December 2001 Bulletin

Steady flow of referrals doesn’t come easy

Orthopaedists schedule patients quickly, fax follow-up reports, meet with referring staff

By Sandra Lee Breisch

In the good old days, it was easier to generate referrals. "Before managed care, orthopaedists would invite primary care doctors and other referring doctors out socially to cultivate a relationship for a referral basis," explains Laurie Ross, administrator, Atlantis Orthopaedics, West Palm Beach, Fla.

Because there are so many managed care products on the market, Ross says orthopaedists don’t know what primary care physician is on which plan. "Doctors don’t really have time to socialize with referring physicians," she says.

Because competition is stiff, even in a growing market, the practice still has to vie for patients. "The importance of generating and keeping new referrals is critical," says Ross.

To keep the referral stream flowing smoothly, Ross says the group’s four orthopaedists quickly schedule all referrals and provide referring physicians with follow-up reports and phone calls regarding those patients.

But orthopaedists alone cannot build rapport with referring practices.

The etiquette of an orthopaedist’s office staff with the staff of other referring practices is an important element in keeping the referral streams flowing and growing. "Whatever is the path of least resistance, they’ll [the patients] go," Ross stresses. "We let the primary care doctors and their office staff know they can refer patients to us without delay or conflict and get the patient a timely appointment. By doing this, they know our system works and our relationship is established."

To make sure Atlantis is a household name, Ross says their office staff regularly visits referring practices. "We give out chocolate business cards wrapped in cellulose that come in a little clear box so they don’t melt. A little red ribbon is wrapped around the box with our regular paper business card tucked into it," she explains. "It’s less costly than paying for dinners at a steak house. This personal touch is remembered as, ‘Let’s call that orthopaedist’s office with the chocolate business card.’"

How important are referrals from other physicians?

"Even in the busiest of practices, the referral by other physicians is critical to your reputation among your peers," says Stuart A. Hirsch, MD, who practices with four orthopaedists at BioSport Orthopaedics and Sports Medicine Associates, Bridgewater, N.J. "It just may be the most important grade we get."

In today’s complex patient referral patterns, orthopaedic practices need to be aware of the different methods patients use to access your practice, says Dr. Hirsch. "The two most important are referrals from physicians who know you and the patients who have been cared by you," he explains. "These are essentially the people who know you best and therefore who can respond to the quality of care that you provide and who can evaluate it."

To show appreciation for referrals, Dr. Hirsch says they also provide via fax a rapid consult response to requests. "We fax instead of mailing to eliminate any delays by the post office. Immediately after reviewing a consult report, we also use the faxes," he says. "We keep a list of referring physicians."

In addition to constantly evaluating important referral sources, Dr. Hirsch also sends a nurse or other support staff on a quarterly basis to visit referring offices. "We do this just to see if staff and referrals are getting through our office rapidly and easily, if they are having difficulty getting phone appointments and to learn about patient satisfaction from these major referral sources," he says.

It is essential that you keep everyone happy if you want to keep your practice growing, stresses Dr. Hirsch. "If another physician or staff member from a medical group takes the time to call my office, obviously he or she can always get the patient in," he explains. "But I want to know that those patients are getting the service they want and the referring doctors’ staff are finding the interface between their office and our office an easy and positive experience."

Some orthopaedic practices also keep a computer-generated list of referring physicians and those patients, hold routine meetings with referring offices and keep tabs on the percentage of referrals generated.


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