Marketing Your Practice

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Build Your Referral Base Efficiency, Accessibility Keys to Happy

Referral Relations

by: Bob Keaveney

When he left his medical group late in 2002, anesthesiologist

Schneider knew he was simplifying his life in one respect and

complicating it in another.

Schneider's wife is an emergency room physician who works a lot of

nights and weekends, so he wanted to be home more. Quitting his

hospital-based group in Southern California accomplished that.

But it also forced Schneider to find his own referrals; he decided to

market himself as a " doctor's doctor, " pinch-hitting for colleagues

at hospitals and outpatient surgical centers in his area, picking up

work per diem where he could while maintaining control of his

lifestyle and schedule.

" I definitely had to get my name out there in the community, "

Schneider says.

He leveraged his contacts with his colleagues at his former group by

picking up some work for them, talked to surgeons he knew, applied

for privileges at several area hospitals, and in some cases cold-

called surgical centers to offer his services.

" Basically it was a matter of using people I knew, and then expanding

my network, " he recalls. " It was networking and marketing, and trying

to identify a need and how I can best meet that need. Like anything,

the best way to do things is to know someone who knows someone who

can vouch for you — who can say, 'Yeah, he's a good guy, he gets

along with nurses and patients, and he gets the job done.' "

But it was more than just marketing that helped Schneider succeed.

Realizing that per diem physicians sometimes have a reputation as

somewhat less than committed, he was determined to become known as

different. He wanted to be treated as " part of the team " during his

time on a job, and in turn he would work as diligently as if he were

there full time.

" That's what people are looking for, " he says. " When you act like you

want to come in and be part of the team, it really goes over well —

that you're willing to do whatever it takes. "

Schneider's willingness to extend himself and his commitment to

quality are the two fundamental elements to building and maintaining

a solid referral base, according to physicians who make and get large

numbers of referrals, as well as practice management experts.

Clever marketing tricks are fine, but physicians who get the most

referrals are known more than anything for efficient business

practices, a friendly and courteous staff, and good patient relations.

Say hello

When family physician Crow was starting out, he spent two

months walking the halls of the large medical office building he

works in, visiting colleagues, introducing himself, and talking about

himself and his practice style.

" Just fostering relationships, " he recalls. " 'Here's who I am, here's

where I come from, who my family is, what would you like to know

about me? I'm going to offer these services and if I can help y'all

out in any way, let me know.' "

Now that his practice in Plano, Texas, is established and refers a

lot of its own patients, Crow says he expects new specialists to

extend him the same courtesy of a personal greeting. He won't refer

patients to a physician he's never met, or one who hasn't made an

effort to establish a relationship with him.

" I want them to come to my office and say, 'I'm the new doctor in

town,' " Crow says. " I don't want their representative; I don't want

their office manager. I want them personally to just stop by and say

hello. A new gastroenterologist might want to say, 'Hey, y'all want

to go to lunch?' It's worth it to that GI, because we refer a lot of

colon screens, and we want to know whom we're referring to. "

Urologist Neil Baum makes it a point to introduce himself to any new

doctor who arrives in his medical office building in New Orleans. He

offers any help he can and drops off some materials: information

about his practice, a couple of articles he's written on practice

management (including one titled, " 10 Things to Do on Your First Day

in Practice " ), and an oversized Rolodex card with his group name and

number — " We're a urology practice, so the card is yellow, " Baum says.

" I tell them, 'Hey, I know printers, I know software people who might

be helpful,' " Baum says. " I invite them to come over to my office to

meet my staff. "

At Crow's medical office building, there are specialists who say

hello in the halls or sit down to lunch with him in the cafeteria,

and those who don't. The ones who barely acknowledge him when they

pass by, or who always load up a tray of food to go, don't get his

patients, and they're the ones " you hear rumors about how they're

struggling to make it, " he says.

" Hey, if you don't care enough to say hello to me in the hall or talk

to me, if you don't want our business, that's no big deal, " Crow

reasons. " We'll refer to someone else. "

Efficiency and courtesy

Of course, all the friendly welcomes and lunchtime chit-chats in the

world won't keep your referring physicians happy if you fail to

communicate with them promptly about their patients or don't treat

patients with respect. That's why office efficiency is probably the

most important aspect of maintaining good relationships with

referring doctors.

" Nothing irritates referring doctors more than to have a patient come

back to their office without having heard anything from the

specialist to whom the patient was sent, " says Baum, whose policy is

to fax a letter to referring physicians the same day he sees their

patient, thanking them for the referral and indicating the diagnosis,

medication, and treatment plan he's following. He also sends

referring physicians whatever educational materials he sends home

with patients, so their regular doctors will know what their patients

are reading.

All that's fine, says Crow, but if the specialist is proposing

surgery or another major procedure, a big medication change, or a

treatment that might significantly, even if temporarily, change a

patient's lifestyle, he'd like to get a telephone call, too.

Good office efficiency is essential to keeping patients happy — and

keeping patients happy is essential to keeping referring physicians

satisfied. The most successful specialists maintain same-day

scheduling policies that allow them to see a patient whose doctor

says needs immediate attention, according to consultant Vicky

Bradford, PhD.

Successful specialists don't keep patients waiting long when they

have an appointment, she adds, and they and their staffs are

courteous and welcoming.

" Patients who go to a specialist are there because they have

something their primary-care physician needed assistance with;

usually, they're in fairly acute conditions, " says Bradford. " And

anybody who is in that situation health-wise is very vulnerable, and

most of the time very frightened. It's important for the specialist

to remember that. Even brief encounters a surgeon has with a patient

before surgery — just the memory the patient has of that interaction

really goes a long way to their understanding of how they were

treated, because they have no idea, clinically, how they were

treated. But they know whether that physician was comforting,

friendly, and made them feel as though they were in good hands. "

And patients will, naturally, tell their primary-care physicians

about their experiences with specialists. (Indeed, most better

primary-care doctors will ask.) One complaint won't likely lose a

specialist his referral source, but several will.

" Step one is having a personal relationship with other doctors, " says

Crow. " Step two is having a staff, a business plan, and a way of

running your office that is accommodating to patients I send over.

You have to have both. I won't refer to anyone I don't have a

relationship with, or anyone whose office isn't accommodating to my

patients. "

Do the extras

There are some other ways to keep yourself on the minds of referring

doctors.

Baum tries to do little things to indicate he remembers the nonwork-

related conversations he's had with his referring physicians. He saw

a book on fly-fishing at an airport bookstore, and picked it up for a

physician who'd mentioned it was his hobby. He cut out an interesting

article on the University of Notre Dame for a doctor who happened to

be an alumnus. Instead of sending a generic wine-and-cheese basket

during the holidays, Baum sends more useful items; one year he

purchased personalized luggage tags for all his big referrers.

" Everyone said, 'That's the coolest thing; we think of you every time

we travel,' " Baum recalls. " So I try to find unique ways to keep my

name in front of referrers in a positive way — including things that

let them know I'm thinking about them, even when I'm not eyeball-to-

eyeball with one of their patients. "

Be careful with little gifts, though. While some specialists swear by

them, many primary-care physicians say they'd rather not have them.

If you do send them out, try to make them relevant to the physicians

and practices they're going to, so that they know you had them in

mind. Generic trinkets can be turn-offs.

Position yourself as an expert in your field by holding seminars or

grand rounds at local hospitals, especially on topics patients are

probably asking their primary care physicians about. When Baum does

grand rounds, he always creates a Power Point presentation and sends

the slides to any of his referring physicians who didn't show up. He

includes a note: " Sorry you couldn't attend, but I thought you might

be interested .... "

Open your office occasionally for luncheons with your biggest

referrers, during which you can spend a few minutes talking about a

new service you're offering. Or go to their office to talk about a

condition that more patients seem to be asking about.

Finally, always include staff — theirs and yours. Your office

managers can talk about ways they can work together while you talk to

the doctors.

In Summary

Developing good referral sources and maintaining positive

relationships with referring physicians is a function of personality,

marketing, office efficiency, and staff. Here are some tips:

• Make a point to greet personally new physicians who come into

your community or medical office building. Offer to help them as they

get their practices set up.

• Be friendly. Say hello to your colleagues as you pass them in

the hall. Sit with them in the cafeteria or doctors' lounge. Ask

about their families and hobbies.

• Communicate promptly with physicians who refer a patient to

you, regarding your diagnosis and treatment plan, and whatever

medications you're prescribing. Send a note as soon as possible, and

follow up with a phone call when appropriate.

• Hold yourself out as an expert. Give seminars and grand

rounds at your local hospital. Hold luncheons at your office with

your big referrers, where you can discuss new treatments and services

in your field.

For more information on this please contact:

Bill Cassell

Medical Software Consultant

Fax:

bcassell@...

You can also email me with any topics that would like more info on

and I will be glad to reply to you.

Best wishes,

bill

Bill Cassell

medpracticeflow.com

Medical Software Consultant

Toll Free:

Tel:

Fax:

email: bcassell@...

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