Gastroenterologists, if you want great referrals, treat your referring providers well!

referring providers

I often see gastroenterologists struggle in the early days of trying to build their clinical practice.  One thing that GI physicians often fail to learn, to their detriment, is that they are dependent on referrals from referring providers for their business.  

I used the term “referring provider” deliberately in the title because it’s important to treat P.A.s and N.P.s well, not just physicians.  

At academic medical centers, where most physicians train, there’s no financial or business incentive to treat referring providers well.  Having worked as a generalist and a specialist, I’ve seen from both sides how the specialists often treat referring providers very poorly, even to the point of verbal abuse.

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When you train or practice at an academic center, you’re paid on salary, and the demand for your services dramatically outpaces your capacity to provide them.  Thus, even the most boorish specialists will have a busy practice in most academic centers.  From a financial perspective, it doesn’t matter how poorly they treat referring providers – they’ll still get plenty of referrals.  

Once you get into private practice, it’s a very different story.  Referring providers have choices, and they want to send their patients to the best specialists who will care for them, respect them, and help the referring providers manage their patients effectively.

How can you provide exceptional service to earn the business of your referring providers?

Provide exceptional patient care

Be the best gastroenterologist you can be!  This probably seems obvious, but I’m amazed at how many physicians discount the importance of this step.  

I used to work in a very small town with only three other gastroenterologists in the whole county.  Two of those physicians had reputations for being “scoping factories” where they would do as many procedures as possible to maximize revenue but most of those procedures weren’t needed.  

Patients left their offices and came to my practice in droves because we built a reputation for clinical excellence.  Keep up with your continuing medical education so you’re up to date on the latest developments in medicine.  

I remember a hospital I once worked for was trying to hire a second gastroenterologist to keep up with the demand for GI services.  We were desperate to hire someone because of how many referrals we were having to turn away.  

We only got one application, and it was from a physician who had a reputation for poor clinical care and a lousy bedside manner.  As desperate as we were, we didn’t hire him!  We wanted good physicians, not just anyone with a stethoscope.  Your referring providers demand the same.

So, be excellent!

Provide exceptional customer service

Have you ever been to a restaurant based on seeing a funny television commercial or hearing some advertisement?  If you went to the restaurant and it didn’t live up to the hype, you probably never went back, right?  

It’s the same with your clinical practice.  If you have the best marketing anywhere and you get people pouring through your doors only to experience long waiting room times, minimal interaction with the physician, and poor customer service, you’ll never see them again.  

You have to ensure that the care and service you provide your patients is better than anyone else’s.  Referring providers may initially send you patients because of your marketing efforts, but they won’t continue unless you are taking excellent care of their patients.  

Train your staff to be friendly and to greet everyone with a smile.  Have training days to coach people on how to give great customer service.  Publicly praise and reward staff members that you notice making concerted efforts in this arena.  

Work with your staff to maximize your efficiency.  Nothing drives people crazier than getting into a tiny exam room and then waiting an hour for you to arrive.  

Patients will have after-hours questions about how to do their bowel prep correctly and whether labs are fasting or non-fasting.  You need a mechanism in place to deal with those calls.

If you can’t figure out how to make yourself more efficient, hire a consultant to come in and audit your practice to suggest ways to improve efficiency.  You should also check out my article entitled, “9 hacks to increase your clinical efficiency immediately.”  

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Be a teacher for your patients and referring providers

If people in your community, especially local referring providers, see you as the leading expert in your area, you’ll get the majority of their referrals.  One way to accomplish this is to offer to give 30-60 minute learning sessions for physician’s offices, local community groups, and educational institutions.  

Offer your speaking services for free, recognizing that you’re getting 30-60 minutes of uninterrupted time to prove yourself to be a leader in your field.  If you can teach something of value to your local community, they’ll repay by seeking you to be their physician.

For example, as a gastroenterologist, you could call all the primary care offices in your local area and offer to teach their staff and providers a free one hour lecture entitled, “A GI Primer for Primary Care: 10 Pearls for Managing Common GI Complaints.”  

No one in private practice gets to benefit from that kind of personal attention from specialists, so you’ll stand out from the crowd by offering it. 

Who do you think the family medicine team will refer patients to: the gastroenterologist they’ve seen on a billboard ad or the one who came to give a high-impact one hour lecture that made everyone on their team a little better at caring for their patients?  

Also, teach your patients about their disease and treatment so they understand their care plan.  I can’t tell you how many times a patient told me, “You’re the only doctor who ever explained my disease to me in a way I could understand.”  

Your patients will love you for that, and they’ll report that back to their referring providers.  The referring providers will be motivated to send you more patients.

Communicate well

Don’t just treat the patient and send them back to their primary care provider.  Let the referring provider know what’s going on.  Send a letter or make a phone call to tell the referring provider what’s going on with their patient and what their plan of care is.  

Referring providers don’t want to be blindsided by an issue that their patient raises but about which they’ve been told nothing.  A personal note or phone call is always appreciated.  Generating a customized letter is something most good electronic health record systems should be able to easily do for you.

Help referring providers with their most difficult cases

The difficult patient

Every practice has a few patients that are overly anxious, overly demanding, or just plain rude.  A substantial percentage of our IBS patients fall into this category. 

If you can make the referring providers’ life easier by helping these patients understand and come to terms with their disease and treatment plan, they’ll love you!

The difficult disease

Primary care providers depend on specialists to take care of the hardest and most complex specialty cases.  Don’t just “turf” those folks back to the referring providers.  Spend the extra time to figure out these cases and treat them effectively.  

Investing this time is the right thing to do from a patient care standpoint. However, it will also pay big dividends in goodwill from referring providers.

The difficult outcome

When I diagnose a patient with colon cancer, I make a personal phone call to the referring provider.  They care a lot about their patients, so they really appreciate knowing what’s going on when there’s a bad outcome with one of them.

Final thoughts

You could read all of this and form an impression that treating referring providers well is smart from a business model standpoint.  While that’s true, more importantly it’s just the right thing to do.  

Your business depends on outside referrals.  So, you will struggle to grow your practice if you don’t focus on making your referring providers’ jobs easier.  They want to take care of their patients, and you’re in a position to help them do that.  

Ultimately, the strategies we’ve outlined here will be good for you and good for the referring providers.  Most importantly, the strategies will be good for your patients.

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Further Reading

Please leave a comment below.   If you’re a gastroenterologist, tell us what you do that helps you earn the business of your referring provider.  If you’re a referring provider, let us know what you expect from your gastroenterologists.

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Comments (2)

  • S. Dharan Kumar, MD

    Thanks for writing an excellent article. I especially liked the part of being a teacher for your patients/providers.

    My program director during fellowship would remark about the the 3 A’s of being an excellent private practice specialist: Ability, Affability, and Availability. Only after starting in private practice did I realize how spot on he was with his advice.

    As a GI, I have a weekly “satellite” clinic in an office of mainly PCPs. I really enjoy going to this office because if gives me a chance to interact with these docs on a personal basis, and not just over the phone or through the EMR. I also find patient care and satisfaction is greatly improved when I go to this clinic. If a specialist has an opportunity to do part of their outpatient work at a PCP clinic, I would highly encourage it!

    • I love the “satellite clinic” idea!! What a neat concept! I had never thought of something like that. I’ll be the primary docs really appreciate having you there to bounce ideas off of you.

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