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Your Practice is Only as Valuable as Your Referral Base
By: Shaun Kirk

Many physical therapists in private practice have the appearance of a very successful business that is built on the backs of about four to five doctors. Now if anything would happen to any of these guys, the value of these practices would drop markedly. How can you run a practice for many years and then take a good look at it and realize that you have five doctors that represent more than 50% of the referral base? Exactly how can that happen? Well, it’s quite simple really. When you start your practice you have a couple doctors who kind of like you and offer to send you some patients. When the numbers are down and you’ve got to go out and stimulate more referrals, it sure is a lot easier to go and talk to the guys who already love you and are referring and try to get them to send more. If you’re very successful at doing just that, what ends up happening is the group of doctors that you’ve gone out and knocked on their doors and spoke to end up sending you quite a bit more. Well, that is always great provided that the doctors always love you, decide to never open their own practice, and do not die.

What if there was a way that you could broaden your referral base and get many doctors sending you a few new patients every month to create a more long term stability, so when one goes on vacation the stats don’t crash?

In order to understand how things work in regard to getting business and growing your practice, you have to take a good honest look at what does not work consistently with every private practice physical therapist. For example, we go out and knock on doors of the doctor’s offices when we don’t know the doctor and the doctor does not know us. We think that we are going to get this opportunity to sit down and talk to him and he will just be elated and send us droves and droves of new patients. Deep down we know that if the doctor doesn’t already love us he’s really not interested in talking to us, but yet we go out and do it anyway.

Now let’s draw a parallel to a vendor that comes in wanting to sell you some piece of equipment, say an e-stim machine. The guy comes in, he brings his device with him, and he sits in the waiting room and waits for you. You come out and say hello. You talk to him for a few minutes and you have no interest whatsoever in buying another e-stim machine. But instead of telling him you’re not interested, you’re polite and you ask a lot of questions about it. You ask how much it is and are their any kind of payment plans for it, etc. But you know you’re not going to buy it. Why? Well, one, you may not need it and two you may have a vendor you prefer to work with. But it’s somewhat rude to tell the guy to get lost. It’s the same thing with doctors. If you get an opportunity to meet with the doctor he or she most likely is not going to be rude with you. They’re going to ask questions like; "Tell me a little about your practice?" And you will go on explaining your philosophy and what kind of treatment that you do and all the letters after your name and what makes you better than anybody else. Have you ever noticed that when you’re talking he’s looking at his watch? He’s got his hand on the wall, leaning towards the door and yet you continue on. It’s the same kind of thing you do when the vendor starts talking to you about that e-stim machine. You say “Well, tell me a little about it.” And you look at your watch and you lean towards the door and you dart your eyes left and right towards other patients or other staff hoping that someone will bail you out. Doctors do the same thing. Hopefully we can see that.

There are exceptions to this of course. There are the doctors who know you and love you. They know your good work and know of your competence. Those guys you actually can go and sit down and talk to them and they will be interested in what you have to say because they know you’re good and they know you get results. Doctors who don’t know that will pretend to be interested in what you have to say.

Have you noticed that some doctors won’t meet with you unless you buy lunch for the entire office? That ought to tell you something. One, he’s not interested in speaking to you and two, neither is his staff. Quite honestly, you will have better results buying lunch for a doctor’s office that is referring to you, but you don’t stay. In other words, you purchased the lunch, you make sure it arrives, you make sure they know it came from you and you leave. At least the staff members who were sitting there eating will say something nice about you. Like “Wow, that’s pretty nice of that practice to swing by and buy us lunch.” You probably forced that practice to have a staff meeting. Which isn’t all bad. But if you stand up there and talk for 20-30 minutes about your practice and your philosophy and everything else, believe me, if it’s the kind of physician that requires a lunch in order to meet, the staff and the doctor have heard the story and the song and dance many times. In other words, if a doctor requires you to buy lunch for the entire staff in order to have a few minutes of his time, you’re wasting your money and your time.

Let me ask you a question. How do doctors who don’t know anything about you feel about you trying to educate them on patient conditions? Do they appreciate it? Do they heed your advice and do they welcome it? Probably not. Of course, your attention goes to the exception, Dr. Jones, who just knows that you’re the best guy in treating spine conditions in the state and he will listen to every word you have to say. All I’m talking about is the doctors that don’t know you. When the doctor says tell me a little about your practice, you start educating him about your philosophy of treatment, about how you treat a spine condition that is different than anybody else, or what different studies report, etc. And you’ll find that the guy who doesn’t already know that you’re the best in town will be kind of bothered by a physical therapist spouting off that they know everything. Now many physical therapists feel that they know a lot more than physicians do about physical therapy’s ability to help musculoskeletal conditions. They have to keep that to themselves. In actual fact, from the point of view of the doctors, they know more than the physical therapists do. PT’s don’t have to accept it to be true, but they do need to accept that it’s the doctor’s viewpoint when they talk to doctors.

It is because of this tendency of physical therapists and practice owners to want to educate doctors on their services, to want the doctors to know they’re the best physical therapists or clinicians in town, that they are not the one to go out and cold call doctors. The best person to go out and represent your practice is somebody who doesn’t know anything about how to treat somebody. Let me show you how it works. Let’s say that you’ve got this reputation for your spine rehab program, that people woo over it, that it’s well know to be the best in town. And somehow everyone knows. Then you have somebody who is a non-clinician go into their office and have a chance opportunity to meet with the doctor. The doctor says “Well I’ve been hearing an awful lot about your back rehab program. Can you tell me a little bit about it?” The non-clinician simply says, “Well doctor, I would love to tell you all about it, but in actual fact, what I notice is a patient comes in and they can’t even sit in the chair, they have to stand up and hold onto the back of the chair and then after a few treatments they’re walking out feeling great. I really don’t know how they do it. But all I know is that the program works.” Believe it or not that will create more interest, than if you would have told them how you treat and your philosophy and what techniques you use, etc. It has a bigger impact for him not to know exactly how you treat things. Try it, you’ll see. But again, the worst person to represent your practice is the physical therapist or practice owner.

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About The Author

Shaun Kirk is President and Co-Founder of Measurable Solutions Inc., a consulting firm engaged in all areas of business management. Measurable Solutions trains entrepreneurs and executives how to be consultants to their own businesses, so they not only can expand their own business but any business. With his partner, he has built the most rapidly expanding company of its kind in the world. Visit his website at www.measurablesolutions.com.

This article was posted on March 23, 2005

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