Ancient History

When I got out of residency in 2004, this question was easy to answer. A good referral source was a general dentist or pediatric dentist who sent me every child or adult that the dentist decided needed braces and gave a strong endorsement. I, like most orthodontists, tracked where our new patients came from and regularly thanked our good referrals with a wide array of ever more interesting and personalized stuff. I spent a great deal of money and time knowing who liked what, who expected what and fulfilling expectations that continuously spiraled up. I also sent patients to our “good referrers” but the dentists and pediatric dentists never seemed to track or appreciate all the patients I sent them (and that was a constant source of frustration because I sent out a lot of patients).

As the years passed I could see the writing on the wall – GPs doing Invisalign, GPs and Pediatric dentists who’d never done ortho before taking a course in Dallas and putting brackets on (usually about the time I finished treating them, their spouse or their last child for free), DSOs buying up GP offices, large GP offices and Pediatric Dentists brining in their own orthodontists – and we decided that we’d best find other, more stable and reliable sources of new patients.

The New Normal

The most obvious and easiest source of new patients are referrals from existing, happy patients. This is and has been our largest source of new patients for quite some time. We don’t have to do a lot to get these patients. As long as we deliver as promised in the vast majority of cases, in the timeframe we promised, and do so with what the consumer perceives as good value; our customers will share their general happiness with their friends, families and neighbors. Of course we ask for their support as well but we have never been ones to reward our patients for doing what comes naturally.

Direct to consumer advertising is a popular choice among orthodontists for soliciting new customers and I spent a great deal of time and money on DTC advertising early on. I’ll admit DTC was useful years ago before other orthodontists were doing it but DTC is cumbersome and expensive and we orthodontists are generally not as good at it as we think we are. These days it’s difficult to be heard over the big players in our space so you have to pick your spots. Internet marketing is still a big part of what we do but we have a professional handle this for us.

At some point I realized that Medicaid was an excellent source of new patients. When I was young and proud and knew everything, I refused to accept Medicaid. I was frightened of letting “those people” into my awesome, fee for service practice. I even went so far as to have a separate office for Medicaid at first because I believed what my professors told me about “those people”. What an idiot I was for several reasons. First, I defy anyone to point out the difference among “Medicaid patients” and “regular patients” in my office. Second, though a very strong percentage of our new patient flow comes from Medicaid, only about 16% of our revenue does. How can this be? What does it mean? It means that something magical happens when a “Medicaid patient” doesn’t score enough to qualify for state treatment. The instant they don’t score they become a “Private pay patient” and these private pay patients convert/start treatment at about the same rate as new patients who are not eligible for Medicaid! But this magic only happens only if you treat “those people” like everyone else! Once I realized that Medicaid was a huge referral source I started treating the state entity as such. We made sure we had our heads right about being grateful for the patients they “sent” us, we made sure to be extra polite and courteous in our interactions with the people who worked for Medicaid and we showed our appreciation any time we got the chance in the form of emails and letters of thanks. Being nice, responsive and likable certainly doesn’t hurt when dealing with an awesome referral source!

The next major, non-traditional referral sources we identified were insurance companies. We choose to be providers for several and we love our insurance partners. Just like in our dealings with Medicaid, we strive to be courteous, thankful, helpful, responsive and nice when dealing with the folks who work at insurance companies. Why wouldn’t we? After all, we evaluated what they offer and decided the deal was good for our business so we signed up to be a provider! It is interesting to me that so many orthodontists choose to work with insurance companies then have such a bad attitude towards our chosen business partners. Insurance companies are a huge source of new patients and should be treated as such! We make it our business to know the names of the people in charge of each of the major insurance referrals in our state and the adjacent ones just like we used to do for referring dental offices. To act otherwise makes no sense!

I know I’m slow but just yesterday I recognized another big referral source while reviewing our new patient trackers. Over the last 5 weeks Invisalign has sent us 19 new patients. That’s huge. What would you do for a dental office that sent you 15 patients a month? I know what I used to do and it makes me cringe! Now that I’ve recognized Invisalign for the great referral source it is, I am treating them as such. It’s hilarious to me that the entire reason I re-engaged with Invisalign was to get new patients but my mind was so stuck in traditional thinking that only now did I really recognize the important and valuable referral relationship. Just like with insurance, it’s amazing that so many doctors would choose to be a provider for Invisalign because it makes sense for their business but then focus on what they are not getting while being resentful of our chosen partner. No more. Yesterday I made sure the Invisalign team knows how grateful we are (see photos below) and starting today I’m going to make sure our team has the proper attitude of thankfulness. Why wouldn’t we? Anyone who sends us that kind of patient volume deserves our respect, admiration and gratitude! To do otherwise is to act like the dentists who don’t track or appreciate the patients you send them…

Now I just wonder what other sources of new patients am I taking for granted?


2 thoughts on “What Is A GOOD Referral Source?

  1. I agree, Invisalign is a great source of referrals and the old model of having a “friendly” gp referring you, becomes less and less prevalent and soon will die out like dinosaurs, especially outside of big metro communities. In big cities, with a GP on every corner, it is still working, but not like 15 years ago. I agree with you that we cant differentiate Medicaid patients from private patients and quality and care must be exactly the same. The only issue with Medicaid I see that it comes with a cost from the practice. When you start taking MD insurance, you compliance cost will be increased significantly due to State regulations (all it takes one complain and you will witness what State could do in this highly regulated and anti business environment) Additionally, having MD will decrease your potential equity value significantly, due to many potential buyers viewing a practice taking some MD as a liability.

  2. taking medicaid is not about the patients you treat for the state – very few get approved – it’s about all the patients that come in and don’t score and you get to sell treatment to.

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