We have seen a slowdown in our production, as I am sure a lot of offices have recently. Ours is not catastrophic, but it has slowed down. We are trying to figure out trends or issues internally that can possibly lead to increased production. We try all the stuff from internal marketing, recapturing lost production, advertising, anything and everything that could benefit the office. My friend told me about a little "misadventure" that he had trying similar ideas.
He had heard from another office about their wonderful referral program. Here is how it works. You give the referral cards to patients, staff, any old stranger. The cards state that with the referral card and completion and payment for specific treatment (in our case comprehensive exam and full mouth series of radiographs) the referring person and the patient will each receive a gift (in this case, a gift card to a local store). Supposedly it works great for new patients at the other office.
I called my friend up to get more info and this is what I heard. Let's call him "Dentsit Close Call." He told me they were so excited to try it. After a few weeks, it was going well. He said he soon realized one of his patients sells dental insurance and he was getting a boatload of patients from her. So, in reality, she should have been getting lots of gift cards. He started thinking that maybe there could be a problem here.
He knew he had a great office that every patient would love because they would receive high quality care and his intentions were pure and good. He started to think that possibly an outsider could see this as a “kick-back” to the insurance agent for selling policies and referring patients to his office. There could be a real conflict of interest. He has always tried to stay above board and keep things as ethical as possible. He obsesses over this sort of stuff with me and even told me he was awarded the Student Award for Ethics his senior year in dental school.
Dr. Close Call told me he started getting very concerned and talked to another coleague. He said his friend agreed with him, understood his point, and would be equally as concerned. He decided to look at the American Dental Association Code of Ethics. There is a section dealing with referrals and it is a little unclear but this definitely can be viewed as not “kosher.”
Dr. Close Call called a lawyer with his state’s ADA affiliate. He explained to the attorney the situation and what his concerns were, and the attorney dropped the bomb. He told him not only is it against the ADA Code of Ethics, but it is against the law! SAY WHAT?! The attorney explained that even though most dental offices have good intentions, a law was established making it illegal to give anyone a monetary benefit for referring patients. Part of it stems from when all the MRI centers were popping up all over the country. The MRI centers would pay MDs money for sending them patients. Well of course some dumb @$$ took advantage and starting sending people that really did not need an MRI. Poof, a new law.
Dr. Close Call totally understand the intent of the law and what the problem is. The lawyer tokd him that the District Attorney is not running around trying to bust dental offices, but it could still be viewed as possibly illegal in his home state. The attorney also said he knows lots of offices that are doing similar programs. What makes his situation unique is that there is a state certified insurance agent getting what could be viewed as kick-backs, and it would just take one person to complain to the state insurance commission and an entire can of worms (or what I would think could be a can of “whoop @$$”) could be opened up. Dr. Close Call became concerned about possibly paying attorneys to defend him, and this would not fall under malpractice, so it would all be on him. Just trying to do a nice thing, and look what happens. Needless to say, my buddy, Dr. Close Call, told me his referal program has been stopped.
He said the attorney did state that you could reward patients for “loyalty” with gifts as long as it was not specified as a gift for specific patient referrals.
There cannot be any “quid pro quo” system. It is all about the wording.
With issues like these, there is a big advantage to being in organized dentistry and having access to an attorney to answer these sorts of questions. Also, having open lines of communication that allow you to call a colleague or friend to run ideas by and get feedback is beneficial. This time it really helped us. I think this is also what this blog does as well. We continue to learn more and more about issues running an office that do not involve teeth directly.
The next time we decide to borrow a great idea from a buddy, I will call and discuss it with them - and I might run it by an attorney to save myself some future anxiety.
Hope this helps someone else out.
Have a great day!