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The Clinical Coach: When Your Approach Fails
What to do when you are out of options?
Thomas Kauffman
September 05, 2025
,
It doesn’t always work out.
Your adjustments will stop being effective.
Your rehab will aggravate the area.
Your patient will get frustrated.
But it’s not your fault, and it’s not your patient’s fault either.
One of the most frustrating aspects in healthcare is not getting the results you want for your patients.
So, what do you do when all else fails?
You find a way. That’s part of your duty as a physician.
That means you’ll look into different treatments, which could include injections, invasive treatments and even the dreaded surgery.
Why? Because in the end it’s not really about what YOU want, but about the QUALITY OF LIFE your patient will have.
When we talk about our practice, we love to hear about how many surgeries we helped patients avoid. How they regained their independence with a few adjustments. How they completed their rehab and got rid of their chronic pain.
No one talks about the injections, invasive treatment and surgical consults they’ve recommended as holistic practitioners.
It would be viewed as a failure.
I would like to argue differently.
These recommendations don’t come lightly as a rehab chiropractor.
But they are part of your duty as a healthcare practitioner.
I would argue that knowing when to recommend these procedures in addition to your continued care makes you a better clinician than trying to prove your point with a specific technique/modality.
As of today I’ve recommended 16 invasive procedures. From cortisone injections, to surgical procedures. All have been wonderfully successful, with patients reporting less pain, improved function and better quality of life.
Did I fail my patients? Their continued support and referrals would like to say otherwise.
Who do you reach out to?
This was the MOST difficult part of the recommendation. Mostly because networking with other doctors is quite difficult as a chiropractor.
So here’s what I have done to find trusty doctors in different areas of expertise:
Reach out to all nearby MRI/X-ray centers and inquire about their new patient process from out of network doctors. Most MRI clinics will not deny imaging services for patients and may even set you up with your own portal access. (Less likely if its a big hospital network tho). Inquire about their doctors on staff, and who’d they recommend for XX procedures. Reach out to the doctor via e-mail and introduce yourself prior to sending them a patient.
Privately owned imaging clinics have their own onboarding reps - develop your relationship with them, and invite them to your clinic. This gives them an opportunity to bring any pamphlets, flyers, and other items to you and begin to develop an in person relationship. (Controlling when they come to your office is important, you don’t want them to arrive in between patients and rush the interactions).
Ask for clinician recommendations. I learned this from “browsing” the local facebook groups. These are hidden gems. Find a local facebook group and search for posts discussing doctor recommendations, or simply post yourself asking to network with other healthcare practitioners. It’s free, and demonstrate your interest in the community.
Ask for clinician recommendations from your patients. Specially if you are new to the area. Most of them have at least a PCP they trust.
Network with other chiropractors. Present yourself as an aid, not a competing doctor. I currently have three different chiropractic offices I recommend patients to for specific treatments (cold laser, table traction, pelvic floor rehab, and functional medicine). I’d argue that networking with other chiro’s usually goes bad as most new chiros present themselves as competition. Present yourself as a collaborator and you’ll be helping more patients live a healthier life.
Network outside of work. You don’t build a practice from inside your office. Unless you have a huge budget for marketing and advertisement. You network by meeting people in local events, after “work” activities, and weekend events. In other words, whether you are a small business owner, an IC, or an associate. You should always be networking. Keep cards with you at ALL times, and hand them out freely.
Now this is not the only way to network and to get in “good standing” with other practitioners. I’ve actually met two surgeons who’ve become great referring clinicians while out at dinner having a cigar…
Do I recommend you start smoking cigars… no. It’s just an example.
Until next time.
In health and strength,
Dr. Thomas Kauffman
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