of patients you feel you can help that would be worth seeing. Not everyone thinks the way a pain guy does and they need some guidance to what is a good referral and what is not.

If you are a low cost provider, point out the advantages of your practice over others in reducing the cost of procedures and imaging, such that their ACO contracts could benefit from your services. Particularly, tell them you do not require imaging for an "admission ticket" (high cost and wasteful) and that you will decide who needs imaging and who does not. Many practices REQUIRE imaging before they see patients, which is medically absurd and wasteful.

Emphasize that you are nice to patients. Too many pain/spine docs are complete asses to patients. This information is returned to the PCPs and they are not very happy about such treatment. Keep in mind that it takes more work to be a jerk, so just realize that your patients have better things to do with their time than being told they are fat or lazy. Everyone who is fat and lazy already knows that and they don't need to be insulted when they are paying for the time.

Bring some treats, like cookies or a few cheesecakes, bring some info, and make sure you leave a bunch of cards with the SCHEDULER. The scheduler and nurses are more important than the docs, as they decide where the referrals go.
 
Dress to your area though - east coast city, yeah, suit and tie is probably appropriate. Where I am that would just get funny looks and could be interpreted as being business/money focused. Jeans and a plaid shirt would be better received in my area.
Mm where r u?
 
Anything. I work with a very large multi-specialty clinic with three quarters of the docs internists and primary care. Many of them wear jeans and flannel shirts. Some wear khakis, blue/white shirts and a tie.

They will not care what you are wearing, as long as you are fully clothed.

Keep in mind that many PCP referrals are garbage, relative to referrals from neurosurgeons/orthopods. Be very clear about the type of patients you feel you can help that would be worth seeing. Not everyone thinks the way a pain guy does and they need some guidance to what is a good referral and what is not.

If you are a low cost provider, point out the advantages of your practice over others in reducing the cost of procedures and imaging, such that their ACO contracts could benefit from your services. Particularly, tell them you do not require imaging for an "admission ticket" (high cost and wasteful) and that you will decide who needs imaging and who does not. Many practices REQUIRE imaging before they see patients, which is medically absurd and wasteful.

Emphasize that you are nice to patients. Too many pain/spine docs are complete asses to patients. This information is returned to the PCPs and they are not very happy about such treatment. Keep in mind that it takes more work to be a jerk, so just realize that your patients have better things to do with their time than being told they are fat or lazy. Everyone who is fat and lazy already knows that and they don't need to be insulted when they are paying for the time.

Bring some treats, like cookies or a few cheesecakes, bring some info, and make sure you leave a bunch of cards with the SCHEDULER. The scheduler and nurses are more important than the docs, as they decide where the referrals go.
I’m a pcp (FM) and I despise the imaging requirement. Some require a new set of images within the last 12 months..... super wasteful to duplicate their imaging they’ve typically already had. Especially because they sometimes need a different set of imaging from the specialist than what I’ve ordered which is even more waste! If my patients let me I refer to the place that doesn’t require new imaging over the other one. (We have no pain management in town or neurosurgery so it’s a 45 min drive to all of them).
 
I’m a pcp (FM) and I despise the imaging requirement. Some require a new set of images within the last 12 months..... super wasteful to duplicate their imaging they’ve typically already had. Especially because they sometimes need a different set of imaging from the specialist than what I’ve ordered which is even more waste! If my patients let me I refer to the place that doesn’t require new imaging over the other one. (We have no pain management in town or neurosurgery so it’s a 45 min drive to all of them).
Agree 100%. I'm curious about something... How often do pts c/o their pain doc refuses to give them narcs?
 
Agree 100%. I'm curious about something... How often do pts c/o their pain doc refuses to give them narcs?
I’ve had 1. (Very good reason for them not to prescribe, can’t describe because so bizarre I can’t without violating hipaa)
I do my best to send before they are on opiates so pain management can determine if best. I have one patient who was really angry at me for sending her who is now super happy after injections have given her back some functional ability. (She’s on Norco 5 once or twice a day and gabapentin). I never tell the patients that pain management will give them pain medications but I won’t increase pain medicines unless patients have a diagnosis that is basically terminal and I told them all this when I started last year. I give a detailed explanation of how I am not an expert in pain management and I’ll send them to people who are. Then I go through (again) the studies about opiates and why other options are better than just opiate management.
 
Every PCP lunch I've been to I just wore whatever I'm wearing that day for work. Sometimes it's nice clinic clothes, sometimes it's scrubs. I leave the white coat in the car because I think it's obnoxious to go to someone else's place of work and act like you're the doctor there.
 
Agree 100%. I'm curious about something... How often do pts c/o their pain doc refuses to give them narcs?

Very rarely, but it usually serves to reaffirm the suspicion that I probably already had in the first place of misuse/diversion.

When patients come to me asking for either benzos or narcs, most are just looking to feel better and I automatically begin my spiel on not turning 1 problem in to two. Anxiety alone is much better than anxiety + a benzo dependence. Same goes with pain. More often than not, it goes over well. If they continue to demand, I let them know that we have reached an impass and I won't be able to offer what they're wanting. They sometimes come back. The more patients you have on scheduled medications, the HARDER the job is for EVERYBODY.

When it comes to referrals, if I'm going to give you my good, then you also have to be willing to accept my difficult. We all have them. The legacy patients. The ones who have been really screwed up by those who came before you. I don't send them all, so please realize that I'm even more in the woods than you are when they walk (or roll) in to my office.
 
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Very rarely, but it usually serves to reaffirm the suspicion that I probably already had in the first place of misuse/diversion.

When patients come to me asking for either benzos or narcs, most are just looking to feel better and I automatically begin my spiel on not turning 1 problem in to two. Anxiety alone is much better than anxiety + a benzo dependence. Same goes with pain. More often than not, it goes over well. If they continue to demand, I let them know that we have reached an impass and I won't be able to offer what they're wanting. They sometimes come back. The more patients you have on scheduled medications, the HARDER the job is for EVERYBODY.

When it comes to referrals, if I'm going to give you my good, then you also have to be willing to accept my difficult. We all have them. The legacy patients. The ones who have been really screwed up by those who came before you. I don't send them all, so please realize that I'm even more in the woods than you are when they walk (or roll) in to my office.

Helpful info. Let me ask- do you expect the pain specialist to assume mgmt of the "problem" opioids or are you happy to get recommendations for mgmt, help with interventional therapies and tweaking of non-narcotic medictations.
 
I send many non-opioid patients pain management's way if I feel like it's something an interventional modality that I don't do can be helpful for, and if typical things I can do haven't helped (NSAIDS, Gabapentin, therapy, steroids, exercise, stretches, wt loss, etc) . I Send a lot of new onset, non-surgical radiculopathy their way. I've sent 1 for med management that came to establish with me on stupid doses of Nucynta and dilaudid for fibromyalgia. I'm certainly far from a dumper, but if I send patients your way, I expect you to manage their schedule medications if that's the modality you choose. 2 cooks spoil the broth. I VERY rarely write opioids for chronic pain so that decision is typically between my patient and whomever I send them to.
 
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