Physician Relations: Referral Barriers and How to Move Beyond Them

By:?Kriss Barlow, RN, MBA?|?[email protected]

Remember the time when you shared information about a service with a doctor and they loved your idea? It’s happened to most of us one or two times!

More often, the path to a referral is not fast, easy nor straight. Maybe that’s our job security, but only if we can figure out how to move beyond the barriers. Various challenges can slow the success of a referral relationship. Can you identify your most common one? Let’s tackle a couple.

They Don’t Listen: We’ve all had a “conversation” that is really just us talking to the other party. Every part of their body language says they are not listening and that they don’t really care about what we are saying. Do you just keep talking and hope something sticks? In the quiet of our office, we know that it’s our job to engage the audience. So, start with them. Ask a couple of questions to learn about their interest in your planned topic…“Dr. Smith, can I ask a couple of questions about sports needs of your high school patients?”?With a positive response, ask another to better qualify the conversation and zero in on type of sports or age of the athletes she sees. If the response feels like a dead end, shift to another clinical area. While there may be a time and place to educate on a topic that is not of interest, it’s rarely in your first minutes of engagement. The goal is conversation and that requires mutual interest. The great liaison comes prepared with questions to engage so it’s not a battle for attention; the attention is a result of their interest.

They’re Set with My Competition:?Classic indifference is more common in liaison work than we’d like. The indifferent prospect has no perceived need for your product and the reason is generally because they are satisfied with your competitor. The first challenge is simply getting them to engage in a conversation. If you’re not prepared, these attempted conversations generally don’t go well, so do your homework. Know their practice and referral patterns and consider your best product/service for their needs. I’ve had some success with a patient focused discussion. For example, “Dr. Doe, I know that because of our location, from time to time your patients seek heart care at our facility. My visit today is to make sure you are comfortable with our team of interventional cardiologists.” These prospects are slow to move, but if your service is a match for a patient or provides a differentiated niche service, it’s worth the journey. Offer calculated ideas, get them talking and you can earn a patient. From one, the goal is more!

They Say They Are Decisionmakers, but… Referrals sometimes stall because while the referral coordinator, APP or other physician says they make referral decisions, it’s not that simple. Do they only have the authority to work within a select list of providers? Maybe their part to make the actual referral call once the doctor selects the desired referring physician. Perhaps leadership is closely monitoring out- of-network numbers. Until you understand how referrals really work inside the practice and for each individual referral source, it’s a guessing game to determine the path to success. Good research questions should be asked with each visit to create a clear picture of the process. Spreading out questions moves you out of the interrogation role while still providing a clear picture. One idea for the referral coordinator might be,?“I assume you’re making the appointments when a newly diagnosed cancer patient needs to be referred to a surgeon. Can you share more about that process?”?This assumptive question allows them to confirm what you believe to be a standard approach for acute referrals. It also sets you up to learn more about those referrals the referral coordinator personally owns.

When it all goes perfectly, this job is a piece of cake, but we’re light on those cake days! Every day earning of new referrals is tough. It requires good understanding of the process and the barriers by referral source. Skills matter! The bottom line is that if we can’t create the right relationship with the decisionmaker, we’ll visit, likely form relationships, but we will not advance the relationship toward a referral. What’s slowing you down?