How To Get Referrals

Why Are Referrals So Hard?

It's always been true that referrals are the best new patients--they can arrive already 50% closed for your services.

If you're having difficulty obtaining referrals or are looking for a kickstart in that area, I believe you will find these 6 points not only helpful but indeed necessary for getting referrals.

Prescott Management

Deliver Excellent Service

Of first importance in acquiring referrals is, deliver excellent service. But mind you, this does not mean that you must spend an hour with each patient as if you get into that habit, you are limiting your future growth and the number of lives you can positively impact. If that amount of time is mandatory for the type of service you deliver, schedule a call with me, and I will be happy to cover it with you. But in any case, you will find this content helpful.

How one gets from excellent service to referrals is no significant mental jump, everyone knows that, right? But read on.

Let's take a look at what I mean by excellent service and come back to referrals. Excellent service means the patient feels he/she has received even more than what they paid for. I'm not talking about giving away free stuff, however.

The Actions and Mindset of You And Your Staff Count

Your actions and the way you deliver them add up to excellent service. Take it from when the patient walks in the door. Greet them with a smile and an intentional & honestly meant, "Nice to see you, Mrs. Jones." And what if Mrs. Jones is a crab apple? Well, is she actually trying to get better? Is she making gains? My point is to find something to like about her and then proceed with that mindset. If you think of Mrs. Jones as a crab apple, that thought will influence ALL of your interactions with Mrs. Jones.

Correct mindset for your entire office

Adopt the attitude that every patient you have knows others that need and want the same kind of gains that they are experiencing due to your service. This mindset alone will significantly assist you in obtaining referrals.

Talk & listen to The Patient

When you are talking with the patient, actually speak with the Patient. Meaning have your attention on the patient that is before you at that moment. Don't allow your mind to wander off onto other things. Think about it for a minute. Every one of us has had this happen. Your attention drifts onto billing or lunch or whatever, and the patient has said something to you while you were mentally elsewhere. This leads to inappropriate responses, no responses, etc. Now the patient may not mention it to you, but I assure you they notice it.

Appropriate Bedside Manner

When you have treated the patient and want them to remain on the adjusting table for a min or two before getting up, place your hand on their back and tell them something like, "All right, Mrs. Johnson, I believe that should help make your day a little better; I am so glad to see the improvements you are making. Just lie here for a couple of minutes and then get up slowly. Susie will schedule you for your next visit at the front desk, ok?" And do not remove your hand until they have responded. Adjust your actions to fit the specific situation. Naturally, with a patient that does not like being touched, respect that but still put the communication in right then and there.

Why would I say to do this? This action communicates to the patient: You are important. Your gains are seen and appreciated. Well done, etc.

Notice And Acknowledge Their Gains

When Mrs. Jones gets to the front desk, it could be you at the front desk same difference. Susie schedules them for their next visit with a smile and handles them appropriately.

 Maybe they feel they have had some improvement and are hopeful..., as can be the case early on in treatment; "Mrs. Jones, you are a member of the team now, and we are going to see that you achieve your goals, thank you for making your appointments. The doctor will see you next Wednesday at 3:00, ok?" Be sure and get the patient's acknowledgment. Remember to look at the patient as you are saying this.

Every Member Of Your Staff Must Agree With And Act Upon This Type Of Thinking

These are the first foundational things to get moving on. These actions will cultivate a clientele that genuinely enjoys being in your office and refers others.

Is There More To This?

Indeed, keep reading it gets better.

Pulling Referrals

Ok, once you get steps 1-6 going in your practice, you can begin reaping the fruits of your labor.

First a Quick Review of The Steps

Deliver excellent service.

The actions and mindset of you and your staff count.

The mindset is, every patient knows others that want the same type of gains.

Talk & listen to the patient.

Appropriate bedside manner.

Notice and acknowledge their gains

Bonus step—Every member of your staff must agree with and act upon this type of thinking.

If you have begun implementing these points, you will have noticed a few things

1) You are having more productive interactions with your patients.

2) Your staff are experiencing the same thing.

3) You and your team are becoming a better-coordinated unit.

4) Your patients are enjoying their visits more and are likely having more gains.

5) You have created an environment conducive to referrals.

What's causing this?

With the points above, you are establishing policy. Policy is powerful and necessary for success--I covered that point a bit more in an email, "What Phase 2 Really is," But it's not the point of this blog.

Example of Pulling a Referral

Now that we have covered the groundwork that makes the playing field, it’s time to play the game. “Ready Break” (football talk for let’s approach the line of scrimmage!)

Here comes Mrs. Jones

Mrs. Jones, is making gains, loves being in your office, and enjoys the staff. After her treatment, she says how well she is doing, etc. It can go like this:

You: "Wow, Mrs. Jones, that is so wonderful to hear; it really makes my day. Hey, who do you know that should be in here having the same type of gains that you are?"

(Then let her answer. She may have someone in mind right at that moment).

Mrs. Jones: "Nelly Johnson." she has such bad lower back problems, but I'm not sure how to tell her; you know I don't want to be a meddler..."

You: "I completely understand Mrs. Jones, but we have made that part easy for you; just hand Nelly this coupon for a no-charge consultation and report of findings. Have her call this number on the back here."

Mrs. Jones: "I suppose I could do that."

You: "Great, when do you next see Nelly?"

Mrs. Jones: "Tomorrow morning."

You: "Will you remember to give this to her then?"

Mrs. Jones: "Yep, I'm gonna do it."

You: "OK, let's help Nelly get rid of her back pain. Let's see you are back in on Thursday, right?"

Mrs. Jones: "Yep, that's my next appointment."

You: "Great, if Nelly hasn't called in by then, I will check with you on how it went with her."

Mrs. Jones: "OK, I sure hope she does call and come in. She needs to do something effective about this."

You: "Me too, Mrs. Jones, that's the whole reason we are here."

There are many variations on this primary line, such as the patient can't think of anyone. Help jog their memory, "What family member is always complaining about headaches, back pain, joint pain, migraines, body problems.... This puts their attention on it and up pops John at the meat counter in the local market or something, "Well, no family member but John at the market is always telling me about how being on his feet all day causes him problems...." And you are off to the races.

On Hiring Employees

Hiring employees can be a love/hate relationship.

At least I use to feel that way about it. All entrepreneurs go through this, and as you can see by its definition, it can be an adventure. If you have been in business for any length of time, you know exactly what I mean.

If you are experiencing hiring pains, feel free to get your copy of Seven Steps to Hiring Great Staff Click here for the 7-Steps

Before Hiring Don’t Forget the Basics

Of course, there are the Administrative Basics to consider:

1) Have your records & system for reporting to IRS, State and local agencies as applicable. This would include I-9 forms, payroll method, workplace posters, etc.

2) Running a background check which seems to be becoming more common these days.

An Often-Missed Pre-Hiring Step

Now that you are set with the paperwork, you can turn your attention to who you are looking for to do what. This can be more important than you think. I well recall writing an ad for a receptionist many years ago. I expected it would pull in many good candidates; I had had good success doing this already, so naturally, the only attention required of me was simply writing the ad and getting it run in the local paper, right?

Wrong. I did get about eight responders to my ad, but to my shocking surprise, not one of them was remotely qualified. It was a head-scratcher until I examined my actions leading up to running my ad. I discovered that in the past, I had always started my ad writing process by naming out precisely who I was looking for; I guess these days, they call that an avatar, but whatever you call it, it is essential.

Literally Describe Who You Are Looking For

What I mean by that is to spell out who you are looking for. For a receptionist, it might go something like this:

"My receptionist is relatively young mid 20's to early '30s. He/she loves to multitask and is a "people person." They love helping others, are great with kids, are punctual, and getting the job done completely is important to them."

In my incredibly time-wasting flop, I had utterly skipped this step. My ad was good; I knew it was good. What I had written before worked, and the ad that bombed was very similar to my earlier ads. So my failure pulled down to the lack of naming an avatar.

I went back to the drawing board, listed out precisely who I was looking for to do what, wrote and placed the ad, and pow, qualified applicants again began coming in. 

This might strike you as, "right, no way, voodoo..." I don't know, but whatever it is, it works, so skip doing this at your peril!

How Important is getting it right?

There’s nothing like a good story to get the point across, and luckily I have many of them to draw upon. This one on hiring starts off rather alarmingly, but I promise you it does end well.

It was all going so well!

The names have been changed to… well, just because.

My phone rang, “Hello, this is Dr. Prescott.” “Hi, Dr. Prescott, this is Nancy; we have a call scheduled for today.” “Hi Nancy, I was just about to call you, but it looks like you beat me to it. Yes, and I think you have questions on hiring staff, right?” Oh God, it’s more than that, but yes, definitely how to hire staff and also how to let staff go that just aren’t doing their job! I don’t have an employee handbook, and frankly, a friend of mine put the fear of God into me on that subject. I can’t afford to have my practice shuttered, it’s my livelihood, and I am afraid of losing it!

“Whoa, take a deep breath, and let’s start at the start. I bet it’s going to be easier and less stressful than you think. So, tell me how you got into this situation, so that I can get a full understanding.”

She continued, “Only six months ago, I was a new chiropractor right out of school, boards passed and ready to get started. I had set aside enough money over the years to rent a space for a few months so I could get on my feet and be independent. I had known I would do this since I was twelve.

“My friend, Susan, had been a part of the plan for a good while. She was a natural as a Receptionist and Office Manager and agreed to work with me for a small amount as we grew and then begin earning more as we became more successful.

“It was going great; we were acquiring patients, and they loved my adjustments. We got friends and family, then word of mouth, and Susan, being a natural talker, talked it up everywhere she went; dinner, school, the gym, you name it. In two months, we were seeing 100 patient visits; in six months, they hit 235 with just the two of us. It was my dream come true.

“But then, did I mention that Susan’s husband was in the Army? Well, he is, and you guessed it, he got transferred. They had to pack and leave in two weeks; she was excited as it meant advancement for her husband and I was excited and happy for the both of them while at the same time being sad because I knew what I was losing.

“No problem, we thought. We had done the hard part establishing and growing a successful practice. We would simply find a great qualified replacement for Susan, and all would be right, right?

Hiring the wrong person can have a recoil effect

“We began looking for a replacement right away. Neither of us had ever had to do hiring before, but it was an employer’s market, so we figured how hard could it be? We put an ad on Craig’s List and were flooded by resumes in only a couple of days.

“We sorted the resumes and set aside the three-best based on education, experience & work record. You know, like getting three bids from different contractors when you are having fixtures put in your office. We called them in one by one for interviews. All three showed up for their interviews at their appointed times, Jade, Frank, and Molly. We thought that meant they weren’t flakes. All three said the right things, looked good and presented themselves well—you know, “I’m a people person that loves helping people, I am very trainable and have nothing but good things to say about my last job, believe in being punctual and staying till the job is done, etc.

“It was a tough decision, but we ended up hiring Frank; it boiled down to the fact that he had more experience in a chiropractic office. Susan had four days left before leaving town and spent those days showing Frank what to do and how to do it. Frank's first day alone in the position was a Friday; all seemed to go pretty well.

She Should have used the 7 steps

“The next week a couple of patients mentioned how the office felt different with Susan gone. Well, of course, but wasn’t that natural? Then a couple of weeks later, I got complaints about Frank not doing reminder calls. Various other complaints followed that; the most alarming was telling a patient they could not reschedule their visit for any reason. I can assure you Susan never taught him that! Then there was the steady decline of patient visits, not to mention new patients. Frank couldn’t get a new patient if they threw themselves at him!

“So I called a meeting with Frank to right the ship. Wow, what an eye-opener! What the heck happened to the Frank we interviewed? I’m telling you he has turned into a completely different person in a few months. I can’t afford to keep him, and I can’t afford to fire him, not because I can’t handle the work by myself at this point, I mean my patient visits are so low; what am I going to do?”

Hiring Questions get asked

An aside here: Nothing had happened to Frank. It was just now she had the “Real Frank”, not the “Friendly Frank” façade he put on for the interview. With a bit of questioning, it was clear that Frank had undisclosed baggage. He “knew” how to run a chiropractic office. Sure the last office he was at had gone out of business, but that had nothing to do with him, right?

So, what did we do? I helped her let Frank go without getting herself into any kind of wrongful termination trouble and then helped her find the correct replacement for Susan. How we did it is contained in my publication “Seven Steps to Hiring Great Staff”. You can click here to get a copy of that.

What Statistics Really Are

What are statistics in reality? They are a representation of complex and multiple actions that when combined, result in some desired production represented in two dimensions so you can SEE THEM. In Bob’s case (see my last bog), patient visits. Think for a minute, what does it take to achieve a patient visit? Really break that down. Do they just walk in and you say, “Hi Jane, good to see you. I’ll adjust you and then you will come back when you feel you need to.” If that were true you would not be reading this, right? Now get this. All those actions you just thought about are represented in that two-dimensional graph. That graph comes to useful life only through what you know.

Back to the golden rule

Now back to that golden rule: statistics are caused, they don’t just happen. Getting a little clearer for you now? What were the actions it took to achieve a Patient Visit in Bob’s office? What were the actions surrounding that activity? When did the decline begin? Who was involved at the time? What was happening at the time?

Statistics do not lie and have no emotion

Another fact: Statistics honestly kept DO NOT LIE AND HAVE NO EMOTION. So, when you are looking at a mountain range graph like Bob’s patient visit graph was and you are told that all the usual actions are being done, you can bet there is some false report happening. That doesn’t say it is an intentional false report, but it does say something is amiss.

Watch your stats and follow what you know

So were Bob to have been versed in Managing by Statistics way back when his Patient Visits statistic began going down and not responding to his efforts to correct it; he would have inspected the actions that resulted in Patient Visits. This would have, as surely as gravity keeps you from flying off into space, drawn him to the cancellation policy and led him right to a valid question of his emotional staff member, “What patients have said they do not like the cancelation policy?” The answer to that question would inevitably be one or two out of 200. And that would have been the end of the cancellation of the cancellation policy. Remember statistics do not just happen, they are caused. Statistics represent complex action in a form that is easily seen. They require your understanding of the actions behind them to be of any use, and statistics take the emotion out of the picture. I personally view managing by statistics as sanity on paper.

There you have it

So there you have it, the saga of Bob’s statistical roller coaster ride and its solution. I hope you have found this helpful and something you can put to use in your practice. Is there more to know on the subject? Well, yes but I have been at it for years and was not born knowing this stuff any more than you were. I learned it through study, trial and error, and being just like Bob now and again.