Building a Referral Relationship With a Sports MD
Most of the practice-development advice handed to chiropractic students about referral relationships is some version of "drop off business cards at clinics." It's well-intentioned, almost completely useless, and a reliable way to get a polite nod and zero referrals. This post is for the students rotating through Boreal Spine & Sport this spring — the ones already thinking about how a serious sport-focused practice gets built — and for early-career colleagues asking the same question.
Building a referral relationship with a sports medicine physician takes months, sometimes a year or more, and follows a specific arc. Here's what's actually worked.
The relationship is patient-mediated, not clinician-mediated
The single most important thing to understand: sports MDs in Winnipeg, like sports MDs everywhere, do not care about your business card. They care about how their patients describe what happens in your office.
The first cohort of patients you see who were referred by a particular physician — even informally, even one or two — is the most important cohort of your career. If those patients come back to the referring physician saying the assessment was thorough, the plan was clear, the communication was respectful, and they're getting better, the referrer notices. If those same patients come back saying the visits were short, the explanations vague, or they're being asked to come three times a week indefinitely, the referrer also notices. There's no shortcut around this part.
Communicate every time
For every patient referred from a physician, every patient with an active medical workup, and every patient where a co-managed condition is in play, send a clinical note. Not a marketing letter. A clinical note. Subjective, objective, assessment, plan, with concrete details about what was found, what was done, and what the next steps are.
This sounds basic. The reason it's worth emphasizing is that the absence of clinical communication is one of the most common complaints sports MDs have about chiropractic practice. The bar to clear is not high. Clearing it differentiates you immediately.
If imaging is being considered, copy the physician. If the patient isn't progressing, copy the physician with a clear reasoning note about why and what's changing in the plan. If a red flag emerges, the referral letter goes that day, not the following week.
Be willing to send patients back
The fastest way to lose a sports MD's confidence is to hold onto patients who aren't improving. The fastest way to earn it is to send them back at the right time, with a clear note explaining what's been tried, what has and hasn't responded, and what we'd like the physician to consider next — imaging, injection, surgical consultation, or another diagnostic step.
This is the regional-interdependence principle applied to professional practice: you're not the whole answer for every patient, and acting like you are is what damages the relationship. Knowing where your scope ends and saying so cleanly is one of the most underrated practice habits in this profession.
Show up — but don't waste their time
An in-person visit to a sports medicine clinic, scheduled at a time that works for them, with a clear purpose — usually to discuss a specific co-managed case — is far more useful than a drop-by. Bring the imaging, bring your assessment, bring a question. Walk out in fifteen minutes. Repeat once a quarter or so as cases warrant.
The goal of these visits isn't to "build awareness." It's to build a working clinical dialogue around real patients. The first one is awkward. The fifth one is a colleague conversation.
Stay in your lane on what you do well
The strongest position from which to build a referral relationship is one of clarity about what you do and don't do. We're a rehab-focused practice that uses manipulation as one tool inside a structured plan, with a movement-system assessment lens (SFMA, FMS) and an emphasis on graded loading. We don't do open-ended maintenance schedules, we don't do passive modality stacks, and we don't position ourselves as primary diagnosticians for non-musculoskeletal complaints. Saying that clearly to a referring physician on the first conversation removes ambiguity. Ambiguity is what stops referrals.
Year-one realism
In a typical first year, expect a handful of physician referrals — not dozens. The relationship is built case-by-case. By year two or three, if the patient experience and the communication have been consistent, the volume builds in a way that compounds. There's no marketing version of this that works. The clinical work is the marketing.
This pattern is consistent with what's described in the broader literature on inter-professional referral networks: trust between disciplines is built on observed clinical behavior over time, not on credentials or proximity1,2.
For the students rotating through this month
If you take one thing from this post, let it be that the work you do for the patient on the table is the same work that builds your future referral network. The two aren't separate channels. The patient leaves the office, talks about the visit, and that conversation either makes future referrals more likely or less likely. There's no version of the practice in which the clinical quality and the practice growth are independent variables.
The slow version of this is the only version that works. The fast version doesn't exist.
References
- Boon HS, Mior SA, Barnsley J, Ashbury FD, Haig R. The difference between integration and collaboration in patient care: results from key informant interviews working in multi-professional health care teams. J Manipulative Physiol Ther. 2009;32(9):715–722.
- Mior S, Wong J, Sutton D, et al. Understanding patient profiles and characteristics of current chiropractic practice: a cross-sectional Ontario Chiropractic Observation and Analysis STudy (O-COAST). BMJ Open. 2019;9(8):e029851.
Author: Dr. Michael Minenna D.C., B.Sc., SFMA, FMS — Boreal Spine & Sport, Winnipeg, Manitoba.