Podcast ep. 4: Grow Your Practice with a Healthy Patient Referral Program – Wendy Reifer, ePractice Manager

For practices with a growth mindset, a healthy client referral program is critical. Not only is it highly cost effective, but it also brings in more patients that align with your practice philosophy, and engages your staff in your practice growth goals.

Wendy Reifer is the VP of Client Management at ePractice Manager, a firm that provides training and consulting services for practice owners, managers, and teams across the country.

With over 30 years of experience, her expertise lies in helping practices to grow using proven systems and training methods that create stability and get results.

In today’s episode, Wendy reveals what a healthy client referral program looks like and debunks the top myths that keep practices from taking action.

For questions or information, please email info@practicepeakpodcast.com.


Brought to you by the dental advisors at Jones & Roth. The podcast for dentists who want to take their practice to new heights…. This is Practice Peak. 
Hello and welcome to Practice Peak. The Jones and Roth dental advisory team’s new podcast series. My name is Elliott Tracy and I’m a member of the Jones & Roth dental advisory team. We’ve created this podcast with one purpose in mind: bringing together a community of experts and thought leaders in dental practice management to give dentists like you a place to explore, discover, and maximize opportunities.

00:00:45 – 00:01:28
I am excited to be joined today by Wendy Reifer. Wendy is the VP of Client Management for ePractice Manager. ePractice Manager is a firm that provides training and consulting services for practice owners, managers and teams across the country with over 30 years of experience in the field. Wendy’s expertise lies in helping practices to grow using proven systems and training methods that create stability and get results. Wendy, thank you so much for joining us today. I am really excited to have you on to talk about patient referral programs in a dental office. I know this is an area of specialty for you and an area that we see a lot within our practices. We get a lot of questions about these and kind of how to best structure these. 
So let’s start that off first. This is in a general conversation about marketing and growth in a practice. What challenges do you see that dentists face when addressing marketing and growth in their practices? 

00:01:41 – 00:02:24
Well, Elliott, thanks for having me today. It’s nice to have a conversation with you about this and I agree with you. I think this is a very important topic. I mean particularly during these times but during any time in a dental practice, um you know, owners are faced with the expense of marketing when they take on these types of campaigns and programs. They’re worried about the quality of patients that they’re going to acquire. Are they going to get a lot of emergency-driven one-and-done kind of patients out of the marketing attempts that they make, are they going to get people who will follow through with the treatment? And then there’s an awful lot to it. If you’re talking about an online marketing system, you have to do a lot of maintenance with the vendors and the systems. There’s a lot of internal personnel, extra personnel that are involved with maintaining those systems. So a lot of people faced with those problems tend to neglect marketing to the degree that they should within a practice. And so we work with practices on that and making it as efficient as possible. But one of the things that we always like to talk to them about is a referral program, right? Just a general approach to getting referrals from existing patients, friends, family members, colleagues, things like that. Um, It tends to be an undercut to some of these other challenges that they have. 

00:03:02 – 00:03:49
Yeah. And a referral program seems like a really inexpensive way of going about marketing. And so often, you know, in my world, the accounting, you know, the numbers are very important. And so we’re looking at, you know, marketing as a percentage of the revenue in many cases, you know, we want to kind of limit certain things when they’re as a percentage. But marketing we often take a very different approach. It’s more about return on investment and bang for your buck. And like you said, you mentioned a minute ago, is that patient coming in a one time or is it you know, recurring revenue or where they’re bringing in potential other patients, they’re referring their friends as well. So let’s talk about that. So why is a patient referral program something you know that an office should implement? 

00:03:49 – 00:04:21
Well, like you said, you know, we’re always looking at the cost ratios too, and there’s a point where there’s something that’s saving you money versus something that’s costing you income, right? And, so we all have to be aware of. That patient referral program is kind of a two-fer in this regard, it’s practically free. I mean there isn’t a lot of outgoing cash having to do with administering patient referral program. You also tend to get this quality of patients referred friends, family members, colleagues, things like that. 
These are people who have similar values to the patient who’s right in front of you, right? They have the similar approach to taking care of their health. They tend to follow through with treatment, they pay their bills, they become a part of the practice family and you know, here’s the kicker: They will, in turn, refer others to your practice. So it tends to be the most cost effective with just compounded returns on the investment that there is, which is minimal in the first place. We recommend this to everybody. 

00:04:48 – 00:05:19
Yeah, I love that. I think that’s great. Especially, you know what you mentioned in terms of folks that have similar values and you know, a lot of times they might have the exact same insurance and so for you, you know, for an office that creates a lot of efficiency because you already know what the reimbursement is and you know those in network out of network, which you know, create all kinds of other issues… and we could have a whole conversation about that as well. But yeah, I couldn’t agree with you more. I think it’s great. You’re aligning the goals with the patients and what their goals are as well. 

00:05:19 – 00:05:56
Well, you know, what’s funny about that is that you hit the nail on the head. Oftentimes colleagues have the same insurance program because it’s through work, right? Oftentimes family members are on the same insurance program or they’ve recommended it to others. So, you’re pretty well versed in what the profile of this patient is in particular. But we’ve found another thing which is quite interesting when you referred to a business, let’s say, I sent you to my gym for example, and you’re going to go have an appointment with the trainer, so to speak. Aren’t you somewhat psychologically accountable to me and to the trainer? Like, you kind of already bought into a certain degree. 
So usually the uptake on things like that is a little bit better because people are entering the situation thinking this is going to be good, right? They’ve been referred, they’ve got a good word about the situation. They kind of, wouldn’t have shown up in the first place if they weren’t going to engage. So it is really a matter of the quality involved with the situation. The efficiency practices get a lot of attractions on this program. 

00:06:20 – 00:06:50
That’s great. It’s an interesting way to think about that. You’ve created a little bit of accountability. When that happens… you don’t want to let your friend or your colleagues or family member down by not going to at least see this person and see if it’s a good fit. But, when you go along those lines, I mean those are a lot of the things that worked really well in this. You know, what problems do you see offices and doctors encounter when they’re trying to start up these programs, or in their approach to these programs? 

00:06:50 – 00:07:21
Well, it’s funny how everyone seems to agree on the parameters here, right? Doctors will tell you that they agree that referred patients are the best as the consumer. We all want to operate off of a good recommendation from somebody else, right? If you’re in trouble, you need a lawyer, don’t you want to hear about a lawyer that somebody else has used that has gotten them out of trouble? Or what about the proactive approach? What if you’re trying to get more healthy or more financially secure? You want someone who really can be a leader and somebody else telling you that they’ve had that experience.
So, we all agree. The referral process is key to how we interact with each other. But there is a gap, right? Just sitting there agreeing on that doesn’t make patients ask their friends about a dentist and doesn’t make the dentist get referrals from patients. So sometimes it’s a matter of managing that gap. You have to actually create a referral program which we’ll talk about here, and you have to administer it. I’d say a couple of other points are involved and we can just fly over them really briefly. One of them is that for the communication process, doctors and staff tend to think that it can be awkward, right? Like, asking a patient for a referral, talking to them about their friends and family members. 
So we do an awful lot on making it the right type of conversation. They also get to elaborate about their planning for this type of a system where as it can be quite simply administered, to be honest with you. They don’t do enough of it. Kind of a one-shot deal where we had a staff meeting. We talked about getting referrals from patients. We didn’t really have a plan, but we talked about it that one time, so we’re good. Right. We never have to talk about it again… it is something that has to be addressed repetitively: you’re not spending money on this, but you are putting energy into it as part of making it a mainstream part of the practice and that’s how you administer this type of program. At some point, I’d like to go over, kind of, what the steps are involved to address that communication process simply because it’s not as hard as people think, and they’re making it too big of a barrier for how easy it can actually be. 

00:08:54 – 00:09:13
Yeah. And I think that I’d love to hear about those, you know, I think so often when you hear about these programs it’s, there’s got to be some type of monetary incentive or something that entices, you know, the patient to make a referral and whether it’s monetary or not or there is some type of other perks that’s involved in it. What are these plans? What makes them successful? 

00:09:13 – 00:09:58
Well, here’s the thing: when somebody dials in how to have a natural conversation that’s centered on the right topic, it’s quite organic and it gets its own momentum. You don’t really have to manage it and administer it and tend to it and water it and grow it. It’s just normal human interaction at that point. So, one of the things that we do is we change the subject in the conversation: Instead of asking a doctor or a team member to go and have what they perceived to be maybe a used car salesman type of an approach to a conversation where they’re saying to a patient, ‘hey, would you kind of, give me a referral? Is there anybody you know that you could send to me, kind of thing?’ They get really awkward about the conversation. 
It’s easy to do that differently. All you have to do is change the topic and start talking about helping other people. And frankly, if I get my doctors talking about helping other people, the clients that I work with and the doctors who are really the leaders in the industry, I can’t shut them up. They’re so passionate about what they do, they want to talk about helping other people. So now we’ve taken that barrier totally out of the equation. And if a patient says to them, ‘thank you so much, you helped me today. I didn’t know this was possible. I put this off too long. I wish I had done it a long time ago.’ The backbone of a good referral program happens in that moment. When you say to that patient, ‘I’m so glad to hear that. And it’s a shame because we run into people putting this off all the time and it becomes more extensive than it needs to be. So if you know somebody who’s in this situation, the thing to do is tell them your story, tell them about your situation and make sure that they don’t struggle with that same problem because we take care of this quite easily these days and we’re here to help patients.’ 

00:10:59 – 00:11:40
Yeah, that I mean that’s great and I like your approach. I can’t tell you how many phone calls we’ve had with folks just offering, like you said, to just help and just provide some guidance and not have to charge a fee just to provide that guidance. And so we have offices who, you know, good referral partners and referrals of clients saying, ‘can you help my friend?’ Like they have questions and that sounds a lot like what your approach is: you’re having a conversation and you’re trying to help without really having to feel very sales-y about it. And if it works out it works out because it was the right fit for the office. 

00:11:40 – 00:12:24
Absolutely. And, you know, you in your firm as consultants and these doctors that we’re talking about today, it’s a strange way to say it, but we’re almost in, like, a recession-proof type of industry. We’re in a service industry, we’re in a hopeful industry in the first place and people need this help. We don’t have to create the circumstances in society where people need our services and we don’t have to create the circumstances in a practice or in your business where we want to help others. It really is just a matter of closing this gap between the situation already existing. People have teeth, they need help with them. That’s already happening with people’s friends and family members. You don’t have to, you know, make that occur. 
And it’s just a matter of taking it one step further, taking it across the finish line by talking to your patients about your purpose to do something about that for their friends and family members and letting them grasp and hold onto a concept that they can really get inspired by and believe in. You mentioned earlier incentives, right? We’ve done a ton of surveys on this and we’ve worked with lots of practices on this subject. An incentive-driven program is fine. It’s actually not legal in all states, so not everybody even has access to the idea of doing it, but it’s fine, right? When we do an appreciation for a referral, we don’t proactively promote it: Hey, if you do this, we’re going to give you a credit on your account or movie tickets or, you know, something like that. We simply, after the person has come in, send them an appreciation and say it was great to meet so and so, you know—obviously within the constraints of HIPPA—and say, you know, ‘it was great to meet this person, thanks for helping them out. We’re here to take care of them, appreciate you, kind of thing.’ That way, you can use an incentivized type of approach, but almost as an appreciation because, straight incentives, just that kind of speak with the patients, it doesn’t work. It is not a robust referral program. 

00:13:36 – 00:13:55
Yeah, and I think that’s a good point. I think that, you know, that sort of thing is going to attract a specific type of referral, right? It’s just the referral to make the referral and receive the incentive, versus, like, what you said is you want, you know, you want somebody who is a good fit within the practice and somebody who’s like-minded 

And you’re going to attract a something-for-nothing public who’s like, wait a minute, I can get a free whitening, you know, that kind of thing. As opposed to somebody who’s like, you know, Elliott really does a good job of taking care of his health. I’m in a tight spot. I’m gonna ask him what he’s doing. You know, he’s going to send me over to someone that I can trust. That’s a different type of referral process altogether. It’s also easy to keep something like this simple, right? So, let’s say the front desk is checking out a patient who’s just been seen in your office. And we were talking a little bit about the COVID environment, right? This is this unprecedented set of circumstances. 

00:14:33 – 00:15:03
A lot of practices are backing off of their normal actions, even making regular appointments with their patients, let alone administering a referral program. Well, I’ll tell you one that’s working tremendously well for a lot of our practices, when that patient is checking out, they simply say to the person, ‘can I help you with any other appointments?’ And the patient will oftentimes even look at them a little, like, you know, bewildered, like I just made an appointment with you. What do you mean, right? But that sinks in for a second and the front office person simply says, ‘look, a lot of people have gotten behind on medical care or haven’t had the access that they wanted during this time. Our patients are making appointments for spouses, children, parents, that kind of thing. And they oftentimes want to take advantage of doing that while they’re right here, compare calendars make that kind of thing happen. That’s really helpful to people who need that.’ Now, if somebody doesn’t need that, they’ll say ‘no thanks. I’m all set.’ You haven’t created any friction or any rub, but for somebody who’s been trying to get that spouse over to the dentist or isn’t sure what’s going to happen with kid’s school and like, ‘okay, I was putting it off, but I don’t see a reason why not to.’ Now you’ve got the capture mechanism of low-hanging fruit that’s right there to be had. 
These people are happy to send you a referral. They just need a way for you to make it easy for them to do that. And that’s what we’re trying to accommodate with these conversations about helping another person tell your story. Do you need any other appointments? These are simple steps that can be taken. Makes a big difference. 

00:16:03 – 00:16:08
What are you seeing in these practices that do have a really healthy patient referral program? 

00:16:08 – 00:16:53
Well, overall they tend to spend less money on marketing, which I’m cringing as I’m saying it because as a consultant, I’m going to have to talk the Doctor into spending money on marketing at some point, right? Some of them spend more money than I want them to. Some spend less money than I want them to. You’re in the same boat. You know exactly what I’m talking about here. But overall, in terms of cost effectiveness, in terms of return on investment, they don’t need to spend as much money on marketing. Some of these practices get 50% of their patients from referrals. At that point, you have a lesser burden of bringing new patients from a different source into the practice. They get better patients that align with the practice philosophy, they get better case acceptance overall, which is something very, very important. If you have to go and get a bunch of new patients, it’s going to take your time and money to do that. If you simply get an update from the patients that are already in your practice and they are accepting the treatment that you’re presenting to them, that is very cost effective for a practice. 
You know, the patients that they do get in their new patient capacity tend to refer others. So, this is an expanding concept that happens. Another point is that they’ve got a staff that’s more oriented overall to the marketing growth of the practice. Every team member has these conversations with patients. Every team member understands that we’re working to its family’s practice. So, when other marketing techniques come into play, first of all, they work better because you’ve got an entire marketing environment that’s going on, it ties in with things like getting reviews, your online presence, all of that kind of thing and your staff are participating at a totally different level. But I’ve got to say the biggest thing that I see in a practice that has a healthy working patient referral program is that they have less worry and they have less stress about how they’re going to maintain the productivity level of the practice because it’s simply more stable overall. 

00:18:08 – 00:18:53
It’s really well said. And I, you know, something you said that I couldn’t agree with more is you know, some of these other marketing methods, whether it be direct mailers or kind of an infusion of money into some type of digital marketing or SEO, a lot of times, like you said, is you put a lot of money into that and then you just get a couple out of it and it’s just a quick infusion, but it’s not this consistent flow. And that’s something that I think every practice is looking to create as a consistent flow of recurring revenue to where you don’t have these huge cyclical swings throughout the year to where, ‘ok, well we know coming up this is our low month,’ right? Like this is the month that’s just always low because of the timing of when we see our patients every six months or you know, whatever it is with vacations and things like that. Yeah, I think that’s something that a practice is always trying to create as a consistent flow of revenue to where every month, like you said, it’s been scheduled and they don’t have the stress of looking at it and saying, ‘have we hit our goals for the month or for the quarter for the year,’ whatever it is. And that’s something I know we talk about a lot is making sure that they have those goals and those goals all align with each other. 

00:19:23 – 00:19:43
And it’s interesting because we’ll make a, you know, we’ll do an analysis of a practice, right? And then we’ll start talking about goals, numerical goals, but also just growth and leadership goals for practice, right? And oftentimes the Doctor will say,’ okay, well, I’d like to double my practice. I’d like to see twice as many new patients each month,’ and they say ‘great, me too, I want that for you as well. What is your strategy to do that?’ And they’re like, ‘well, I just want those new patients,’ right? And so at that point you’re really confronting a conversation where you have to show a person that they need one or two or three or four or five different ways of bringing new patients into a practice. You can’t put all your stock in one thing: Digital marketing program, SEO, review program, and ad-driven campaigns, things like that. They come and go, right, they have their effectiveness that waxes and wanes type of thing. If you have a healthy referral program it’s almost like you can’t stop it if you wanted to. And if you really get that idea and you build upon that concept, that is something that, wow that’s now going to become your main way of marketing your practice and anything else that you add on top of it, you can think of turning it on and off like a spigot, right? If you’ve got particularly heavy flow you can turn that down. You can turn it up. You’ve got all of the flexibility of that. But once you’ve got a base of patients who are referring their friends and family members to you, and so on and so on, with those who are referred to the practice, it’s kind of like you can’t stop it. Like we said, people have dental emergencies. They have dental needs. They’re going to at some point pop up on your schedule. And just the necessity that’s right there from that populated of quality base is going to keep you going during the lean times will be your extra during the already flush times. 

00:21:15 – 00:21:21
So, for an office who wants to start a program, what would you say is the very first step in establishing a program? 

00:21:23 – 00:21:45
Well I’m going to talk about this in the context of what practices have been through recently because I think it’s a very important point that this stuff applies no matter when you’re kicking off a referral program you need to have a staff meeting and you need to let the staff know that we’re expanding this practice. I would be amazed at how many staff do not have the awareness of that concept that they should. 
Especially in contrast to the owner’s strong intention to make that the case. So just bringing the staff awareness up on that point in the first place is quite important. It has to do right now with turning the page, right? We’re not necessarily only in the mode of coping with COVID and the after-effects, we’re actually turning into a situation where, yes, we have new circumstances, yes, we need to keep everybody safe. But expansion is possible and that’s what we’re aiming to do. And so, getting everybody out of that mindset and into a new fresh mindset is actually gotten some good results for our clients when they have this type of staff meeting and introduced this concept. It’s also important to get the confidence of the staff by saying, ‘hey, we’re not going to all go out and wear sandwich boards around town and route people into this practice, we’re going to use a mainstream, comfortable, proven marketing technique: the patient referral program. We’ve got these great patients here. You cannot target-marketing any more directly than with the patient referral program. If you’ve got a great patient that has been there for a long time, cares about health, pays their bills, keeps their appointments. So are their friends and family members, like-minded individuals, that’s who they’re going to refer to you.’ So now you’re starting to speak the language of the staff and you’re going to get more engagement from the staff on this type of thing, because you’re saying logical, you know, very straightforward, wholesome things that everybody can get behind

Especially in this time. You know, I think everybody has probably seen, you know, some hesitation to go back to their office. And I think there’s a huge opportunity where, you know, you can have a patient who has been in your office; they can see the precautions that you’re taking; they can see all the things that you’re doing to try to help them during a difficult time. And then, you know, like you said with the right approach, you know, there’s a real opportunity for practices to grow in a time where many are contracting and afraid of what the future will bring because of COVID or whatever circumstances we have in the future. 

00:23:55 – 00:24:38
Again, we’ve surveyed this to death, the practices that are growing or the ones that are trying to grow and the practices that are shrinking or the ones that aren’t sure what they should do right. And it’s not that there’s anything wrong with that fear. We understand it. But what we have to do now is we get into the circumstances, make it part of the environment and definitely be safe and proactive, but we do need to move forward because the businesses aren’t growing or contracting and this is the kind of environment that will just overtake a practice that isn’t taking those proactive steps. By contrast, you’re right, it happened first with staff, but secondarily with the patients, they start coming into the practice and they look around and they’re like, ‘oh, this is okay here, I am, I’m safe.’ This is normal, we’re doing normal things here and it is going to take brokering that understanding with the next person, right? So maybe I go home and I do that with my spouse and I say ‘I went to the dentist, it was so normal and I got my teeth cleaned. It was great to see everybody,’ you know, those kinds of communication points happen with friends and colleagues and family members and you’re not asking for something out of bounds to happen in those conversations. You’re simply asking for the right conversation on the right topic, helping a person and you’re just the dentist to do it for them. And I hope that practices feel like they are the best practice in town, that they really can’t accomplish that help for another person. So again, we’re just right on topic. We’re talking about the right things. We’re talking about them the right way and it becomes pretty natural. 

00:25:29 – 00:25:30
Yeah, well Wendy, this has been amazing. There’s so much great information. I really appreciate you taking some time for us. I love your point of practices getting on the growth mindset because I think that’s so important, is everybody’s on the same page and the other thing too, that I think you mentioned is, and just kind of reiterated is this doesn’t have to be rocket science. It can be very simple process that you set up and just being consistent with it is going to work. So, I love all of that. And if you have any final pearls of wisdom, you’d love to leave us all with, I’d love to hear it. 

00:26:08 – 00:26:44
Well. I think that, as we said earlier, this is something that you have to do a lot of right. You have to talk about it at your staff meetings and you have to talk to your patients about it. So how are you going to remind yourself to talk to your patients about it? Oftentimes you have a great happy patient right in front of you and it’s a great person to talk to about this, but you’re not sure or you didn’t remember how to broach the subject, that type of thing. So, one of our suggestions is just to use an existing system that you already have. People use charts. People use routes, slips. People use all kinds of administrative systems. What is the lowest common denominator? What does every patient have? Perhaps they have a chair or trade whatever it is that everybody has in common. You want to include some reminder for yourself to have that conversation with the patient and then listen for your opportunity because they often times are thanking you. They oftentimes are expressing satisfaction with the service that they have received and that’s a great time for you to just move into a segway into the helpful conversation, helping another person about that. At that point, practices sometimes do hand out a business card or throw cards something like that if they want to, and that’s fine. But honestly, the biggest point is do not exclude people in terms of who you should have conversations with people. If they pick and choose who they’re going to talk to about referrals, they’ll pick a handful of people on their schedule every day. You take the approach that you’re going to talk to everybody and you’re just going to have this conversation just like you talk to them about flossing their teeth or paying their bill. It’s just a normal conversation that you have with every single person, then yeah, there’s going to be a couple of people that day who may be there in the middle of a batch of really difficult treatment and they’re not through to the other side yet. You may not pick to… you don’t choose to have that conversation that day, but everybody is a candidate for this conversation. Once you adopt that mindset, you build in some very slight reminder processes for you and your staff, the follow through is there with the staff meetings, you start tracking how many referrals you are getting and you share your wins on that kind of thing. It’s quite an inspiring program for people to be involved with. So, I hope that today we’ve talked about making it easy for people, something that they can do quite simply that it’s based on the right types of wholesome concepts that they want to use in the practice and they can take it from there. It will grow right before their eyes. 

00:28:30 – 00:28:43
Right, well, Wendy, thank you so much again. This was great information. We’ll be sure to include some communications so that folks can reach out to you if they have other questions about these patient referral programs. But, thank you again for joining us. This has been fantastic information. 

00:28:43 – 00:28:51
Thank you, Elliott, nice to be with you today. I appreciate the opportunity. 

Yeah, absolutely. 
Thanks for joining us here at Practice Peak, the podcast for dentists that want to take their practice to New Heights. We’d love to hear from you. And if you’d like to connect with us or any of our guests, please email us at info@practicepeakpodcast.com.