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Building Physician and Patient Referrals

Richard L. Reece, MD

February 15, 2001
Commentary

At one time, building a referral base was relatively easy. It was a personal process that involved being available, accessible, and amiable. Managed care has changed the process, however. To build and maintain referrals today, a physician still must be available, accessible, and amiable, but he or she must also be board-certified, be in the health plan referral panel, and have a physician profile demonstrating cost-consciousness.

Being selected or rejected for the referral panel may be based on inaccessible physician comparison data, such as cost per patient, average number of procedures and tests ordered, referral rate, average length of stay of patients, adherence to the requirements of the Health Plan Employer Data and Information Set, and patient satisfaction.

Cogs in the Machinery

In the eyes of patients and peers, being a so-called good doctor may no longer be enough to attract referrals. In the mid-1980s, Richard Frey, MD, a Minneapolis internist, commented on managed care growth in the Twin Cities, “It doesn’t matter anymore if you are a good doctor. In fact, good doctors may be punished for being thorough and meticulous.” Shortly after making that statement, Frey left practice in frustration, and accepted a management position.

Three years ago, Harper’s magazine published an article critical of managed care, “The Doctor Is Not In: On the Managed Failure of Managed Care,” by Ronald Glasser, MD, another Minneapolis physician. Glasser wrote that under managed care, physicians are merely interchangeable cogs in the managed care machinery.
While such attitudes may be common, there are, nevertheless, several techniques physicians can use to attract more referrals. Neil Baum, MD, a urologist in New Orleans, who writes a column on marketing for Practice Options, believes physicians need to focus on pleasing referring doctors. To ....

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