Issue 3 - March 2004

Don’t ask, guide!
This 5-step formula will improve your referral requests
How to finance your wellness center
By David Singer, DC

We all know our patients should be referring
to us, because we know they have friends and family who need our care. So why doesn’t each of our patients bring in friends and family members who would benefit from chiropractic care?

Shyness and ignorance are the two biggest barriers that keep patients from making referrals: Some patients are shy about giving other people healthcare advice. And many are also unaware of the broad spectrum of health conditions that can be improved through chiropractic care.

The point of view of these patients may be limited by their own experience. In other words, patients who come to you for low back pain may not think about referring anyone with a problem other than low back pain. Without your guidance, they will not make referrals to your practice.

Consequently, if you directly ask these patients to hand out cards or to refer friends, you will probably be disappointed in the results.

For example, do you think this dialogue will result in referrals?

Doctor: Hi, Dale. How have you been feeling?

Patient: Better, thanks.

Doctor: Listen, I would like to give you some of my cards to give out to your friends, okay?

Or how about this one?

Doctor: Chiropractic has helped you a lot, right?

Patient: Yeah, it has.

Doctor: Well, here are some of my business cards. I would like you to send in some people that you know chiropractic can help, okay?

Neither one of these dialogues is likely to result in an increase in your patient volume. In the first dialogue, the doctor assumes the patient sees the link between chiropractic and feeling better. And in the second conversation, the doctor burdens the patient with diagnosing health problems! Although the patient may accept the cards, he or she will probably not give them out.

Asking for a referral takes planning, practice and persuasive verbal skills. Essentially it is a five-step process:

1. Identify good referral candidates among your patients.

2. Improve their understanding about the scope of chiropractic.

3. Get agreement on the value of chiropractic.

4. Guide the patient into making referrals.

5. Document and follow up.

Working the steps

Listing steps is easier than actually asking for referrals. Here is an illustration of putting the steps into action:

1Select your referral patients. Not every patient initially is a referral source. Pick patients who are doing well and who have experienced a considerable improvement in their conditions since they started receiving care from you.

2Increase the patient’s understanding about chiropractic. Don’t assume that the patient has a full understanding about chiropractic and why you do adjustments. Use the following dialogue between a doctor and a patient who has been coming to the clinic for treatment of headaches as a script:

Doctor: I would like to ask you a question: Do you know why I adjust your spine?

Patient: Well… to make my headaches go away.

Doctor: Yes, that’s right. We do it to help end your pain, but also to correct the subluxation that is the cause of irritation to your nervous system that leads to malfunction. Now let me ask you another question. Do you know why I check your entire spine and give you adjustments, even when you have no symptoms?

Patient: I’m not sure.

Doctor: Here’s why I adjust areas where you do not currently have complaints: Those nerves in your lower back go to your kidneys, your bladder and your legs. Although you have no symptoms in those areas, I don’t think we should wait until you do. I think we should be preventing future problems, not waiting for them to show up.

Do you understand why I would feel everyone should have his or her spine checked by a chiropractor? Because I believe that everyone would be healthier if they had their spines checked and any problems corrected.
(At this point in the visit, give this patient his adjustment.)

3Get agreement on the value of chiropractic. After the adjustment, pick up the thread of the referral conversation again. Help the patient see the value of chiropractic for conditions other than his by reviewing a list of health conditions that chiropractic can help:

Doctor: Do you remember how you used to suffer with your headaches when you first came to see me?

Patient: Yes, I do.

Doctor: Do you remember how bad it would get?

Patient: Yes, I would be in a lot of pain and I was really irritable.
Doctor: That’s right, and how are you feeling now?
Patient: Much better.

Doctor: Would you then say that natural healthcare has helped you?

Patient: Definitely.

Doctor: That’s great. I would like to ask you a question: Do you think there are other people in our town who suffer a lot with headaches, arthritis pain, fatigue, carpal tunnel syndrome, hormonal problems or other types of pain or health problems who could use our help but just don’t know what we do?

Patient: Yes, you’re right.

Doctor: Well, I’d like to ask you a favor. My purpose is to help as many people as possible get well and stay healthy without needless drugs. Think about who you know locally who has a health problem such as sinus troubles, allergies, carpal tunnel syndrome, fatigue, allergies or headaches that we could send some information to. (Show a brochure.) This brochure explains why natural healthcare works.

4Guide the patient into making referrals. In the next step, you’re going to “close” for the name of the person they feel chiropractic can help.

Although everyone knows somebody who can benefit from chiropractic care, some patients need to be prodded and guided to come up with names of referrals.

Ask questions to jog the patient’s thinking of who suffers from problems that natural healthcare could help. You don’t want to badger the patient, but you do want to find out if there is anyone you can help.

Here’s how you do it:

Doctor: So, is there someone you can think of who has a health problem and would like to feel better that we can mail this information to?

Patient: Not really.

Doctor: Well, let me ask you if there’s someone you live with that maybe has a health problem … such as sinus problems, allergies, hormone problems, arthritis, headaches or fatigue? Your wife or kids?

Patient: No, they’re in good health. Really — they don’t have any problems.

Doctor: What about your relatives — your mom, dad, siblings, aunts, uncles, cousins?

Patient: They don’t live locally.

Doctor: I see. No one that lives locally has a problem?

Patient: That’s right. At least, not that I can think of.

Doctor: Well, let me ask you this: How about a neighbor, someone where you work, a friend, someone like that who may have a problem or appears to have a problem?

Patient: Well, there is this guy in the neighborhood who has bad knees.
Do you treat knees?

Doctor: Absolutely. Do you think he would like to get rid of that problem?
Patient: Well, yes, he’s been going to doctors for years but I haven’t seen him get any help for it yet.

Doctor: What’s his name?

Patient: Bob.
(Now you need to cultivate this referral to get the person’s full name, perceived health condition and the relationship to the patient.)

Doctor: Would you be willing to help me help your neighbor?

Patient: Sure, but what would you want me to do?

Doctor: Basically all you need to do is tell Bob how well you’ve done since receiving care, ask him for his phone number and let him know the office will call him to schedule a free consultation. Could you do that?

Patient: Sure, I could handle that.

Doctor: Great! Let’s go see Barbara at the front desk and tell her about Bob. We’ll keep an eye on this to see if we can help your neighbor!

5Record and follow up. After getting the referral information from your patient, make a record of the referral, the problem and contact information and then follow up.

And be sure to thank your referring patient for his help.

This is the core of a procedure that can build a strong referral activity in a practice. Rehearse these steps with your staff or even your friends until you are comfortable with the sequence.

Dr. David Singer is the CEO of David Singer Enterprises, a company that offers an honest and ethical approach to building a practice, delivered through seminars, one-on-one consulting and products. For information on seminars and other services, call 800-326-1797 or visit the website at www.davidsingerenterprises.com.