"Your most important asset." That's what one healthcare marketing expert called a specialty physician's referral base, and he said way too many specialists are failing to nurture the relationship between their practice and the doctors who send them business.

 

"Forget about growing. What about protecting what you already have? Remember, your best referrers are the ones who are most sought-after by competing practices. The ones you rely on the most are the ones that the other guys want," said Stewart Gandolf, MBA, a founding partner of Healthcare Success Strategies, based in Irvine, Calif., with representatives in eight other states, including Florida and Louisiana.

 

"In some markets, it's really a competitive bloodbath," Gandolf said. In terms of the Southeast, he called relationship dynamics between primary-care physicians and specialists as "very political. … There's more of an establishment. It's everywhere, but in the Southeast in particular. That's even more reason why doctor referral marketing becomes important."

 

Larry Van Horn, PhD, faculty director for healthcare programs at the Vanderbilt University Owen Graduate School of Management, said the idea is "creating value" for the referring physician. "The last thing a primary-care physician wants is to refer one of his long-standing patients to a specialist and have them come back and say it was a bad experience," he said.

 

Van Horn said the effort on the specialist's part is two-fold: Providing the referred patient an exceptional service experience "on top of the clinical expertise," and providing timely information and service to the referring physician. Does the staff of a referring physician continually play phone tag with the specialist's staff at the other end to set up a patient appointment? Does the referring physician wait for days, even weeks, for a report about his or her patient from the specialist? Is the specialist inaccessible if the referring doctor has a question? If the answer to these or similar questions is "yes," then the specialist is flirting with disaster. The goal should be "streamlining the communication and outreach flow to primary-care docs with the express interest of being more service-oriented," Van Horn said.

 

From the patient perspective, service certainly is a marketing tool, as well. "In a world where incentives are changing and patients are going to get increasingly involved in the consumption and decision-making around specialty referrals, these service dimensions are actually quite important," Van Horn said. In many scenarios, it's all about the specialist's staff, both experts agreed, and customer-service training for receptionists, office managers, nurses and physicians themselves is a positive investment. A practice's staff is "one of the most tangible points of perceived care and empathy and engagement," Van Horn noted.

 

While specialists may want to believe that quality of care should be the only deciding factor, the ability to communicate quality-care delivery "can be a difficult proposition," Van Horn said.

 

"Referrals are not only about clinical expertise," Gandolf added. "They [specialists] would like to believe that it's about clinical expertise, but the reality is, success in this world comes down to relationships. Clinical skill is assumed; it's not enough." For many physicians, that's a tough pill to swallow, he acknowledged. In fact, he suggested that specialists ask themselves, "Are people referring to me begrudgingly or happily?"

 

According to research cited by Healthcare Success Strategies, 20 percent of doctors win 80 percent of referrals. What's more, most specialists would agree that 80 percent of their referrals are from just a handful of physicians. That's a precarious stance, Gandolf said.

 

And it's not a comfortable position for today's physicians, who aren't trained in marketing and don't relish the role of a sales person. Gandolf said that, much too often, he's helped practices that assumed their referral base was secure, only to have a new specialty provider – younger with up-to-the-minute training and a congenial bedside manner that prompts buzz – enter the market and gobble up referrals at an alarming rate. It's too late, then, for a specialist to call up a long-time referring doctor and schedule lunch or a Saturday morning 18 holes. "Then it seems insincere. It's much better to be proactive," he said. To do otherwise is depending on "happenstance and luck."

 

Specialists looking to build referrals must craft "an ongoing system" that administers several approaches, Gandolf said, adding, "You don't just go bumbling in. How do you do all this stuff without looking needy, cheesy, greedy or sleazy? Those are the subtle nuances."

 

Because most physicians and their existing staff members don't have the time, expertise and penchant for selling the practice, Gandolf recommended either contracting with a healthcare marketing professional or hiring one in-house if the size of the practice warrants such an investment. "Even though they think sales is a dirty word, they are looking for someone who can build relationships with other doctors and get the ball rolling between the practices," he explained.

 

Gandolf said one of the biggest challenges in working with his physician clients is helping them understand that a marketing professional is, in essence, a sales professional. "There are about 400 subspecialties within marketing – Web designers, copywriters, account managers, publicists, search-engine optimization experts, pay-per-click experts, graphic designers. Yet, when doctors say they're going to hire a marketing person, they assume that one person has all these skills. Those people don't exist," he said. What a practice needs to build referrals is someone who is skilled at the art of the "sophisticated sale," he explained. "They cost more, but they're worth it. As you can imagine, corporate America wants those people."