Patients
follow your advice for continued medical care needs. Its not just anecdotal information any
longer. The National Bureau of Economic
Research studies the impact of physician recommendations, price and geography
on a patient’s choice of provider, and their conclusion – what you say matters.
Overwhelmingly,
patients sought services from the providers, physician, hospital, ancillary,
based on the recommendation of their physician irrespective of price, or geographic
differential. Transparency, the doctor
next door, the big bill board, the advertising, the bottom line is that
patient’s trust their physician. While
the reality is that not everyone will follow your recommendations, but the
majority will.
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This means you have power of the
purse, power to influence the economics of others.
The only way that you can use
this information is to understand what your referral pattern means to
others. You probably already know what
it means to clinical labs that grovel (and at times to too far) in seeking your
specimens, but have you thought about your impact on others? The specialist,
the hospital?
The best way to understand your
role in others income is to measure it, that is estimate it. Turn to your EHR/PMS to see what reports it
is capable of running. If your system
can, take a periodic run of your referrals, and where they go. Not its not going to be in your system, but
you can estimate the economic value of your referrals in a crude way, by
assigning a dollar value to an office visit and if to a proceduralist, an
estimated value of their work, surgery, colonoscopy, etc. Need a data source, you google Fair Health
and see what the rates are on the average for these services. For
hospitalizations, just use the average of $10,000, which is the average for a
hospital stay in the US.
The value of this information is
to understand the economic power that you and your referral pattern
command. Not that its your money, but
your decisions mean income to others.
Now with this information
consider if the revenue you are producing for others is being respected by
them.
For example, if you continually
make referrals to Dr X and he never sends you a consultation report, then
perhaps for the betterment of your patients, you should consider another
physician to receive your largesse. Similarly, if there is a receiver of the
bulk of your referrals, that makes your life more difficult by not taking
patients with insurance A, again consider a conversation about it with them, and
after they balk at accommodating your patients, slip into the conversation the
estimated value of your referrals, if not the dollars the number of cases
referred. A reminder may be even necessary to the physician when their office
staff won’t accommodate a patient of yours that is in more immediate need of
their services.
Specialists, with few exceptions
(Allergy, dermatology ophthalmology) are largely in the wholesale business,
that is their business is based on referrals, from you and from other referral sources. While the specialist may command a certain
higher stature by virtue of their specialty, they are dependent on your
referral for survival. This means that
you have the clout to impact their responsiveness to you and your
patients.
Don’t be afraid to use it.
