HOW TO GET MD REFERRALS BOOK
MELISSA ROTH, Cht. Ph.D.
INTRODUCTION: A survey done by the American Medical Association found
that 58% of physicians were in favor of their patients using complimentary therapies. We
also know that more and more patients are asking their physicians for information on
various complimentary therapies. With all this heightened awareness about
complimentary therapies, are you getting referrals from half of the physicians in your
area?
Another recent survey documented that as many as 66% of patients are trying
complimentary therapies. The highest percentages of utilization are among people with
chronic illnesses for which traditional therapies offer little relief or hope. This is the same
patient population that the physician has the greatest difficulty with and the ones he/she
are most likely to refer out.
Unfortunately, the average physician does not know to whom to refer the patient
or how to make a referral for complimentary therapies. And, when they don't know to
whom or how, they usually keep quiet and do nothing. (p 1)
Those physicians who suggest complimentary therapies usually tell their patients
that they should consider hypnosis or acupuncture or some other modality and leave it up
to the patient to find an appropriate therapist. At that point, the patient usually turns to the
yellow pages or an advertisement. Basically, they pick the therapist whose ad looks the
most appealing that day. They have no confidence level and no direction. They mayor
may not make the most appropriate choice.
Possibly you already get referrals from your personal physician and maybe even a
couple of other physicians you know. Getting physician referrals insures a steady stream
of interesting clients and it sets you apart from everyone else who are advertising. The
patient automatically transfers to you the same level of esteem and regard he or she has
for their physician. And, unlike expensive advertisements, all it costs you to get these
referrals is your brochure and telephone. This course teaches you step-by step how to
become known to any physician of any specialty and how to secure their referrals. (p 2)
Getting Started: First, compile a comprehensive listing of physicians in your
area. Next invest the time on the telephone to screen each physician's office. Judging by
the answers and reception you get during the telephone screen, sort them by those
physicians you want to see first, second, third and so forth. Obviously, those who say
they already refer to complimentary providers will be ones you want to see first.
Although the receptionist may state that her doctor would not be interested in
your services, you still want to put them on your call list. Do not make a special trip to
see them. But, make a point of leaving brochures and literature when calling on someone
else in their building or neighborhood. I had a case like that recently. The receptionist
told me plainly that her doctor, a Rheumatologist, would not be interested in referring
patients for hypnotherapy.
When I was in her neighborhood I stopped by to see if I could see the physician
anyway. The receptionist was even more emphatic. So, I left my brochure on
fibromyalgia and a study published in the Journal of Rheumatology advocating
hypnotherapy for alleviating (p 7) symptoms of fibromyalgia. I never spoke with this
physician. However, two weeks later I received an email from her referring a patient.
After you have sorted them into groups by interest levels, further sort them into
geographical areas so that you can call on as many as possible during each trip. Many
physicians have offices in large medical buildings owned and operated by hospitals. This
allows you to see several people in a short amount of time. Driving to remote locations
will be necessary to see all the people on your list but it eats up time. When you are
seeing physicians on this initial visit, time is a valuable commodity. After you have
worked through all the physicians in your area who are appropriate for you to call on, you
will periodically return to visit those who have shown an interest in your services or who
have referred patients to you. Each time you call a physician's office, make an office visit
or have any contact with a physician's office make a note on that M.D.'s page. You want
to keep brief notes about whom you talked to, their interest leve1, what you discussed
and if you left brochures and literature. Each time you get a referral make a note of the
patient's name and reason for referral on that M.D.'s page in your (p 8) workbook. You
want to have adequate notes to tell at a glance what your experience with this physician
has been. And each time you call on this physician you want to discuss a different topic
and leave different literature. Be sure to take them new information that has value for
their practice each time you visit. If-vou can do for them what they need done, they will
refer to you If you are talking about services for which they have no need, you are
wasting everyone's time and costing yourself money in lost productivity.
Make notes immediately after visiting with each physician. When you get back to
your car take a few moments to make notes when things are fresh on your mind. If you
postpone this step you
may forget important details.
Follow up with those physicians who showed an interest in your services. If you
promised to bring back literature on atopic, bring it back promptly. If you spoke with the
doctor about atopic and later you find you have a brochure or literature discussing that
topic, drop it in a brief note to his office. It is best if these notes are hand written. It can
be something as simple as, thought you might be interested." It should always be on your
letterhead. I have (p 9) special note size letterhead for such notes. If the doctor referred a
patient to you, send letters and progress reports for their chart.
For each day you plan to make office visits, put 15 - 20 M.D.'s on your call lists.
Prepare two to three possible presentations per physician. Take a brief case with enough
brochures and literature to supply at least four or five M.D.'s before you have to return to
your car to restock. It is a good idea to take a "cheat sheet" listing the M.D.'s specialty. If
you are unable to see the physician, give your presentation to his/her nurse. (p 10)
FINDING PHYSICIANS: Of course, the first place to start compiling your list
of area M.D.'s is the yellow pages. In large cities you will find them listed alphabetically
and by practice specialty. Just because an M.D. is listed under Internal Medicine doesn't
mean they are a generalist. Many of them have a sub-specialty. When you do the
telephone-screening step be sure to ask if Dr. XX has a sub-specialty or what type of
patients he/she sees.
If you only look in the yellow pages of the telephone book you are missing many
of the physicians in your area that might become excellent referral sources. There are
many physicians who do not have private practices and are, therefore, not listed in the
yellow pages. You may miss important contacts if you do not ferret out these health
providers and add them to your contact list.
Consider the hospital-based physicians. They have their offices in the hospital.
They may see only in-patients or a combination of in-patients and outpatients. An
example of this type of physician would be a Physiatrist or Physical Medicine doctor.
These professionals typically work in rehab units or rehab hospitals. (p 11) This type of
physician is taught to take a team approach to treating the whole patient. They have little
hesitation adding you to the team. In addition, you can provide a valuable service for
their patients.
Another example would be the Radiologist. Common problems associated with an
MRI are the anxiety and fear of being immobile in a small tube. Open MRI units do not
give as clear a picture as the traditional tube. Many patients simply can not handle being
in such a small enclosed space and must be rescheduled and sedated. This takes a lot of
valuable time. If you can lessen a patient's anxiety and fears to allow them to be
comfortable in the tube, you will be considered a very valuable resource.
Another source of physicians is university-based physicians. These doctors
usually see patients in various specialty clinics within the university or teaching hospital.
Also, within the university, are the physicians in the student health department. The
students are their patients. But not ail students are the typically healthy 18-22 year olds.
They encompass all ages and all health problems. And, if it is a large university, they
probably include patients of various (p 12)
ethnic backgrounds and countries of origin, for whom pharmaceuticals constitute
alternative medicine.
There are also the public health physicians. They serve the lower economic levels
of society. The majority of their patients are Medicare and Medicaid recipients. Medicare
will reimburse for hypnosis for certain medical conditions. Do not exclude this group of
physicians.
There are also company physicians. These doctors treat only employees of the
company. Sometimes they also see dependents or family members of the employee. You
can usually obtain a listing of these physicians by calling the company or by walking into
the clinic and picking up cards.
In addition to looking in the yellow pages, you can call the hospitals for a listing
of the physicians who are credentialed to practice there. You will find that many
physicians have privileges at more than one hospital. In other cases, the physicians will
be polarized around one hospital and will not or cannot work at another one. All of these
are good resources to help in compiling a comprehensive listing of physicians in your
area.(p 13)
TELEPHONE SCREENING SCRIPT: How do you get all the information
about each physician? Most of it can be obtained by calling his/her office and talking
with the receptionist and for nurse. Simply explain to the receptionist that you are a new
professional representative in the area and need to get some information. They are
experienced with pharmaceutical representatives asking for information and calling on
the doctor. Usually, the receptionist can give you most of the information you need.
Simply go down your list and ask the following questions.
1) What is Dr. X's nurse's name? Does she have a direct phone number or extension?
2) What is the fax number for Dr. X's office?
3) Does Dr. X see pharmaceutical reps?
4) Do I need an appointment or do I just come and wait to be seen?
5) What is the best time of day and the best day of the week to be seen quickly?
6) Are there certain days or times to avoid? (p 14)
7) Does Dr. X see patients with (specific diagnosis)?
8) Does Dr. X ever recommend complimentary therapies such as physical therapy,
acupuncture or hypnosis?
9) Does Dr. X have any special interests such as Fibromyalgia or mitral valve prolapse
(substitute indications you know you want to target?
10) If you need an appointment to see this physician, go ahead and set one up now. (p 15)
The Presentation: Your presentation should be no longer that two minutes. If the
physician wants to talk longer than two minutes then be prepared to spend as long as they
desire. Be sure you have answered their questions to their satisfaction. Remember that
brief answers are best. This is no time to launch into a detailed description of hypnosis
and how it works. This takes more practice to achieve than it sounds.
How do you know if you have answered questions to their satisfaction? Ask, "Is
that what you wanted to know?" or "Did that answer your question?" Be aware of their
interest level. When it drops off, stop talking.
You should make three points about the topic in your presentation. Numerous
studies document that people do not remember more than three points. Don't waste your
precious two minutes on material they will not recall. Save it for the next visit.
Question your way to agreement. You must ask questions to determine if your
planned presentation is valuable to this M.D. If this M.D. is in Internal Medicine but
specializes in pulmonary (p16) comfortably discuss with your patients?” “Would you be
interested in having more brochures for your waiting room? It’s that simple. (p 18)
THERAPIES THAT WILL GET REFERRALS: There are several therapies
that a physician will readily refer to you. Basically, these are therapies for which there are
either no conventional treatments or the conventional treatments have not worked for this
patient. Also, there is a growing class of patients who do not want to take medications.
Pharmaceuticals, physical therapy and surgery constitute the majority of conventional
treatments available to a physician. If the patient either rejects these or is not a candidate
for one of these, the physician has little else to offer them. This is where you come in.
Also, do not forget that medications have a price to pay in side effects. Sometimes, the
reward is worth the price you have to pay. Sometimes, it is not.
The following conditions are ones which the physician will refer patients to you.
This is not an all inclusive list. However, it will be a good place for you to start. Develop
a script educating the physician how you can help his/her patients alleviate the
objectionable symptoms of each of these conditions. (p 19)
* Anxiety- Typically, when a patient has high levels of anxiety, or generalized anxiety
disorder, the physician prescribes an antidepressant. Unfortunately, antidepressants do
nothing to alleviate anxiety. Paxil is the antidepressant that works best for anxiety and it
provides inadequate relief. When the patient comes back complaining of anxiety
symptoms they are then referred to a psychologist for therapy. Cognitive-behavior
therapies, like hypnosis, work best for anxiety. But that is not what most mental health
professionals do. Psychiatrists rarely do any therapy. They prescribe medications and
monitor psychotherapy done by the psychologists. Tradition psychotherapy is a slow,
sometimes agonizing process. Anxious patients want and need relief NOW.
* Hypertension: - There are hundreds of anti-hypertensive medications on the market.
Finding the one that works best for the individual patient is similar to shopping for new
shoes. You try one and then another until you find the right fit. In addition, most of the
anti-hypertensive medications have an undesirable side effect. They cause impotence in
males. The choice is to live longer but without sex or not take the medication, risk death
by stroke or heart (p 20) attack, but continue to have a sex life. Hypnosis, however, can
reduce hypertension in mild to moderate cases without medications. Also, hypnosis can
make it easier for the patient to adhere to recommended lifestyle changes that will lower
their blood pressure. Specifically, hypnosis can help the patient maintain dietary changes
and exercise programs.
* Irritable Bowel Syndrome - IBS is a chronic illness characterized by chronic diarrhea,
chronic constipation or both. It effects up to 20% of the population striking one out of
three women. Conventional medical therapies consist of medications and dietary changes.
These are only effective for 25% of patients with this condition. And the side effects of
the medications are so noxious that most patients quit taking them. Whether the
medications worked or not, when the patients quits taking them, the symptoms return.
However, with as few as six sessions of gut specific hypnotherapy, the patient can
become symptom free and the symptoms do not return when the sessions end. (p 21)
* Chronic Pain - As much as 90% of the population experiences some type of pain every
day. The number one complaint seen in the physician's office is PAIN. Narcotic pain
medications are very addictive. Routinely, several pain medications head the list of most
commonly abused prescription medications. Every physician has heard urban legends of
some other physicians in the community who had his license reviewed or even pulled due
to over prescribing of narcotic pain medications. They are, therefore, hesitant to prescribe
adequate amounts of narcotic medications to provide the chronic pain patient with relief.
Further complicating the picture is that after a fairly short time the patient develops a
tolerance to the medications and requires higher and higher dosages just to achieve the
same levels of relief. Due to its relentless nature, most chronic pain becomes debilitating
to some extent. It disrupts sound, restorative sleep. It impairs cognitive functioning. It
creates depression and anxiety. Hypnotherapy can reduce pain levels, relieve anxiety and
depression. It can he1p the patient achieve refreshing, restorative sleep patterns. At the
very least, it can alleviate enough of the chronic pain to allow the patient to reduce (p 22)
the amount of medication necessary to remain comfortable. This is of major importance
to physicians and patients alike.
* Acute Pain - Hypnotherapy can sometimes relieve all of the pain. For other patients it
can alleviate enough acute pain to allow the patient to be comfortable with greatly
reduced needs for pain medications. The medical literature is full of reports citing as
much as a 60% reduction in analgesic usage after surgery.
* Diagnostic Testing- Many diagnostic tests can be performed using hypnotherapy
instead of analgesic or sedating medications. Not only does this save the hospital money
by speeding up the process; it produces a happier patient who is more willing to comply
with doctors' orders afterwards. It also produces more accurate test results. For example,
many people have great difficulty with closed
MRI tubes. The top of the tube is only three to four inches from their face. This causes
claustrophobia in people who have never suffered with jt before. These machines are
expensive to own and operate. Therefore, the hospital must keep then operating in a time
efficient manner. A patient who hesitates or can not tolerate being (p 23) in the MRI tube
costs the hospital money that they can not pass along to the insurance company. They can
only bill the insurance company for the procedure, not how much time it took to get the
patient to cooperate.
* Pain Free Childbirth- The most desirable scenario for both mother and doctor is an
unmedicated birth following an uncomplicated pregnancy. Hypnosis for childbirth can
allow them to achieve this scenario. The greatest risk of birth defects is from anesthesia
during childbirth. OB/GYNs are interested in reducing their patient's need for anesthesia
and pain medications. In addition, the time of labor for most first pregnancies is eleven to
fourteen hours. If a woman has practiced a method of relieving childbirth pain by
utilizing breathing exercises, she is fatigued when it is time to push. If she has utilized
hypnosis, she is rested and can actively participate by pushing. This is pleasing to both
mother and doctor and safer for the baby.
* Eibromyalgia- FMS accounts for 10% of all conditions seen in a general physician's
practice. It is characterized by widespread pain, (p 24) fatigue, sleep disturbance and
cognitive dysfunction. While this illness is not life threatening, it is progressive to the
point of becoming disabling. Currently, 36% of all social security disability payments go
for FMS. This one illness is capable of bankrupting the social security system. Twelve
sessions of system specific hypnotherapy can alleviate most of the symptoms of FMS and
return the patient to a higher state of functioning with significantly reduced needs for
narcotic medications. Nothing, other than hypnotherapy, provides lasting relief for the
FMS sufferer.
* Smoking Cessation - Multiple times a day the average physician tells his/her patients
who smoke to stop. For most patients this is easier said than done. The physician can
prescribe Wellbutrin (Zyban) for those patients who can tolerate it. However, not
everyone can tolerate this drug and not everyone is successful using it. When everything
else fails or when the patient doesn't want drugs, the physician will refer patients to you
for smoking cessation therapy. Know your success rate with this therapy. It is not enough
to say that most people don't come back for the free follow up. You can not assume that
the person quit smoking just because they didn't (p 25) come back for the free session
you offered. A physician wants to know numbers and percentages before they feel
comfortable referring their patients to you. There is no faster way to end your referrals
than from a dissatisfied patient telling their doctor that they quit for a month or two and
then resumed smoking.
* Weight Reduction - Just like with smoking cessation, you need to know your
percentage success rate. You need to know exactly the number of sessions you typically
see someone for weight reduction
of X number of pounds. For example, if someone needs to lose 35 pounds, you need to be
able to tell the physician it typically takes X number of sessions. A weight loss of 100
pounds typically will require XX number or sessions.
* Somatoform Disorders - These are sometimes called Conversion Disorders. There are
no conventional treatments for these. Also there are no psychological interventions that
are effective for conversion disorders. Hypnosis is both effective and produces relatively
quick results. (p 26)
Listed below are a number of other therapies which a physician will refer his/her
patients. This is not a comprehensive list. However, it will get you started.
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Needle Phobia
Depression Tinnitus
Stress Management
Headaches
Migraines
Memory Enhancement
Insomnia
Phobia Relief
Nail Biting
Concentration
Sexual Enhancement
Unexplained Infertility
Treatment Compliance
Exercise Motivation & Compliance
HIV/AIDS
Immune System Boosting
Wound Healing
Erectile Dysfunction
Dysmenorrhea (Menstrual Cramps)
Bashful Bladder
Enuresis
Nausea/Vomiting (Chemotherapy & Pregnancy) (p 27)
Indications by Specialty: Listed below are some of the indications for which
an M.D. will
refer patients to you. They are broken down by specialty. While this is not a complete
listing, it will get you started. Use this list to develop presentations that are tailored to
each medical specialty. There are certain conditions that are so pervasive in our society
that they are seen by every specialty. These conditions are pain, stress, anxiety, smoking
and weight control.
* Allergy rashes, allergies, asthma
* Anesthesiology decreased amount of anesthesia needed during surgery, pain
management
* Bariatric Medicine: weight loss, exercise motivation, behavior modification
* Burns: pain control, anxiety, healing
* Cancer (Ontology): pain relief, boosting the immune system, nausea control
* Cardiovascular Disease (Heart): angina, anxiety, hypertension, diet and exercise (p 28)
* Dermatology: pruritus, warts
* Endocrinology: diabetes, diet and exercise, weight loss
* ENT: tinnitus
* Family Practice: pain, irritable bowel syndrome, fibromyalgia, chronic illnesses,
hypertension, stress reduction, anxiety, panic attacks, insomnia, migraines
* Gastroenterology (Digestive Disorders) irritable bowel syndrome, chron's disease
* Gynecology (OB/GYN): pain free childbirth, PMS relief, nausea control, unexplained
infertility, dysmenorrhea, anorgasmia
* Inertial Medicine: hypertension, irritable bowel syndrome, fibromyalgia, mitral valve
prolapse, stress, anxiety, somatoform disorder, pain, insomnia
* Maxillofacial & Cosmetic Surgery: minimize scaring, anxiety
* Neurology: pain, multiple sclerosis
* Neurosurgery. pain, healing, pre and post surgery
* Orthopedics (Bone & Joint): healing, pain, exercise motivation
* Pain Management: pain, exercise motivation, anxiety, depression
* Pediatrics: study skills, needle phobia, enuresis, thumb sucking, asthma, bashful
bladder, nail biting
(p 29)
* Physical Medicine (Rehabilitation): exercise motivation, healing, anxiety, somatoform
disorders
* Psychiatry: panic disorder, anxiety, depression, somatoform disorders
* Radiology: anxiety, claustrophobia, relaxation
* Rheumatology: Fibromyalgia, pain, lupus (SLE)
* Surgeons: anxiety, pain, healing
* Urology: bashful bladder, enuresis, urinary incontinence, erectile dysfunction,
premature ejaculation
(p 30)
Dentists: Dentists have as much need for the services of a hypnotherapist as
physicians do. Open your telephone book to the section for dentists. Many of the ads are
stressing the fact that their dentist is painless or gentle. Dento-phobia, fear of the dentist,
is universal in our society. The severity of this fear ranges from mild anxiety to total
avoidance of the dentist. I have had a number of clients who are so fearful of the dentist
that they have not been for ten years or longer. The only reason they were considering
going back was due to the intense pain of an abscessed tooth or for another dental
emergency. When you are developing you referral network, do not overlook dentists.
Some of the indications that a dentist would refer patients to you include:
Gagging, vomiting, TMJ, clenching, bruxism, pain, anxiety and phobias, stress,
smoking, dipping snuff or chewing tobacco. (p 31)
PROFESSIONAL CONDUCT: Understand that when a physician refers a
client to you, they are putting a tremendous amount of trust in you to conduct yourself
professionally and ethically. It generally requires a great leap of faith on their part. Not
only do they stand to lose the patient if the patient does not trust you, but they risk losing
the patient's family and close friends also. A physician only has to lose one patient or get
a complaint from one patient about your conduct to stop your
flow of referrals. They do not expect you to be successful with 100% of the patients they
refer. They do expect you to conduct yourself professionally 100% of the time.
What constitutes professional conduct?
#1. The referring physician makes ALL referrals and recommendations. The patient
always belongs to the physician who referred them. The physician always remains in
charge. Any additional referrals or recommendations must come from the physician. If
you think the patient needs massage therapy in addition to hypnotherapy, you must
contact the physician and (p 32) recommend that the physician refer them to a massage
therapist. If you think the patient would benefit from herbs or supplements, you must
contact the physician and allow the physician to make the recommendation. If you think
the physician has made a misdiagnosis or has not diagnosed some other problem with this
patient, you may not tell the patient to go see Dr. So and So instead. You must either
remain quiet, call Dr. X who referred the patient and suggest he/she take another look at
the patient for the possibility of ----- condition, or you can suggest to the patient that they
return to Dr. X for further evaluation emphasizing the symptoms to discuss. No matter
what you think, you may not refer this person to another doctor or another therapist.
#2. You may only do therapy for the condition indicate prescription or referral
form. If you do not agree with the diagnosis or if some other problem is uncovered
during the course of therapy, you must contact the physician and have them write anew
prescription or referral form. This does not mean that you can't work on weight loss as
part of the therapy process for bringing the patient's hypertension under control.
However, if the patient has (p 33) been referred to you for smoking cessation, you are not
entitled to do past life regression. In the past, I have had a number of patients who were
referred to me for various conditions who were interested in regression work to uncover
suspected past abuse, past life regression or a personal growth therapy. In each case, I
have told them that I would happily work with them on those issues but they would have
to pay for those sessions out of pocket. They would be in addition to and separate from
the sessions we were having for whatever condition they had been referred to me. Since I
also want to keep my relationship with them and the referring physician clean and above
board, I will only do those other therapies after I have completed the work they were
referred for .
#3. Do not discuss the more esoteric aspects of hypnotherapy with the physician or
the patient. I like to think all physicians are enlightened and a few of them even have the
lights on. However, they have a11 been trained in allopathic or conventional medicine.
They do not want to think you are going to talk to their patients about angels or past lives
or the other esoteric aspects of our profession. (p 34) Patients will bring up these topics
to you. It is okay to acknowledge this with them and discuss it to the point where you
discern the patient's model of the world. And, as always, you must honor the patient's
representations. But, it is NOT okay for you to initiate the conversation or otherwise
direct the conversation to these topics. The same holds true with physicians. Do not
initiate the conversation of these topics. Often, I have physicians ask me what I think
about past lives, reincarnation, angels, etc. I always tell them I honor the patient's
representation of reality-whatever that may be and that my personal belief system has no
place in therapy. Other than that, I do not elaborate. Certainly, I have done past life
therapy to relieve chronic pain. I use angels, tapping, divine energy, colors, Reiki, etc., in
my therapies. But I do not initiate the conversations about them. I utilize the patient's
belief system only. We always seek the Source Cause however and wherever we find it.
Once we resolve the initial problem for which they were sent to me, we stop. This area
has the potential to become a roadblock in the referral pathway. Decide how you are
going to handle the inevitable (35) questions. Practice your responses until they sound
natural and sincere. Be sure it sounds like you understand the physician's concerns and
have the sensitivity to honor them.
#4. Professional Dress Code: Notice how the physicians in your area dress and dress
yourself accordingly. For men, that means leather shoes with hard soles, a tie, a solid
color button down shirt and a sport jacket or suit. For women, it means a conservative
dress or skirt or a dressy pantsuit. It means conservative dress shoes. It does not mean
jeans, shorts, casual clothes or casual shoes. It also means a conservative hairstyle and a
clean-shaven face. Mustaches are acceptable. Beards are usually not. We put effort into
creating repoire with our clients. Strive to create that same repoire with the M.D.'s you
call on. People prefer to do business with people they believe to be like them. One quick
way to begin gaining that repoire is to look the same. That means the same type of
clothing and the same hairstyles. What your mother to1d you is correct, "You will never
get a second chance to make a good first impression." (p 36)
#5. Professional Presentation: Write out the script for your meeting with the physician.
Polish it on
paper first. Then practice saying it out loud. Listen to how you sound. Do you sound
natural? Smooth? Or, are there pauses where there should not be. The points you desire to
make should flow smoothly from one to the next. You should anticipate the physician's
objections or discomforts and formulate your presentation accordingly. Rehearse your
presentation over and over until you can say it automatically.
#6. Limitations: Know what you do not do well and be honest about it, if asked. Know
when your therapy modality is not the best option and be up front about it when asked.
Obviously, antibiotics are the smartest choice for strep throat. Massage therapy is a wiser
choice for a pulled muscle. Know what your part of the healing process is and convey
that you can do that part well. But you do not want to come across as though hypnosis,
NLP or whatever other therapies you can do are all the patient needs. The rule of thumb
is to always conduct yourself as a team player. (p 37)
Follow Up: Once a physician refers a patient to you, follow up with progress
reports for the patient's file. This is professional courtesy. It also constitutes good
business practices. Each time that M.D. receives a letter documenting that patient's
progress, it makes them more receptive to referring additional patients.
What do you include in this letter? First, you name the patient and describe the
indication or condition for which they were referred. For example, "Thank you for
referring Mary Smith for hypnotherapy to alleviate the symptoms of Irritable Bowel
Syndrome." Next, you describe the patient. "Mary is a 43-year-old white female who
developed IBS symptoms following a complete hysterectomy in 1996."
Then, you rank the severity of symptoms on the patient's first visit. You want to
rank their level of symptomology before you begin therapy to establish a base line or
benchmark against which you can judge the effectiveness of your therapy. For example,
initially, Mary ranked her symptoms on a scale or zero to ten as (p 38) follows: diarrhea
8, constipation 3, gut pain 6, spasms 7, bloating 9, gas 8.
Next, outline your proposed therapy plan. "The proposed therapy plan consists of
a series of six gut specific sessions held two weeks apart combined with behavior
modification suggestions concerning diet and exercise. The first of those sessions was
held MM/DD/Year. Mary was re-appointed for MM/DD/Year for the next session In
sequence.
It is a good rule of thumb to send follow up notes for the patient's file after three
sessions. Each note should document objectively judged progress. You get this data by
ranking the patient's level of symptomology on each visit and having the patient rank
their symptoms on a daily basis between visits. This provides you with documented,
objective progress results. Example, "Today was Mary Smith's fourth session for relief of
IBS symptoms. After three sessions she was reporting symptoms as follows: diarrhea 2,
constipation 0, gut pain 1, spasms 2, bloating 4 and gas 3. This represents a XX%
reduction in her overall IBS symptoms. She also reported that she has resumed grocery
shopping for her family and (39) has gone to her son's baseball games for the first time in
two years. We expect continued progress."
After the final session that the physician has prescribed, send a note thanking
him/her for allowing you to work with their patient. Document the patient's progress. If
you think the patient could make additional gains in symptom alleviation, write a note
stating what you expect to accomplish in additional sessions. Include an estimate of the
number of additional sessions it would take to accomplish this goal. Be sure to include a
revised therapy plan as part of th is note.
If the patient fails to keep appointments or does not comply with the therapy
program, you need to document this in a note to the referring physician. If you do not
report that the patient failed to comply with the treatment plan, the physician, having no
other knowledge, will think your treatment failed. Whatever happens with that patient
needs to be reported to the referring physician.
Periodic follow up on each patient insures repeated referrals. It establishes you as
a member of the health care team. 1n my office, we ask each client for the name of his or
her personal physician. Whenever possible, we have the client sign a release to (p 40)
report their therapy progress to their physician. It is good practice to keep their physician
informed of therapies the patient is utilizing. It also put our clinic name in front of
physicians more frequently that I can personally visit with them. (p 41)
HANDOUTS: You want to leave something behind when you leave the
physicians office that will be a continuing reminder of your services. The most important
things to leave are your brochures and your business card. Your brochures are easy for
the doctor to hand to a patient. It not only tells them how to find you but also should give
them some basic information about hypnotherapy and how it can help with the condition
they have. This means you must prepare specialty brochures for all the indications your
therapies address instead of one general brochure. I leave brochures for smoking
cessation and weight loss regardless of what else I have discussed.
In addition to brochures and my business card, I also leave printed prescription
blanks. Why? Because most physicians do not know how to write a prescription for
hypnotherapy. They did not know how to write a prescription for physical therapy until
recently and, therefore, did not utilize it to its fullest potential. Don't let the reason they
don't refer to you be due to them not knowing how to write a prescription for your
services. An example of a prescription blank that I leave for physicians is enclosed in the
booklet. All the (p 42) physician needs to do is check off the appropriate areas and either
send it by the patient or fax it back. If they have to create a format for a prescription, it
may not happen and you may not get the referral.
I also went to one of the office supply houses and bought the blanks for business
size refrigerator magnets. Them I made my own refrigerator magnets out of my business
cards. They are inexpensive and they have staying power. Think of your own refrigerator
and the magnets on it. Whether you like them or not, they are still there year after year
and you still see them every day.
These are the only things I leave with a physician. If you want to leave other
reminders I would recommend pens, pencils and note pads. No office ever has enough of
these and they never throw them away. Your name will constantly be in their face. Just
make sure they are conservative and professional. A (p 43)
Medical Journal Abstracts: During the telephone screen part of this process
you asked what medical journals the physician read. You want to know so that you can
search the medical abstracts in those journals for articles about hypnotherapy. More and
more frequently in the medical literature are reports that hypnotherapy has been proven
effective or beneficial for one condition or another. Several times a year some journal has
an article on hypnotherapy. The National Institute of Health (NIH) has added an entire
division to discerning the efficacy of alternative and complimentary therapies. This
research is being done at major universities and teaching hospitals around the U.S. and
the results are being published in medical journals. If it hasn't been published in a
medical journal, it may have been published on the web site for the NIH.
Every time you go out to meet a physician with the intent of discussing how
hypnotherapy can benefit his/her patients you should take a copy of a medical journal
article documenting the efficacy of what you are claiming. If you take an article from (p
44) Readers Digest or Newsweek it doesn't evoke the same respect as a peer reviewed
journal. If the article was published in a respected medical journal it will gain the most
credence. Examples of respected medical journals are JAMA: The New England journal
of Medicine, Southern Medical journal, The Lancet and those journals published by the
various specialty boards.
How to Find Medical Journal Articles on Hypnosis: The easiest way to locate
medical journal articles is on the internet. Popular medical journal search engines are:
* Ovid (subscription)
* Medscape (free)
* Medline (free)
* National Institute of Health
If you do not have internet access you can use the internet in any public library.
Most public libraries do not subscribe to monthly medical journals. You would need a
medical library for that. However, you can usually print a synopsis of the article off the
internet.
Alabama Hypnotherapy Center
211716th Avenue South. Birmingham, Alabama 35025 (205)933-5705
Fax: (205)933-5041 . E-mail-hypnosis@mindspring.com
Date:
Dear Doctor ,
I am a Doctor of Clinical Hypnotherapy candidate, certified by the American
Board of Hypnotherapy and the National Guild of Hypnotists with a private practice in
Birmingham, Alabama.
Your patient _____________________ has requested help in the area of
_____________________
I do not attempt to treat or diagnose disease or mental disorders of any kind.
Hypnosis in no way replaces standard medical procedures, but works in conjunction with
them by freeing the patient of feelings and attitudes that may be inhibiting his or her
response to them. Through hypnosis, one uses the natural facilities of the mind to create a
positive attitude and boost the immune system, allowing the client to make the most of
the medical help available. Hypnosis helps to create strong positive expectancy and
reduces stress, thereby normalizing the action ot~ the autonomic ne[\'ous system.
Your signature below allows me to help your patient to increase his/her own
natural resources through visualization and progressive relaxation.
Thank you,
Melissa J. Roth, CHt., PhD(c)
Doctor's Name
Doctor's Signature Date
Patient Name
(p 48)
Sample: Stop Smoking Script: [Every physician has smoking patients who need
to stop smoking. The nicotine replacement patches and Zyban are contraindicated in
many patients. And, for many more patients, they either don't work or they have
undesirable side effects. In addition, the patches, the gum and the pills are all invasive
therapies. Hypnotherapy is noninvasive and therefore safer.]
Hello, Dr. XX. My name is {your name). I'm with (name of your practice). Do
you ever recommend to your patients that they should stop smoking? (Obviously, the
answer will be "Yes. ') For those patients who have tried "everything else" or who can not
tolerate Zyban or for whom the patches are contraindicated, please consider
recommending hypnosis to them. I have an XX% success rate in helping people quit
smoking. It isn't necessary for them to believe it will work or even for them to believe in
hypnosis for them to stop smoking using my techniques. And hypnotherapy is
non-invasive.
I use a three session approach which disconnects them from the cravings for
nicotine and helps to re-pattern the hand to mouth habit. (p 50)
Invariably the physician almost always ask the same two questions:
1) How much does it cost? rell them how much you charge for your program and
compare it to the cost of Zyban, the patches or the nicotine replacement gum. You will
find you are much less expensive than any of these methods. You find out what the others
cost by going to your local pharmacy or discount store and asking the prices.
2) Will insurance reimburse it? Know whether the insurance companies in your area will
reimburse for hypnosis for smoking cessation or not. Several insurance companies will
reimburse for behavior modification classes for smoking cessation.
Many insurance companies will reimburse for hypnotherapy and many more will
reimburse for behavior modification classes for smoking cessation. When that is the case,
I give the client a receipt for "behavior modification for smoking cessation." The best
way to get an insurance company to reimburse the patient is with your prescription so I
have prepared prescription blanks for that. Would you like some? Would you recommend
hypnotherapy for smoking cessation to your patients? Would you like some brochures to
give your patients? (p 51)
Sample: Irritable Bowel Syndrome Script: Hello, Dr. XX. My name is (your
name). I'm with (name of your practice). Do you see patients with Irritable Bowel
Syndrome that don't respond to drug and diet therapy? (Obviously, the answer will be
Yes.) By now you may have read in some of your professional journals that
hypnotherapy is an effective treatment to alleviate the symptoms of IBS. My therapy
approach consists of SIX sessions, spaced two weeks apart. Using this approach, 94%
have gotten greater than a 50% reduction in symptoms and 86% have become symptom
free and remained that way even after the sessions ended. In addition, by coordinating
with their physician, they have been able to reduce or eliminate the medications they
were taking for IBS symptoms. Would this be valuable for your IBS patients?
Now is the time for two questions you have learned to anticipate:
1) How much does it cost?
2) Does insurance cover this? (p 52)
Sample: Fibromyalgia Script: Fibromyalgia accounts for l0% of the patients
seen in a general practice and for one third of the patients seen in a rheumatology
practice. There is no more effective treatment for fibromyalgia than hypnotherapy.
Hello, Dr. XX. My name is (vour name) and I am with (name of your practice). Do you
see Fibromyalgia patients? I use a progressive twelve session, system specific
hypnotherapy program for fibromyalgia that produces 50% or greater symptom reduction
in over 86% of patients. They are able to reduce their dependence on and use of pain
medications anywhere from 30% to 60%. Their sleep improves without the necessity for
sleep medications. They awaken refreshed and, as a result, the fatigue and mental fog
improves. They are able to resume many of the activities they have stopped. I've even had
two who came off disability and returned to work. This therapy approach was tested at
UCLA Medical School. They used the same type of approach and verified the same
things I see in my practice. The only symptom that does not improve significantly is the
tender point sites. But, the pain, the fatigue, the (p 53) sleep disturbance and the mental
cognition problems all improve significantly and remain that way when the sessions end.
No matter how well controlled your fibromyalgia patients are, when they come off their
medications, their symptoms return full force.
Hypnotherapy is non-invasive. And, unlike medications, it will not mask symptoms. Do
you think this would be valuable to your fibromyalgia patients? Would you like to know
how to prescribe hypnotherapy sessions for your patients? (p 54)