After 11 years of hard work, physical therapist "Richard" had built a busy, successful practice, thriving even with other PTs competing for patients in his urban area. Competitors are a fact of life, Richard reasoned, even though some were former employees with whom he'd worked side-by-side, for years, in some cases. An aging but still active population seemed certain to create enough business for he and his competitors to prosper. He saw no cause for concern until he was blindsided by orthopedic surgeons offering physical therapy in their own practices.

Physician-owned physical therapy services (POPTS) have seized the lead in marketing themselves—and they've got deep pockets backing them up. These competitors aren't being mean-spirited—they're just smart businesspeople. They want to enhance their revenue, secure the future of their practice, and work smarter, not harder—the same things you want.

There was a happy ending for Richard. He began to proactively attract new professional referrals and is now rebuilding his practice. In fact, he may even be better off. He adjusted to the new market reality and is prospering, even with more POPTS competing with him. The good news is, you can do the same thing.

Keep Your Current Referrers Fiercely Loyal

If you're losing current referrers as fast as you're gaining new ones, you've got to stop the hemorrhaging. Here are a few key techniques to help keep your current referrers fiercely loyal to you while you add new ones.

Deliver Exceptional Treatment to Referrers' Patients
First, no doubt you have assured referrers that any patients they refer to your office will be top priorities to you and your staff, and that they will of course receive excellent care.

Make sure you deliver on that promise. When a key referrer's patient calls your office, make time to see him or her promptly, even if you're booked up, and do it at whatever time works best for the patient. Listen to them. Thank them for coming, and make sure your staff does the same. Remember, that patient is going to report back to the referring physician on their experience in your office, and if you give a referrer's patients a less-than-perfect experience, you are making your referrer look bad, too.

Survey Your Referrers
Are your referrers happy with you? Ask them. Survey your referrers. It's like making any relationship work: Communication matters so that small problems don't turn into big ones. Are your reports being received on a timely basis? Are their patients satisfied with their experience in your office? What can you do to improve? By asking, you are showing referrers how much you value their patients and the relationship. Their feedback will help you improve your relationships with all your referrers, too.

Thoughtful Thanks Go a Long Way
We all like to be thanked, so thank your referrers often. An occasional note or periodic lunch works well, but consider something nicer for your "A"-list referrers. Baseball tickets, a trip to a spa, a gift certificate to their favorite restaurant. Don't know? Find out. As always, make sure gifts conform to local professional guidelines.

Yes, building referrals takes time and effort. Consider designating a staff member to handle it, or hire someone so you can keep seeing patients.

Tap Your Gold Mine by Asking Your Existing Patients

"Me, ask for referrals? I can't do that. I'd look desperate, needy, and greedy. Sleazy, even. No way. Besides, I don't need to ask for referrals. I'm good at what I do. That's enough, isn't it?" Does this sound like you? If so, you're not alone. Many practice owners view asking for referrals with the same relish as a root canal—something to be avoided at all costs.

If that sounds like you too, there is good news. Asking your patients for referrals in a completely natural way, without ever sounding pushy or "sales-y," can easily be done. It's all in the scripting. Write down, word for word, exactly how you'll ask patients for referrals. Don't worry—patients usually ask certain questions that give you the perfect opening, so you can bring it up in a natural way.

Stay alert for any compliment you may receive from a patient. For example, if a patient says, "My knee feels so much better!," that's your cue to say something like, "I'm very happy to hear that, Mrs. Smith. And should you hear of any friends or family who could use the same good care, we'd be delighted to have them as patients."

Next, rehearse with your staff. Treat your staff members as patients, and try different ways of asking them for referrals. Test several approaches. You may feel a little foolish doing this, but the payoff for a smooth, relaxed presentation is a growing flow of referrals—the lifeblood of your practice. Your staff will learn, too. Plus, they won't mind the chance to give you a hard time! (Good-naturedly, of course. They'll respect your courage and be flattered that you involved them.)

Above all, relax. Remember that when you ask for referrals, you're not some guy with a "will work for referrals" sign, standing on an exit ramp. You are offering to help your patients' family, friends, and associates. You're holding out the benefits of superb health and the wonderful feeling of well-being that comes with it. Take a deep breath, muster your courage, and ask your patients for referrals. You'll be surprised at how many are eager to send referrals to you.

OK, Now How Do I Get New Referrers?

You're not going to like the answer. Go and ask them. Not by letter, not by phone. Visit their practices and ask, "Who is getting your shoulders and knees, your spinal cases, etc.?" Never knock a competitor, even if you know that competitor is incompetent. Instead, say something nice about them, then add an extra benefit that you offer. For example, "Happy Joints Physical Therapy? They do a great job. We do exactly what they do, but we also (add your benefit here)." Maybe you have two PTs working with each patient, for example. Highlight whatever makes you unique—it's a great chance to differentiate your practice from your competition.

There's a bedrock principle of marketing: Ask for the order. "Dr. Smith, when do you think I can treat one of your [case type] patients?" Notice this question is not answered with a "yes" or "no." Make a promise, too. You can't guarantee results, but you can promise their patient will have a pleasant experience in your office.

The answer could be anything from "No," to "You know, I have someone close to your office who doesn't like to drive too far. Maybe you could help them."

Was the physician out when you visited? Find out when he or she arrives for work or takes lunch. Work smarter, not harder next time.

The secret to success is, keep pounding the pavement. Shake off rejection and go back, over and over again. The most successful PTs drum up referrals by being tenacious. It's too bad that the others get 90% of the way there and then quit just before their efforts would have paid off.

There are still plenty of potential new referrers for you to contact. Use a few simple strategies, and you can pull in plenty of new referrals.

Boost Your Referrals Without Spending a Cent. Here's How …

Turn your own staff into raving fans of your practice. Your staff has a stake in your success, and they're in a great position to create happy patients who will refer their friends and family members.

Here are some good ways to get your staff on board:

1. Make sure they understand your goals, your visions for the practice, and any promotions you have running. You never want this to happen:
   Caller: "Hey, I saw your ad."
   Staff member: "What ad?"
   Keep your staff informed. They're a potent tool for you to attract more patients and referrals.

2. Hold regular staff meetings. People like to be in the loop. When you give them information, they feel valued, and that feeling converts to wanting to do more for you, to help you do better, and to gain you more referrals.

3. Educate staff on fielding phone calls. Script specific responses and have staff members practice them, word for word, until they're second nature. Staffers can work in some of their own language later, of course, so it sounds natural, which is important. We've all heard phone calls from salespeople who were obviously reading from a script. We've all probably hung up without buying anything, too.

4. Your staff should be educated and scripted in how to overcome objections on the telephone, and they need to know how to promote the practice without sounding "sales-y."

Offer Group Rewards
Try to avoid incentivizing your staff individually, which tends to pit employees against one another. Instead, incentivize them as a group. Set a benchmark based on your practice's history. Tell your staff, "If we book X additional appointments, everybody gets Y."

Treating Staff Members as Patients
Are your staff members also your patients? Treat a staff member for free, and it'll pay off. Imagine having staff members tell patients and prospects things like, "Dr. Smith cured my shoulder in 2 days! He's great!" This is marketing gold. Staff members should become patients of yours as soon as possible.

The Payoff

Enthusiastic staff members who treat patients with respect, understanding, and courtesy help create ambassadors for your practice. Satisfied patients, in effect, go to work for you, selling the benefits and advantages of going to your practice to their family, friends, and associates. It's like dropping a pebble in a pool. With every patient or prospect who has a pleasant experience with your staff, you send a ripple of goodwill out into the community … a ripple that will come back to your practice in the form of more referrals, enhanced patient retention, improved phone and case-conversion rates, and an outstanding reputation for you with the public.

David Forbes is senior marketing writer for Practice Builders, a private-practice health care marketing firm in Orange, Calif. He can be reached at , or (800) 679-1262.