Managing Your Practice

Four pillars of a successful practice: 3. Obtain and maintain physician referrals

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Here are 10 simple strategies you can use to increase referrals
to your practice


 

References

READ THE REST OF THE SERIES
Pillar 1: Keep your current patients happy (March 2013)
Dr. Baum describes his number one strategy to retain patients (Audiocast, March 2013)
Pillar 2: Attract new patients (May 2013)
Pillar 4: Motivate your staff (August 2013)

Discussions of medical marketing often begin with the three As: availability, affability, and affordability. But most physicians already think of themselves as available, likeable, and offering appropriately priced services.

How do you differentiate yourself from the competition?

Fancy stationery; a slick, three-color brochure; a catchy logo; and a Web site will not do the trick. In fact, these are the last things you need.

One of the biggest misconceptions about marketing is that, to do it well, you must spend lots of money on peripherals. In truth, there are many other actions that are far more effective and essential to marketing than merely polishing your public relations image. The most essential element of your marketing plan is to make your practice user-friendly.

Nowhere is this need greater than when it comes to working with colleagues who are capable of referring patients to you—or are already doing so. In this article, I describe 10 strategies you can use to enhance your relationships with referring physicians.

1. WRITE AN EFFECTIVE REFERRAL LETTER

To obtain referrals from your colleagues, you need to ensure that your name crosses their mind and desk as frequently as possible—and in a positive fashion.

If you interview referring physicians, you will find that prompt communication is one of the most important reasons they refer a patient to a particular provider. According to the Annals of Family Medicine , more than 50% of physicians state that effective communication is the reason they select a doctor for referral ( TABLE).1

How primary care physicians select a doctor for referral
Medical skill of the specialist 87.5%
Access to the practice and acceptance of insurance 59.0%
Previous experience with the specialist 59.2%
Quality of communication 52.5%
Board certification of the specialist 33.9%
Medical school, residency <1%

Source: Kinchen et al 1

Keep your referral letter short

The traditional referral letter is far too long, often 2 or 3 pages. It usually arrives 10 to 14 days after the patient was seen and is very expensive, costing a practice $12–$15 for each letter sent. The goal of an effective referral letter: Get it there before the patient returns to the primary care provider.

The key ingredients of an effective referral letter are:

  • diagnosis

  • medications you have prescribed for the patient

  • your treatment plan.

The referring doctor is not interested in the nuances of your history or physical exam. They just want the three ingredients listed above.

For example, let’s say that Dr. Bill Smith refers Jane Doe, who has an overactive bladder and cystocele. Her urinalysis is negative, so you prescribe an anticholinergic agent and schedule a follow-up visit in 1 month to check symptoms and to conduct a urodynamic study if she has not improved. Your letter to Dr. Smith would read as follows:

Now the letter can be faxed to the referring doctor, often before the patient leaves the office. That way you can be certain that the letter arrives before the patient calls the physician with questions or concerns.

This is the best way to keep the referring physician informed and to function as the captain of the patient’s health-care ship.

EHRs can smooth the referral process

Most electronic health records (EHRs) have the capability to fax the entire note to the referring physician. However, if you were to ask a referring physician if she would like to read your entire note, the answer would probably be “No.” Most EHRs will allow you to select fields that contain the diagnosis, medications prescribed, and the treatment plan. A sample of this kind of letter appears in the FIGURE.

2. MAKE AN EFFORT TO PERSONALLY MEET EVERY PHYSICIAN WHO REFERS A PATIENT

Not only that, but try to meet all new physicians in your area. It is important to coddle your existing sources of referrals, but don’t forget to reach out to new physicians to let them know about your areas of interest or expertise.

3. REFER YOUR NEW PATIENTS TO REFERRING PHYSICIANS

Don’t refer to the same colleagues time after time. If a doctor starts sending new patients your way, it’s in your best interest to “reverse-refer” when a patient needs a primary care doctor, endocrinologist, or cardiologist.

You can be sure these referring doctors will appreciate your recommendations.


Related Article Complex atypical endometrial hyperplasia: When to refer


4. CREATE A LUNCH-AND-LEARN PROGRAM

You want other offices and medical staffs to get to know your staff and to be familiar with what you do. There’s no better way than to create a lunch-and-learn program in your office and extend an invitation to other offices in the area. At the program, have all of the staff members introduce themselves. Provide a tour of your office and give a 3- to 5-minute lecture on areas of your gynecologic interest and expertise.

5. ACKNOWLEDGE THE ACCOMPLISHMENTS OF REFERRING PHYSICIANS AND THEIR FAMILIES

If you see that one of your referring physicians has received an honor or award, send him a congratulatory note. If her children have been recognized for academic or athletic achievement, acknowledge this accomplishment with a note. You can be sure it will be one of the only acknowledgments they receive and will be deeply appreciated.

6. SHARE INFORMATION WITH A NO-MEETING JOURNAL CLUB

It’s very difficult to keep up with the medical literature. It’s challenging enough to keep up with the literature in your own specialty, let alone articles appearing in other specialty publications. One of the nicest gestures you can make is to copy any article that may be of interest to your colleagues and send it to them. Include a sticky note indicating where you would like them to look so that they don’t have to read the entire article.

7. SHARE NONMEDICAL INFORMATION, TOO

Your colleagues will appreciate it when you share nonmedical information to let them know you are thinking of them even when you are not discussing patient care. For example, one of my colleagues collects fine pens. When I saw an article about a very expensive pen made with diamonds, I sent the story to my friend, suggesting that he tell his wife what was on his wish list.

8. KEEP THE REFERRING DOCTOR IN THE MEDICAL LOOP

If you are caring for a patient and plan to discharge her from the hospital, make sure that you or someone in your office contacts the referring doctor to inform him that the patient is being discharged so he doesn’t make unnecessary rounds. Other times to notify the referring doctor:

  • upon admission of her patient to the hospital

  • after surgery or a procedure

  • when you receive a significant laboratory or pathology report.

9. BE USER-FRIENDLY

If you perform gynecologic surgery on a referred patient, be sure to dictate a discharge summary. If the patient is to be discharged with gynecologic medications, give the patient their names in writing. Another convenience for the patient: Arrange your follow-up appointment on the same day she is to return to see the referring physician.

10. DON’T FORGET NONPHYSICIAN REFERRAL SOURCES

Nurses, pharmacists, pharmaceutical representatives, social workers, lawyers, beauticians, and manicurists—all of these professionals are likely to refer patients to you if you keep them in the loop.

11. BOTTOM LINE

You can build a practice by word of mouth by doing a great job of caring for patients, hoping that they will tell others about their positive experience. However, there are other opportunities to enhance your practice—notably, by nurturing your relationship with referring physicians. Try a few of these ideas and you will certainly see your referrals increase significantly.

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