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Medical Practice Business And Marketing Articles

Article #13 - Jul. 2010

“Referrals Should Be Outlawed—It's Just
Too Difficult To Say Thanks”

The most successful referral system is fueled by
how you express your appreciation.

I just had a silly thought.  You don’t really care about getting free referrals anyway... right?  I say that because I guarantee that you have no idea how many patient or friend referrals you get per month. 

Also, I would bet that you or your office staff do not keep a list of doctor referral patients, let alone the name of the person or doctor who referred
the patient. 

Beyond that, it’s likely you don’t even acknowledge the referral by a written thank you card, phone call, email, or in person most of the time.  You have way too many important things to occupy your mind than to even say thanks.  Why is that?  Why waste the effort to send a thank you note when you already get free referrals joining your practice each week... that is, if you even notice your new patient has been referred to you?

Key = In the business world are you aware of the “life time value” of a referred patient to your medical practice?  It’s important.

Advice: Start tracking your referral patients intensively.

Of course, you might surprise me by telling me you do all those things out of plain professional courtesy.  Funny, I didn’t think that such an old but significant gesture between doctors was used anymore. To tell you the truth, I haven’t experienced a single professional courtesy event in the past 20 years. Maybe, no one gives a damn anymore. 

If that’s true, then why should any physician waste their time referring a patient to you in the first place. However, we all know that the few doctors who refer to you at all are the ones you have a particular friendship or connection with in the community. 

After all, you usually send a Christmas present over to his or her office each year and besides, they already know you are thankful for the referral without any communication attempt because you have told them thanks so often previously... or not.  Is a present given at holiday time enough?
Absolutely not!

Every doctor has their own favorite list of other doctors to refer to when the need arises.  Referrals will continue until some untoward event intervenes.  Does that occasionally happen?  What happens when the patient referred to you has an unexpected complication or terrible result from your medical treatment?  I’ll tell you. 

Very often the person or physician who referred the patient will no longer refer patients to you.  It’s what I call the “One time syndrome.”  If it happened once, it can or will happen again.  At least that’s what they’re thinking.  The tendency is for physicians to avoid confessing their sins to the referral doctor because it puts them in a bad light... not that you would do such a thing to a patient in the first place.

In order to rescue yourself from this unfortunate situation, whether or not it was a mistake you made, a bad judgment on your part, or the bad result of your treatment had nothing to do with your treatment at all, call it a risk of the treatment, there are several ways of mitigating the issue and continue
to get referrals.

These are the professional ways of appeasing your medical complications occurring with a referred patient...

  • Humble yourself whether you caused the problem or not.
    Be transparent.

  • Discuss the problem directly with the patient, be totally honest
    about your part in the process if any, as soon after the incident
    as possible. It should be done face to face with the patient and
    in front of family members if they are present.

  • Call the referring doctor (not other non-professionals who may
    have referred the patient to you) the same day as the problem
    occurred.  Reveal what happened, explain why it may have
    happened in medical technical terms, and apologize for the
    incident happening... even if you know it wasn’t a result of
    your misconduct. 
         Avoid excuses and avoid “taking the blame” for everything because
    that indicates your lack of confidence in yourself... doctors shouldn’t
    ever create that impression.

  • No matter how minimal or serious the complication is, record all
    the details of the event, people involved or present at the time, and
    what was actually said during the discussions. It’s a mandatory
    method for defending yourself if a law suit happens. If you didn’t
    write it down, then you didn’t say it or do it, in the eyes of the
    jury or the court. 

From an economic point of view, the 20 or 30 patients that would have been referred to you over the next 20 years would account for a loss of income for your practice of thousands of dollars.  Each referral patient you fail to get amounts to thousands of dollars of income you won’t have over the years.

Referrals to you usually are not made primarily because of your skills and talents in medical care, but because they’re a friend of yours.  Obviously, most of the doctors are on about an even par as far as expertise goes and the only special connection you share that makes a difference is your personal friendship.  Cultivate those connections.

Referrals can be risky for you.  Have you ever thought about that?  I was lucky for receiving constant stream of referrals from a local respected GP who had been in town for many years.  He called my office and told my staff he was sending a lady over for “surgery to be done.” That was a little pushy and unusual for him. 

When I spoke with the lady, she told me she needed a hysterectomy for fibroids.  She had been told that she had large fibroids and surgery was necessary even though she was, and had been, completely asymptomatic. 

After completing her exam we reviewed the situation and her options.  She had a normal sized uterus and a couple fingernail or smaller sized fibroids present and confirmed by ultrasound.  When I explained my findings and that she didn’t need surgery at the present time, she was overjoyed.  I’m guessing, but she probably couldn’t wait to call her primary care physician and tell him he was wrong.

The next morning in my office I spent an ugly 5 minutes on the phone with the referral doctor who used every element of profanity he could think of to tell me how outraged he was about my lack of professional integrity until I finally hung up on him. 

I hadn’t had time by then to get back to him about the patient, but apparently the patient had.  We (the referral GP and me) never spoke again.  I never got another referral from him.  I’m sure he badmouthed me to everyone he met up with in the future.  I had done the right thing for the patient.  At least I didn’t have to compose my usual consult summary I send routinely to referring doctors.

It would have been very easy for me to compromise my professional
integrity by agreeing with the GP and doing the surgery even though it was not necessary or indicated, which in my experience is quite common in my specialty.  Apparently the unnecessary surgery was a gift for me that I refused, and the GP lost out on the expected reciprocal rewards other local doctors receiving his referrals had been providing to him.  It was a, “When in Rome, do…”

What should be done by every physician who gets a referral
from anyone?

1.  Schedule the patient to be seen within the next 24 to 48 hours
after being notified of the referral. The referring physician
expects it, the patient expects it, and you need to comply.

2.  Have your office staff person call the patient at home as soon
as you receive her information to schedule her appointment and
temper down her anxiety, especially if the patient has never
seen you previously.

3.  Promptly after evaluating the patient, make time to call the
referring doctor directly to discuss your findings and
recommendations even if they have transferred the patient to
your practice for care and follow-up. 

4.  Be sure to send a detailed written letter to the referring doctor
within the next few days to confirm what you verbally told the
doctor, but also for inclusion in their medical record on the patient. 
It confirms the billing validity and appropriate medical treatment
being given to the patient.

5.  Within a week after your office treatment of the patient,
and/or 6 weeks after an in-patient surgical treatment of a patient,
send a thank you card with a handwritten note, which includes the
success of your treatment and condition of the patient.

Preferably, handwrite the name and address on the envelope,
apply a real stamp at a slight angle, and include a business card
with it. Personalization of it creates more impact!

6.  Recognition is a powerful human emotion that happens with
feedback to the referring doctor or other person in the form of a
thank you note. It should be done with every single patient referred
to you.  Ask any physician about what percent of the time they
receive recognition for referring a patient. You will be amazed at
how low the percentage is.

7.  Referrals from other non-physicians such as nurses in the hospital,
a local pharmacist, your neighbor, your friend, office staff in
another medical office, or your dentist should be handled with
the same efficiency and respect while keeping the privacy of the
patient’s medical information secure in any communications
with the referring person. 

In case you haven’t caught on, this sort of medical practice activity is known to be highly successful in obtaining free referrals.  Who do you believe a person would refer a friend or patient to—one who is slow with a thank you gesture or none at all, or one who sends thank-yous' routinely for every referral?  You better believe it!

Remember, marketing your medical practice can be as easy and cheap as doing such things as this.  And, it doesn’t need to be done by you, except for a personal handwritten note and signature.

Note: The next article on this topic will provide you with a totally unbelievable resource for patient referrals that you won’t find anywhere else.  And will position you far above your medical competition in your community.

The author, Curt Graham, is a highly experienced business and marketing expert, copywriter, and entrepreneur who has been published in various media over 50 years while in medical practice and after.
Discover what it takes for you to reach the optimal limits of your potential in medical practice, and how to do it: Click The Link NOW!

© 2004-2011, Curt Graham M.D., All rights reserved.

handwritten signature of Dr. Graham

Article #13A


photo Dan kenney riding on a bull

Why People Fail

A series of No B.S.  Articles from Dan Kennedy

"How To Make A Lot More Money, Fast"

Odds are, your business lost a lot of customers last year. There are holes in your bucket. And odds are, you can’t say for sure how many you lost, who you lost, why you lost them or where they went and are now.  If you do nothing different, I can tell you this same thing next year too. A great way to make more money is to stop losing customers, beginning with the next one you are about to lose.

This will require accurately determining what a customer is worth and what cost of replacing a customer really is… so you can decide how much you are willing to invest NOT to lose a customer.

Next, taking that investment and deciding how to apportion it, between preventive measures and rescue and recovery measures. Then designing or re-designing, beefing up and actually implementing both, the “keep ‘em” program and the “rescue/recovery” program.  Then testing, evaluating, improving, again and again.

Bill Glazer and I often meet to discuss strategies for our business, Glazer-Kennedy Insider’s Circle™.  During our last meeting, we spent a lot of time – and now Bill will spend a lot of time, money and work – doing exactly this, and we already have low loss/high retention stats and sophisticated, multi-step, multi-faceted “stick” (for new); “keep” (for continuing), and “rescue and recovery” (for lost) programs. (Do you?).

But now we will add to, experiment with, refine and hopefully improve all three. (Will you?) I counted 23 different, specific “adjustments” we agreed on, all to be implemented within the next 90 days; some minor, some major, some simple, some painfully complex. (How many improvements are you testing in your three programs in the next 3 months?)

Every year, I’m somebody’s lost customer. Many don’t even realize I’m lost. I guess they think “gee, he hasn’t been in, in a while,” if they think at all.  Every year, national companies and local shops lose me as a customer. I can’t recall even one, ever, doing anything proactive and significant about
their loss.

Okay, so that’s one very practical suggestion for making a lot more money fast. Here’s another: upgrade customers before you lose ‘em. You’ll then lose less automatically. You ought to give that a lot of thought.

You ought to HATE – and I mean, HATE – losing customers.  The athletes or teams who win a lot hate losing – even more than they like winning. To win races, you’ve got to hate losing. Winning is not sufficient motivation.  You NEED to understand the true economics of losing customers. You NEED to get yourself highly motivated and passionately committed to invest aggressively in not losing customers.

By the way, any nitwit can get customers. Thousands of dot-com nitwits got ‘em by the millions with no business model at all. No genius in getting them. But no successful business exists based on its owners’ ability to get customers. Successful businesses sustain themselves only by keeping them.

The WHY PEOPLE FAIL articles are provided by Dan S. Kennedy, serial entrepreneur, from-scratch multi-millionaire, speaker, consultant, coach, author of 13 books including the No B.S. series (, and editor of The No B.S. Marketing Letter. WE HAVE ARRANGED A SPECIAL FREE GIFT FROM DAN FOR YOU including a 2-Month Free Membership in Glazer-Kennedy Insider’s Circle, newsletters, audio CD’s and more: for information and to register, visit:

GIFT OFFER FROM DR. GRAHAM----- https://gkic.


masonic emblembright colored American flag  Curt Graham, M.D.
   2404 Mason Ave.  Las Vegas, NV 89102
    E-mail = cgmdrx(at)
     © 2004 - 2015 Curtis Graham, M.D.,  All Rights Reserved.