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There are many different sources of referrals, so it is important to balance these contactsand not become too dependent on one source. Specialists will have a high percentage ofphysician referrals but should network with other health care professionals for additionalpatients. PCPs can expect to gain a large percentage of their referrals from satisfiedpatients. To encourage these referrals, special acknowledgement should be given,especially when multiple referrals come from the same source.

The first step in analyzing referrals is to obtain accurate data on your current referralpatterns. The information sheet that new patients are asked to complete should include aquestion about how they discovered your practice. If you are already recording thisinformation using a computer system, this data should be easy to extract. An alternativeis to have office staff ask new patients how they heard about your practice and record theinformation manually.

New patients that are referred to your practice by established patients is a positive sign.Patient referrals are usually a sign that patients feel comfortable with office staff andbelieve they are receiving high quality care from their physician. If you are not receivinga significant number of referrals from patients, consider surveying them to determinehow satisfied they are with the services your office provides. (See “Patient SatisfactionSurveys” below.) Office staff should be equipped to refer patients to your practice by carrying businesscards and distributing them to anyone who asks about the practice. In some practices,financial incentive programs or bonuses based on the number of individual referrals or onthe overall growth of the practice help to assure that office staff are promoting thepractice and its services. Incentive programs and bonuses should be reviewed by legalcounsel to ensure compliance with health care  laws, such as the anti-kickback statute.Reviewing referrals from other physicians, and the income generated by providingmedical care to these patients, is another area that should be closely evaluated. You maydiscover that some physicians only refer patients with particular health insurancecoverage. Discovering these trends, both positive and negative, and making attempts tochange the disadvantageous trends before they become widespread is worth the effort.

As you review the data from your practice, look at the number of new patients that youanticipated from your participation in particular health plans. Determine if the contractsyou signed are allowing patients to continue treatment that might have otherwise had toleave your practice. Also, determine if participation in these plans has altered the patternof your referrals to other physicians.

Local businesses may be another important source of referrals for your practice. You canencourage these referrals by providing services to one or more companies, such asemployment physicals or safety lectures, to encourage employees to visit your office foradditional treatment. Distributing a brochure about your practice to the human resourcesdepartment is also helpful to give your practice added visibility and explain the servicesthat you can offer new employees.

Patient Satisfaction SurveysMeasuring patient satisfaction is a process that should be carefully planned to includeboth the survey design and the implementation of system changes once the results aretabulated. Patient satisfaction surveys typically cover: access, communication betweenthe patient and office, courtesy and helpfulness of the office staff, and physician-patientinteraction. The physical environment of your office can play an important role in thesatisfaction of your patients as well. Asking patients about a few specific items mayencourage them to suggest other improvements for your practice.

Another way to assess patient satisfaction is to survey the patients who have left yourpractice to determine why they left. You could try contacting patients that ask to haverecords sent to another physician. If they are simply moving out of your area, which iscommon for many patients requesting records, you have an opportunity to wish them wellin their new location. If they are changing practices because of new health insurance thatyou do not cover, you might consider a new contract with this health plan.


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