Contemporary thinking about the impact of physician referrals on the REI practice tends to be polar. On one end, MD/DO referrals are responsible for the lion’s share of new patients. On the other, MD Referrals are dead and everyone finds their practice on the internet. Bent to their extremes, each pole is factually incorrect.
These are the facts as produced by a 2020 Fertility Bridge survey of over 250 REI patients from across the United States
60% of REI patients are referred by a physician
That’s a lot, but it’s far from 100%
21% of REI patients say their MD referral was the most influential factor in choosing their REI
That’s the #1 slot, but 21% is far from a majority, and it’s almost neck and neck with location (20%) and recommendation from a friend or relative (19%)
While it is remiss to favor a referring provider strategy to the exclusion of all others, it’s equally irresponsible to forgo a system for reliably growing and nurturing referrals and relationships. In order to sustain and grow referrals, your Referring Provider Strategy is built from six pillars.
Reporting
Ancillary Services
Content
Events
Outreach
Referral Follow-Through
By systemizing these six pillars, IVF centers are able to grow and sustain referrals without always adding the overhead of an additional physician liaison.
1. Reporting
Reporting is the first pillar of the referring provider system because time and money are wasted whenever it isn’t correctly established. Three key performance indicators measure your referring provider efforts.
New Patient Volume
Number of Referrals
Total referrals-EMR
% of attribution-patient reporting
If your practice or your goals for growth aren’t large enough to do much outreach, then you only need to measure these two KPIs. Before you put substantial effort and resources into outreach, however, you must report on activity and results across these six categories.
It’s important to consider both practice groups and individual providers for two reasons.
Your top referring physicians may not be accounted for in your top referring practices
If you have served a provider’s patients very well, the earned trust can readily leverage a relationship with their partner
If 60% of patients are referred to your practice by a physician, that means 40% are not. But 100% of pregnant patients are sent back to a physician for OB care. Therefore, a powerful way to focus your target list is to look at the OBGYNs to whom you’ve returned pregnant patients but have not referred to you.
Roughly 25% of physicians that provide OB care for fertility patients are never recorded as a “referral” in most IVF centers’ systems. However, if they’ve heard good things from your graduated patients, and seen the results of your care, they have reason to engage you.
Activity is recorded in a CRM. Results are recorded in the EMR.
2. Ancillary Services
30% of patients that see your practice for a referral Semen Analysis or Hysterosalpingography, will return within one year for a fertility consult. SAs and HSGs are not just useful tests; they’re powerful lead generation tools. Offering them creates a very low barrier for outside providers to refer.
Accept outside SA or HSG referrals
Promote services separately (content)
Return results for SA and HSG to providers within 72 hours of the service performed
Educate referring providers on how to interpret results (events, content)
3. Content
Once you’ve identified your targets and solidified your ancillary services, you need captivating content to reach and promote them. As before creating any content, it’s important to establish brand guidelines. Beyond the look and sound of your brand, referring provider content must include three differentiators
Performance (Success Rates, Technology, Lab, Embryology)
Patient Care (Staff, Physicians, Communication)
Access To Care (Finance, Ease of Appointments, Insurance)
These differentiators appear across five key pieces of content:
Referral pads
Referring provider page
Differentiator checklist
PreConception panel
How to Interpret Semen Analysis guide
Checking these items off of a to-do list does nothing to ensure their effectiveness. Messaging and design is paramount for helping the message to be received and this is where good creative comes into play.
4. Events
Thorough and poignant content makes for cogent event agendas. The return on traditional outreach had diminished for years prior to COVID-19. The pandemic only accelerated the need to rethink the same fruitless methods of calling on doctors and clinics.
Four events increase provider referrals and positively impact relationships. Each of them can and should be done both virtually, and in person. Feel free to turn them into lunches and dinners when appropriate, but the content must be good enough that you don’t have to.
Provider to Provider Meetings
Provider to Group Visits
Open Houses
Single-Topic Educational Events
5. Outreach
Even among groups with excellent physician liaisons, no one can supplant the REI’s ability to build physician relationships. Your reputation as a trusted educator is crucial to building a referral network. REIs must be accessible, present, and communicative.
Four forms of outreach in which the fertility specialist has an irreplaceable advantage are
Residency rotation
Medical school and residency relationships
Membership in local medical and specialty societies
Grand Rounds / Journal Clubs
Once a trusting relationship is cultivated, leveraging other staff becomes far more effective. When REIs are unable to participate, outreach to referring providers should be delegated in this order:
Advanced providers
Nurses
Physician Liaisons and Marketing personnel
Front staff
The Physician Liaison supports these efforts strategically:
Total office calls
Updating target accounts, including wellness providers
Semi-monthly touchpoints
Content and event coordination
Referral follow-through coordination
6. Referral Follow Through
Good News: You’ve gotten people to refer to you
Bad News: Now you have to keep them happy
Once a referral has been made, maintaining and growing the relationship requires follow-through in these forms:
Thank you note for initial referral
Semi-monthly touchpoint
Post-consult referral note immediately following the patient’s consult
Graduation update. If the patient is successful in achieving pregnancy, provide medical records, note and inform OBGYN that the patient will be returning to their practice
WORK THE SYSTEM, GROW THE RELATIONSHIP
Though MD/DO referrals are not the overwhelming source of REI patients that they once were, they still do account for the most common influential factor in choosing a fertility specialist. Growing physician referrals isn’t about hiring a “door knocker” to distribute pamphlets and drop off bagels. A Physician Liaison may be an incredible investment or a complete waste of money for you. First, invest in your system, considering the six pillars of reporting, ancillary services, content, events, outreach, and follow-through.
