Why — And How — To Plug Your Leaky Referral Network

Written July 26, 2018 by Matt Seidholz

Sometimes, referring a patient to a specialist can feel like a leap of faith. Sure, Primary Care Physicians (PCPs) write the referrals, urge their patients to use them, and sincerely hope that they’ll move on to the specialist they’ve recommended.

But, ultimately, a referral is no guarantee. A lot of obstacles can come up between a referred patient and a specialist appointment. If patients get too frustrated along the way, they’ll either find some other specialist to visit, or worse, they’ll decline to see a specialist at all.

When that happens, that’s called a referral leak. They happen to at least 20% of all patients seeking a specialist care. And both PCPs and specialists should do everything they can to prevent them.

Why Are Referral Leaks a Problem?

The business-case for plugging referral leaks is pretty straightforward.

For specialists, a thriving PCP referral pipeline is an essential source of patient volumes. (Which is why ‘referral-development consultants’ can get away with charging specialist clinics $10,000 a month for their services.)

For PCPs, having a network of high-quality specialist doctors bolsters their credibility. More importantly, trusted specialists are invaluable, because they manage health conditions that fall outside the scope of primary care.

When the referral plumbing is working, it leads to healthier patients and thriving physician-to-physician partnerships.

But when it’s leaking, it’s costly. Leaks drain specialist revenues. They hurt PCP reputations. And they scuttle care-coordination, which increases the risk for redundant testing and medical errors.

Why Do Leaks Happen?

Why patients fail to follow-through on referrals can be a mystery. Every case is different. But here are four reasons patients tend to cite:

The specialist is too far away.

Geography is a major driver of referral leakage. Everyone has a busy schedule, and finding time to see a doctor can be a real challenge. A long commute makes that problem worse — and may be the hurdle that keeps patients out of a specialist’s office.

The patient finds a different specialist that, for whatever reason, they like better.

This can be a product a mistrustful relationship between patient and physician. Patients might feel misunderstood, and decide not to take their PCP’s advice.

The specialist is not available to see them.

When patients try to schedule an appointment with a specialist, almost 40% of them can’t even get one. Discouraged, they move on. And they never turn back.

The patient doesn't want to pay.

This is a sad reality of healthcare — for many, it’s unaffordable. High-deductible health plans and soaring care costs persuade 31% of patients to defer or delay treatment. Sometimes permanently.

So What Can Doctors Do?

The problem looks dire. And some factors — like patients balking at costs— are not entirely in doctors’ hands. It’s like that old saying: you can lead a patient to a specialist, but you can’t make them go.

However, though they can’t stop the leak entirely, PCPs and specialists can take steps to reduce it to a trickle.

Tips for PCPS

Form a long-term relationship.

Relationships are the best wrench to use on leaky referrals. Patients are more willing to trust the advice of doctors who know them well. Doctors who understand their patients, in turn, are better able to find a referral solution that works. This can nip some problems — like the two-hour commute issue — in the bud.

Communicate to ensure follow-up.

Keeping touch with patients is a good way to nudge them into seeing their specialists. Even if they don’t go, though, it’s still an opportunity — to ask why not. (And by the way, Luma has a few low-touch ways for practices to talk with patients.)

Tips for Specialists

Talk to PCPs.

50% of referred specialists don’t communicate at all with PCPs. This can cause them both to miss opportunities for engaging patients, and keeping them in the pipeline. Specialists can change that by keeping lines of communication open.

Be available.

Finally, specialists can help close the deal by keeping their doors open. Availability will always be a challenge. But a smart approach to appointment setting can keep patients from getting discouraged.

 

Picture of Matt Seidholz

Matt is a freelance healthcare content writer and journalist. He’s based in Omaha, Nebraska. More about his work at mattseidholz.com.