Editorial Board Forum: How Do You Optimize Referral Relationships?

Some cosmetic surgeons worry they will “lose patients” through referrals to colleagues in plastic surgery or dermatology, respectively. Is this a valid concern? To what extent are professional referrals important to your business?

Sachin Shridharani, MD: Although I can understand how one would be concerned, I feel referrals amongst colleagues need to be just that: “colleagues.” Anyone who “poaches” or “steals” your patient is not a colleague. Professional referrals are very important to my business. The world of aesthetics is vast, and it is very difficult to have every tool or skill set to care for patients. I routinely refer out to dermatologists and other surgeons who may do some of what I do, but specialize in something that I do not or something I do not love to do. Looking from a different lens, does the concierge at the Peninsula not give you the recommendation of a great place to have dinner even if it is not at the restaurant in the hotel? I feel like patients really appreciate the honesty and transparency of sending them to someone else who can help them with something I cannot. If the “colleague” I send them to steals the patient, then a.) they bit the hand that fed them and they won’t get another referral from me (which is a bigger loss for them than a single gain) and b.) the patient didn’t value my expertise, anyway, and is a better fit for that practice. Either way, we will be fine.

Robert Schwarcz, MD: Professional referrals are valued in my practice. I am very careful in my own practice to return the referred patients after surgery back to sender. While patients can be lost to referrals, as long as it is not a consistent pattern I do not find this to be an issue.

How do you approach making professional referrals and how do you maintain strong connections with your patients?

Dr. Schwarcz: I meet many referring doctors professionally while giving lectures at conferences or sharing a panel discussion or via introductions through colleagues or even patients.

Dr. Shridharani: First, I seek out colleagues who will do a great job for my patient. Their ability to deliver the outcome trumps everything, because I will also be judged by my patient based on who I recommend. Then, I reach out to their offices to see if I can get a few minutes on the phone to explain who I am, our practice’s mission, and why I would like to send them patients. If their staff does not organize the brief call, that’s a red flag. I’m not sending patients to an office where the staff will not even arrange a brief call to increase their patient base. If I speak to the colleague and they are a good fit based on the call and overall feel, then great. If not, I move on to someone who will appreciate more “business.” I welcome colleagues who reach out to even come on site to see my office to experience what their patient will when they walk into our office. Some colleagues have taken me up on this offer. Some thank me and say it’s not necessary. Some have turned into my patient.

I maintain strong connections with my patients by letting them know that I feel that this individual specializes in what they need and are better at it than I am. A little humility goes a long way.

What strategies have you found most useful for building referral relationships among professionals in your community?

Dr. Schwarcz: I believe the best referral relationships occur organically; they are met at conferences or there is a patient in common.

If you identified clear mismanagement by another physician, how would you address it?

Dr. Shridharani: I tell patients I was not there and do not know part of what transpired. Complications occur for a host of reasons and anyone who says they don’t have an adverse event is lying or not working hard enough. I’m certain they picked a doctor who they felt could help them and sorry they didn’t have the outcome they hoped for. But what’s done is done and I am here to help fix the issue. Never blame the other physician, because it could be your patient with a problem in someone else’s office next time.

Dr. Schwarcz: This is difficult. If I have a good relationship with that doctor I would call them and tactfully discuss the management. If the patient brought it to my attention and I do not know the doctor I am careful to not be judgmental and focus on how to improve the patient’s status—focus on the positive and making an impact in the care rather than the mismanagement.

Have you found effective strategies for building referrals from among your existing patients?

Dr. Schwarcz: Keeping patients happy and satisfied with the level of care is most important.