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It wasn’t that referrals from primary care physicians were falling at Cardiology Specialists in Memphis, TN. But in mid-1996, practice administrator Deborah Parker-Pratt, FACMPE, thought they were stagnant. And she knew that the only way to win new referral business was to prove to primary care physicians that her practice provided better patient care.
"Our referral sources were dependable, but that was all," she recalls. "We knew that some of those sources were disappearing because an insurance plan didn’t include our practice or didn’t include theirs."
Parker-Pratt knew she had to come up with a rapid way to expand the referral base. She sat down with Alan Flippin, the Germantown, TN-based consultant that Cardiology Specialists retained as a quality care representative and marketing consultant, and developed a referral marketing scheme the VIP program. Among its features are quick appointments, shorter waiting times, and personalized service.
"We had to have quick results," she says, "but we couldn’t rely on a hard sell. The sell had to be based on providing excellent service and care to both the patient and the referring physician."
Previous contact with referring doctors taught Parker-Pratt that the most important thing to them was seeing their patients quickly and providing a timely response on the visit to the referring physician. These were two of the keystones of the VIP program that the pair implemented. (For a summary of the benefits for patients and physicians, see p. 53.)
The results were dramatic and immediate. The program brought in about 150 new patients in 12 months and provided return on the initial investment "well in excess of 100%," she says. "I’ve made our money back many times over."
While unwilling to talk about how much the program cost, Parker-Pratt did say it was less than $50,000. The biggest cost was the design and initial printing of materials that are given to referring physicians an introductory letter, brochures about the practice and its abilities, a list of VIP benefits for patients, and a sample patient packet. (See a copy of the introductory letter, p. 52.)
Parker-Pratt estimates that about three-fourths of the initial investment went to design, printing setup, and printing. "But it’s a one-time cost. Once you have it all set up, the cost of reprints goes down," she explains. The remaining costs were for renovating the VIP waiting room with new furniture and lighting.
While no additional staff were added to facilitate the program, Parker-Pratt did make some changes in both medical and administrative staffs’ duties. For example, all visits to referring physicians promoting the practice as a referral source are made by a Cardiology Specialists physician and nurse team. "We felt the doctor-to-doctor approach would work best," Parker-Pratt says. "The face-to-face visit solidifies the relationship." Flippin also accompanies the medical staff on some of the calls.
Parker-Pratt says the doctors keep profiles of the practices they visit. For example, if one physician is known to be a sport fisherman, then that is noted in the file. When a thank-you note is written to the potential referral source, something personal can usually be included in the note. "It makes the doctor feel special," notes Parker-Pratt.
Each of the four physicians gives up one morning or afternoon per month to make these calls. "They had to commit to this, and that meant they had to see fewer patients or no patients on that day," says Parker-Pratt, explaining that half of each doctor’s day is spent in the hospital a time much less amenable to intrusion than appointments.
Convincing the physicians to market the program wasn’t as hard as she thought it would be. One of the doctors was not as busy, and he spent one day a week making what Parker-Pratt calls "howdy calls." That physician’s referral base exploded, and the competitive nature of the physicians’ personalities came out. "When they see that a doctor gets 12 referrals from one physician resulting in $30,000 in income, it is a real impetus to the other doctors. They can see it works."
The physicians do not earn extra incentive income for the new business they bring in, Parker-Pratt adds.
The other staffing change came in the office. The woman who ran the insurance claims processing had some of her other administrative duties divided among other staff. That free time was then spent as VIP coordinator. It is this person, says Parker-Pratt, who spends her days greeting the patients and seeing to their needs.
The results have been staggering. Parker-Pratt does not like to talk about specific dollar amounts generated by the program. Instead, she views the VIP program as a boon to patient satisfaction. "We make sure patients understand everything the doctor says, that they understand their treatments," says Parker-Pratt. "Those are quality-of-care issues. The [added] effect is more money."
The program has built-in tracking, too. Each packet that the physicians take to primary care practices is numbered. "If Dr. Jones gets packets one through 10 and none come back in the next weeks, we know that we have no referrals from Dr. Jones," says Parker-Pratt. "But if all of his packets come in, then we know we have to [take] him more."
Similarly, Parker-Pratt can track which physicians take those packets on calls. If one of her doctors has no referrals, or very few, she knows that this physician may need some assistance with his calls.
Before this summer, Cardiology Specialists will be doing a formal survey of referring physicians and the estimated 150 VIP patients to gauge their satisfaction with the program. But initial anecdotal responses prove to Parker-Pratt that the system is working. "We have patients say they have never had a better experience at a doctor’s office," she says. And referring physicians are starting VIP programs related to their own practices.
There is little that Parker-Pratt would change in the program, except perhaps to ask for some assistance in program design from the referring physicians. While not unhappy with the program she, Flippin, and the four doctors developed, she says, in hindsight, she wishes she had involved physicians from the referring practices in the developing process. "And if I had known how well it would work, I would have started it earlier," she says.
The program will be expanded to two new satellite offices opened last year in DeSoto County and Collierville, two of the fastest growing regions in Tennessee. Currently patients that come from those facilities are encouraged to come to the main office where they can have the full benefits of the program.
Parker-Pratt says she has to ensure that her staff are aware that there are many sets of customers not only the patients but also referring physicians. "We have to make both happy. The primary care physician is our customer and our product is patient care. We have to expand our program to provide the best to both."
She thinks the VIP program is one way to do that. "Patients and doctors love the special touches," she says. "We used to have the patient representative talk about insurance information, but just by tweaking it a little, by putting them in a comfortable room, it changes the image the patient has to something really special. People need to be more than an account number. They need to be treated with respect."
Deborah Parker-Pratt, FACMPE, practice administrator, Cardiology Specialists, Memphis, TN. Telephone: (901) 747-3330.