A simple guide to make your business
grow and receive referrals from
General Practitioners
- Dr Louisa Yim
General Practitioner
Swinburne University Health Service
Hawthorn, Victoria
Introduction:
Thank you for the opportunity for inviting me to speak at this year’s National
Conference. Given the time restraints on the day of the conference, here is a
complete summary of discussion at the 2012 National AAMT conference
Melbourne
Background:
I graduated from Melbourne Institute of Massage Therapy in 2009 with The
Certificate IV in Relaxation Massage Therapy under the guidance of many
wonderful instructors, in particular, Ms Gail Breckon and Ms Elizabeth
Pavilidis.
Since completing the certificate, the journey has taken me to a very different
aspect in General Practice. The experience, at times, has been emotional
and overwhelming, yet, extremely inspirational and rewarding.
In 2005, whilst completing my Diploma in Obstetrics and Gynaecology at a
maternity hospital, I came across a pregnant lady in her third trimester. She
presented with a very unusual right-sided back pain, with visible muscular
spasm. The swelling radiated from the neck down to the lumbar region. In
addition, the pain also referred to the front of her chest. A urine dipstick test is
routinely done by the midwife in all pregnant patients presenting with back
pain, in order to exclude a urine infection. Interestingly, she was found to
have a large number of blood cells in the urine. Given the extremely unusual
presentation, I referred her to have an urgent kidney ultrasound.
Sadly, this lady was found to have a massive thoracic aortic dissection that
extended all the way from the thoracic region down to the right kidney. She
was immediately transferred to the newly build maternity hospital in
Heidelberg. She went on to delivered a healthy baby but unfortunately, during
the repair of the aorta, she passed away peacefully and pain-free during her
sleep.
This has truly been an emotional experience for everyone involved and has
certainly taught me a very important lesson. Always listen to your patients
and go with your gut feeling. I was not prepared to send her home with
painkillers on that day. From this tragic incidence, little did I realize that it has
planted a small seed in me, to gain more knowledge outside of Medicine.
Since coming out from medical school more than ten years ago, I do not want
to be just any other doctor; I wanted to be a good one with healing powers.
“Feeling your patient’s pain” was published in April 2011 in a General Practice
Medical Magazine. It describes the role of a doctor can sometimes extend
beyond the standard medical consultation. Fortunately, I was able to apply
the basic skills from my massage course and demonstrated to my patient that,
as therapists, our hands have special healing powers.
I am very fortunate to have this inside knowledge of massage therapy. I am
more than happy to refer any patients to massage therapists if it is clinically
relevant. The following is a list of what I look for in a massage therapist
before I initiate a referral:
1. Academic
a. Well-trained and fully qualified therapist from a reputable
college
b. Someone who demonstrates a good understanding of anatomy
and physiology
c. Someone who applies evidence-based practice
2. Good Bedside manner
3. Communicates well and confident
4. Down to Earth
5. Good Ethics
6. Flexible and open to ideas
7. Good rapport and professional
a. Understands the patient-clinician boundaries
b. Understands consent to treatments
8. Client/Patient focused
9. Respect for the client and also to the referring doctor
10. Team player and willingness to seek help or ask questions. We are
only a phone call away. There is more harm to not speaking up than
not knowing.
11. Someone who writes BACK!!
a. We love to hear your assessment, subjective and objection
opinions
b. Based on what you write on the correspondence, I can usually tell
whether I will continue referring patients to you or not.
Limitations in General Practice:



Time
Doctors are only human, we do not know everything, please be patient
with us
Not aware that you are providing such service


Cost for patient
Don’t have a good understanding of what services you provide and
what you can do you offer to help for their patients
Tips:
1. When starting up, you might want to team up with existing clinics or try
approaching GP clinics. Some clinics (especially new clinics) may offer
a room for you to hire, especially in large GP or Superclinics.
2. Approach GPs with special interests in sports medicine (ACSP),
nutritional (ACNEM), alternative and integrative medicine (AIMA).
They are usually a bit more open about referring to allied health
practitioners.
3. Research your area and draft up a business plan. I would approach
privately billed practices first as patients usually have private health
insurance.
4. Introduce yourself to the Practice Manager, practice nurse or to your
own GP. You can arrange to have a meeting with the GP through
lunch. Feel free to bring a plate (healthier option with sandwiches or
fruits of course!). Alternatively, you can offer them a complimentary
15-30mins massage (seated at the GP practice or at your clinic – this
way you can introduce your clinic to them as well). You will be
surprised that most of the GP will pay you back for your treatment time.
5. Don’t get frustrated when you get knock backs, you only need one
really good referral source to build up the clientele. Most of your
referral will be based on word of mouth.
6. If finance permits, you can advertise on their appointment cards
7. REFERRAL PADS!! We love referral pads. It’s simple and easy for us
to use. We love the tick boxes as well, just keep it simple. Don’t forget
to include your ABN, contact details and AAMT number.
8. One better way will be drafting a template of a referral letter addressed
to you and save it on file and email this to the practice manager. The
clinic can then download this file into their computer medical program
under “letters”. This way, all the patient information details will be
transcribed on to the template.
This is what I look for, an example of a referral pad or letter:
Your clinic name & logo
Clinic address
Contact number
Your Qualifications
AAMT number
ABN number
Date of referral:
Name of patient:
DOB of patient:
Address of patient:
Tel:
Reason for referral:
 Pain
 Reduced range of movement
 Cramps
 Post op rehab
 Reduced mobility & function
 Pregnancy massage
 Stress
 Relaxation
 Others:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Allergies (esp lotions, creams, menthol):
Any current medical contraindication for massage therapy?
 Active skin infection
 Active trauma / injury
 Unexplained symptoms and signs
Has the patient given verbal consent for sharing medical information:
YES
NO
Patient signature here: ___________________________
Referring patient back to GP:
YES
NO
Correspondence required?
YES
NO
If Yes: Email/Post
Email address:
How to write a correspondence back to your GP:
Your clinic name & logo
Clinic address
Contact number
Your Qualifications
AAMT number
ABN number
Date:
Dear Dr GP,
Regarding: Patient’s name. DOB. Address
Thank you for referring this (lovely) patient for an opinion and management of
……(condition). I have the pleasure of meeting …(patient’s name) today. After
informed consent and explaining the nature of my work and services, …(patient)…
has agree upon having a treatment session today.
On history taking I noted, he/she has had…(condition) for….(period of time). When
examining him/her, my findings are as follows:
 Restriction of range of movement (take note of the degree)
 Tenderness upon passive or active movement (take note of scale 1-10)
 Patient’s general mood (depressed or anxious) – IF YOU ARE REALLY GOOD,
YOU CAN APPLY K10 TOOL HERE. GP and psychologists love using K10 to
assess patient’s wellbeing.
 (K10 can be found here:
http://www.beyondblue.org.au/index.aspx?link_id=89.678)
The goal of massage therapy is to…(improve quality of life and reducing symptoms),
my recommendations are as followed:
 Outline your treatment plan here
The patient has agreed upon having ….(how many sessions)… over (your
recommended period of time). At the end of the treatment sessions, your aim is to:
 Improvement of range of movement by…
 Improvement of pain by …
 Improvement of K10 (the lesser the value the better)
Should these symptoms and signs continue for more than after the treatment…. (let
say 4 weeks is a safe period) or if the patient develop acute changes, he/she will be
referred back to you as soon as possible.
Please feel free to contact me on…(tel.) or ..(email)… should you like to discuss the
patient’s condition or treatment plan.
Once again, thank you for your referral.
I will keep you informed in relation to this patient’s progress.
Thank you for your kind attention.
Yours sincerely,
An excellent Therapist