Physician Testimonials: The Referring Physician Experience.

A specialty practice depends in 25-40% on Referrals from Primary Care Physicians (PCP) yet most specialists do not consider Testimonials of these physicians

In 2009 HMCOE investigated why relationships between PCPs and specialists are deteriorating. In a follow up study we investigated how to improve those relationships. The following is a presentation of results from 298 interviews with Primary Care Physicians (PCPs) Some of the results are shocking, the others are rather disturbing:

• 45% of PCPs do not know who to refer to.
• 30% of PCPs relay the task of writing a referral to their secretaries.
• 2 of 3 cases, in that 75%, make referral decisions based on a directory listing, not expertise
• The secretaries will look up a directory listing or go on the patient’s insurance company’s website and search by zipcode. She will then give the list of 3-4 specialists directly to the patient and let the patient decide who to go to.
• 80% of PCPs have not met regional specialists in person.
• 72% of PCPs have not met regional specialists in at least 3 different therapeutic areas.
• 33% of PCPs report that referrals came back because the specialist no longer practices out of the office listed in the directory.
• 42% of PCPs have difficulty reaching specialists for consultations
• *important* 25% of PCPs who met specialists in person ALWAYS refer patients to them exclusively, whether out of network, in-network, for for a consultation

Physician Testimonials: The disturbing part:

• 81% of PCPs report being labeled as “the lesser folk”
• 20 % of PCPs refuse to have contact with specialists after years of not being able to reach them. They will send patients even to different regions or outside of insurance coverage to see someone they trust. 
• 95% of PCPs despise the “pharma rep” approach of introducing specialists. (Where a specialist office hires a liaison to go around the region to introduce the specialist) In a different study HMCOE reported that of every 1000 engagements with PCPs, only 120 representatives get beyond the secretary to see the doctor, and in 90% for less than 5 minutes. 
• 98% of PCPs say they never felt welcome during consultations 
• 67% of PCPs say they have been mistreated by at least 2 specialists within the last 6 months. 
• 75% report that specialists aggressively ask for referral during First consultation! 
• 80% report that specialists NEVER follow up after treating their patients. 
• *important* 33% of PCPs do not regard local specialists as Experts in their therapeutic areas.

The following tips on "how to improve PCP-Specialist interaction" are based on 240 Primary Care Physician Testimonials:

• Acknowledge the fact that a relationship with Primary Care Physicians counts for 40% of your business! Do you know any business that would say NO to that much revenue?
• Introduce Yourself! Pick up the phone and call.
• Attend a local Grand Rounds or community healthcare event. Bring your business cards. Feel free to participate and present your outcomes research, after all you are an expert, right?
• Update your listing in directories.
• Publish information on your medical website both for patients and healthcare providers. Publish information that speaks about your expertise.
• Build a patient and physician portal for instant and secure sharing of information.
• Make sure your phone works. Have a dedicated phone for consultations.
• Consultations are your way to earn trust. Don’t disappoint.
• A 10 minute consultation might not get you a referral all the time, but it certainly establishes your credibility in the PCP’s eyes … for LIFE!
• Make sure your secretary knows who you are and what you do.
• NEVER send someone to introduce you. You will lose the referring physician’s trust for a very long time.
• Invite yourself to visit the PCP at his office. Do you think a PCP wants to spend his lunch-time with the pharma rep?

• During your visit, Ask your PCP to review a few patients with you, as it pertains to your specialty. Give advice in a respectful manner. Propose a treatment algorithm for management of specific cases. Give a recommendation as to the perfect Time to make a referral.
• Propose steps in the management of cases. Educate them on trusting you to become a part of THEIR practice. Educate them on what a team effort means for the patient’s clinical outcomes. Share your results, your studies, demonstrate your expertise.
• Always, Always, ALWAYS follow up. Follow ups make or break your practice. Follow up with patients. Follow up with referring physicians. If you’re a surgeon, show pictures of before and after. Show what you have done. Share your expectations. Allow the PCP to feel welcome to treat the patient with you.
• Go back to recommendation nr 1: Acknowledge the fact that PCPs account for 40% of your business.
  As the Primary Care – Specialist relationships continue to decline, stand out from your competition as the only practitioner who believes in a team effort in ensuring the best standard of care for patients from the first point of contact to the end of their treatment.

Since establishing E- Medical Marketing, now known as Healthcare Marketing Center of Excellence, it’has been 8 years. Every few months I get a story in my email box talking about a doctor who sent patients to a specialist they’ve met a long time ago only to have them come back to the PCP saying that the specialist already passed away.

This is exactly why introductions are so important… because they’re memorable, and they last for LIFE.

40% of your business…. Do something about it. Do everything about it.