Whether you have just started practicing medicine, or you have been in practice for decades, your reputation and income often depend on reliable referral sources. Many of us physicians get spoiled and just “expect” to get a regular influx of patients from our colleagues every year. But we shouldn’t. We need to nurture these referral relationships. When you see the number of referrals decline or end from an individual referral source, try to figure out what may have motivated this. From a business perspective, you will be better off protecting your current referral relationships than wasting time scrounging around for hundreds of new referral sources. You will often be better off going out of your way to please your referring doctors than posting ads in papers and online for tens of thousands of dollars to attract random patients. Just one doctor may be the source of thousands of referrals a year. Losing the trust of that one busy doctor may be a far bigger blow to your bottom line than you can imagine. At DoctorCPR.com, we have polled over fifty doctors to come up with a list of reasons why you may be getting “dumped” by long time referral sources.
1. Patients Complain About You or Your Office to the Referring Doctor: If you and/or your office staff are rude on a consistent basis, patients can’t get an appointment for over a month, or the in-office wait times are just way too long, you may lose out to other doctors in your field who can provide a better office experience.
2. You Do Procedures that the Referring Doctors Want to Do: Be very careful! Don’t do any procedures on referred patients that your referring physicians do themselves. If you are unsure about whether they do a procedure, you must ask them first. For example, if a doctor (who is trained to do Botox) sends you a patient specifically to look at a rash, don’t evaluate the rash and do Botox on that patient as well. If your referring doctors do a procedure that their patient wants or needs, don’t take business away from them!
3. You Do Procedures that are Unnecessary or Could Harm the Patient. It goes without saying that you shouldn’t do unnecessary testing or procedures. Patients may not know whether or not these procedures are unnecessary, but other doctors in the community will know and they will find out. You will get a reputation for being a “money-grubber” or poorly trained (as you are unable to make clinical decisions without unnecessary work ups). If you are planning to do something off-label, experimental, or controversial, you should discuss this with your referral source first (even before discussing it with the patient).
4. You Fail to Communicate or are Inaccessible to Referring Doctors. You cannot send a note to referring physicians a month after seeing the patient and expect that to be acceptable. If the patient has a diagnosis or a treatment plan that the referring doctors should know about ASAP, make sure to call, text, or e-mail the doctors . You can also fax them a note the same week you saw the patient. Just communicate. That will demonstrate that you really care about your patients and your referring partners. Give your referral sources your cell phone number. Do not be stingy about that. That signifies that they are important to you. Respond to all of their texts within 24 hours. If they want to send you a same day emergency or have an after-hours patient with a problem—be available! Get their patients in to be seen right away.
5. You Stop Taking Insurance or Your Referring Doctors’ Patients Cannot Afford Your Fees. There’s not too much you can do about this. However, most of the time, going out-of-network with insurances will not lead to a complete loss of a referral source—particularly if you have a great reputation and a very high level of patient satisfaction.
6. You Send Patients to Other Doctors Whom Your Referring Doctor Doesn’t Know or Like. If an Internist has referred you a patient with severe joint pain for a Rheumatology evaluation and the patient also complains to you about constipation, do not send the patient to a Gastroenterologist for a constipation evaluation. Have the Internist make that referral. He may not like the Gastroenterologist you select or may want to treat the constipation himself.
7. Your Referring Doctors Join Hospital Networks, Retire, or Leave Town. Unfortunately, you don’t have much control over these circumstances. Don’t take all losses of referrals personally. Times are changing. Doctors are going bankrupt, burning out, opting-out of private practice, retiring early, and leaving cities that are over-saturated with too many providers. Now with a rapid expansion of hospital-employed physician groups, independent physician practice referral networks are being threatened.
Even if you have been getting steady referrals from one particular doctor for over a decade, don’t expect that relationship to persist on auto-pilot until you retire. The business of medicine is definitely more complex, and referral sources are free to change their relationships at any time. By paying more attention to the 7 influential factors mentioned in this article, you will be better prepared to safeguard many of your partnerships with other physicians and, in turn, reap great financial and personal rewards.
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