Doctors as Referral Sources

Doctors are an excellent source of referrals for unlicensed and alternative practitionersSome people believe that there’s a big war going on between conventional and complementary and alternative medicine. But I have news for you: the war’s over!

Physicians now routinely recommend complementary and alternative medicine to their patients. No, I didn’t say, “they roll their eyes, but they’ve given up arguing.” I said they “routinely recommend.” The doctor brings the topic up. The doctor makes the pitch. The doctor refers patients to specific practitioners — if they know any good ones.

To paraphrase an article in JAMA Internal Medicine from March 9, 2011, When Conventional Medical Providers Recommend Unconventional Medicine: Results of a National Study:

In a 2007 study including 23,393 respondents, 2.9% answered “yes” when asked if they had used a mind-body therapist in the last 12 months because it was recommended by a health provider. Extrapolated to the whole US population, that’s 6.4 million successful referrals per year.

The same survey showed 15.5% of respondents seeing a mind-body therapist in the last 12 months on their own initiative, without the recommendation of a health-care provider.

The top modalities mentioned by respondents were:

  • Deep breathing exercises
  • Meditation
  • Yoga
  • Progressive muscle relaxation
  • Guided imagery

Why Does This Happen?

It’s because the war between conventional and alternative practices is over, and we all won! The people who used to believe that no alternative modality had anything to offer have mostly died of old age. And the anti-doctor, “don’t let them set your broken leg” crowd never had much of a following in the first place.

What Does This Mean to an Alternative/Unlicensed Practitioner?

It means that members of the health-care establishment will send you clients, and they probably already are, if you’re in a modality they’ve heard of. The numbers show that about one person in six who sought out a mind-body therapist did it due to a referral from a conventional practitioner. That’s about where my tally is running right now. But I think we can do better than that.

The main way to get lots of referrals is to do good work with lots of people. Word will get around. Eventually. The process can be sped up by:

  • Having a Web site that isn’t too horrible or weird, so it’s not too hard for a doctor to imagine that you’re competent.
  • Having clients sign releases so you can send their doctor a courtesy letter or ask for a referral.

Your Web Site

The Website thing should be pretty self-explanatory. My basic recommendation is to use WordPress, because everyone in the Web-site biz is familiar with WordPress, so you can get help with the hard stuff, while simply writing and editing pages is pretty easy.

Professional Courtesy Letters

The most direct, useful, and professional way to establish yourself as a practitioner that a doctor can work with is the professional courtesy letter.

What’s a professional courtesy letter? It’s a client information release form combined with a note that says why the client is seeing you and a request for the doctor to contact you with any questions, concerns, or objections. Letting the doctor know what’s up with their patient is a professional courtesy.

This accomplishes several things:

  • It allows the doctor (or other provider, like a counselor) to talk to you, which may help your work with the client if they know something that you should know, but the client hasn’t told you.
  • It lets the doctor know what’s going on with their patient, which may help focus and improve the doctor’s treatment.
  • It informs the doctor of your existence. When their patients who see you improve, the doctor will likely start sending more people your way.

Unlike a referral, where the doctor gives explicit approval, most professional courtesy letters are merely filed — you’ll rarely receive a response. But they’re read, and you’ll get a call if the doctor has real concerns.

I like professional courtesy letters for all clients who aren’t seeing me for stuff that’s purely medical. As a hypnotist, this means things like weight loss, habit control, stress relief, focus issues, and so on.

Note that even a professional courtesy letter gives the doctor every opportunity to call me up and tell me to stop if he thinks what I propose is a bad idea. So it provides a safety net for clients who appear to have routine, non-medical issues.

A good reason to let the doctor know is that sometimes success has negative implications unless adjustments are made. For example, a type 2 diabetic who is using insulin but isn’t testing blood-sugar levels can start having hypoglycemic episodes if eating habits change for the better. So it’s good for the support team to be informed.

Requests for Referrals

Asking a doctor for a referral is a request for explicit approval of what you’re doing. These can be hard to get, just because doctors are so busy. If they want the answer to just one question before approving, the request may land on an overflowing “IN” box. This is why the professional courtesy letter is better in situations where you don’t really need their approval.

Referrals come in two flavors: “approval” and “not contraindicated.”

  • Approval. The doctor signs on the line and says, in essence, “sure, go ahead: I approve.” By doing so, the doctor accepts some responsibility for the outcome.
  • Not Contraindicated. The doctor signs on the line and says, in essence, “on the surface of things, I don’t see anything wrong with this.” This is more like the doctor saying, “Good luck with that.”

(There’s also “supervision,” but that’s a topic for another day.)

Hypnosis trainer Cal Banyan recommends that, if you need a doctor’s approval at all, start with the “approval” flavor and, if the doctor doesn’t go for it, try for the softer, “Not contraindicated” form. Be aware that this weaker referral may provide you with less protection.

When to Ask for a Referral

I’m a hypnotist, and I don’t know all that much about other alternative and complimentary modalities. But here’s where I ask for a referral, as opposed to sending a professional courtesy letter:

  • When a client has a current mental-health diagnosis.
  • When the client wants to work on something overtly medical, like cancer pain.

Health-Care Professionals Make Great Clients

I’ve worked with a lot of health-care professionals, especially nurses. I’ve found them to be delightful, intelligent, practically minded people. They’ve done their research, walk through the door ready to get down to work, and have realistic expectations that can generally be met or exceeded. Conventional health-care professionals make ideal clients! So it’s not just the referrals, it’s the providers themselves that provide plenty of upside for your less-conventional practice.


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