Tag: referrals

Optometry to Optometry: An Untapped Resource for Better Health Care Delivery

Career Options, Differentiation | Business Strategy, NextGenOD, Practice

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Optometry to Optometry

Intraprofessional collaboration is not new to health care. Although only making up a minority of referrals1, referrals within a profession address commonly faced pain points: wait-times, access to specialized care, and communication.2 There are tremendous advantages for our patients when optometrists embrace this type of referral practice.

A referral is defined by the World Health Organization as “a dynamic process in which a health professional at one level of the health system (…) seeks the help of another facility at the same or higher level to assist in the care pathway.”3

Other Profession’s Experience

In dentistry, general practitioners with advanced training (ie. in oral pain or sleep apnea) accept referrals from their colleagues while maintaining streamlined referral patterns.4

In physiotherapy, intraprofessional referrals look like a patient seeing their primary physiotherapist for running optimization, another physiotherapist for biking-related injuries, and another specialist for glute and lower leg health.5

We are no strangers to intraprofessional referral pathways in medicine. Specializations have been traditionally well delineated within medicine, allowing traditional intraprofessional referral pathways to exist.

In optometry, intraprofessional referrals are increasing, though there is room to be more supportive of each other’s areas of expertise. For some, intradisciplinary referrals might be conceptually challenging because historical referral pathways positioned optometry as primary care and ophthalmology as secondary care. However, we must recognize that access to appropriate care is improved when everyone practices to their highest ability.

Optometry Referral Opportunities

Optometric specializations include specialty contact lenses, myopia management, vision therapy, and many advanced ocular disease subspecialties. As subspecialties grow, the goal is not to multiply professional silos but rather, to improve collaboration and integration in the context of knowledge-sharing; a principal borrowed from operations management.6 As a profession, we must stop fighting this because all we accomplish is an attack on ourselves and a disservice to our patients. Intraprofessional referrals done properly lessen the volume burden on tertiary care and enhances patient care overall.

Dr. Debbie Luk, a Canadian leader in Sports Vision and Vision Therapy, describes optometry-to-optometry referrals being key in increasing awareness for optometry’s scope. Patients better understand their options and have better accessibility that can ultimately improve their quality of life.7

To adopt intraprofessional referral pathways as a referrer, one must be self-aware. Being humble to know where one’s competency starts and ends is a sign of a prudent practitioner. It is not a weakness to not know everything. In fact, it is a strength to recognize it. Learn what you do not know. Talk to those who specialize in areas that you do not and learn the referral protocol that you can adopt.

To adopt this as a referee, one must have training and one must be willing to add value to the referring community; to be trusted with referred patients. This is a commitment to communicating well with referring doctors and an openness to respecting the level of referral they prefer. For example, some may be referring to you for co-management whereas others may be referring for a complete transfer of care. And of course, the patient must be clearly communicated with regarding the referral arrangement as they have complete choice in their care.

Dr. Natalie Chai, who has a thriving referral practice for Dry Eye Disease and Myopia Management, intentionally empowers her patients and provides education to referring doctors to demonstrate that they may one day be able to offer the service themselves.8

The Power of Together

For myself, one of the most exciting things about building an optometry-led ocular disease triage model is brainstorming with referring doctors to find solutions for their patients. Every correspondence is an opportunity to collaborate and to provide more efficient access to secondary or tertiary medical management and surgical access.

However, a pearl of wisdom: it is vital that anyone receiving referrals be self-aware too. It is just as crucial to a patient’s care to accept a referral within one’s area of expertise versus denying a referral when that patient is best served elsewhere.

There is power in learning collectively and there is power in working together. Regarding hesitations because of unfamiliarity, know that you are not alone and trust that the hesitation can be overcome by having a dialogue about it. On concerns about knowledge or competency gaps, know that you are not alone in that either. You can learn anything if you really want to.

Finally, if there is a fear in getting started, a quick chat with your colleagues who are a few steps ahead of you will show you that we have all been there too. Remind yourself that you have started big things before and have come out on the other side better for it.

Optometry, let us believe in ourselves and in each other – for the sake of our patients, and for the sake of health care of which we play a crucial part.

References:

  1. Binczyk NM, Nazarali SA, Damji KF, Solarte C. Epidemiology of ocular emergencies in a large Canadian eye centre. Can J Ophthalmol. June 2023. doi:10.1016/j.jcjo.2023.05.008
  2. Seyed-Nezhad M, Ahmadi B, Akbari-Sari A. Factors affecting the successful implementation of the referral system: A scoping review. J Fam Med Prim Care. 2021;10(12):4364. doi:10.4103/jfmpc.jfmpc_514_21
  3. World Health Organization. High-Value Referrals – Concept Paper.; 2023.
  4. Wong C. Interview with Dr. Cameron Wong (Calgary, Alberta) – 07-10-2023. 2023.
  5. Wildeman A. Interview with Alyssa Wildeman (Calgary, Alberta) – 06-28-2023. 2023.
  6. Gifford R, van der Vaart T, Molleman E, van der Linden MC. Working together in emergency care? How professional boundaries influence integration efforts and operational performance. Int J Oper Prod Manag. 2022;42(13):54-78. doi:10.1108/IJOPM-10-2021-0644
  7. Luk D. Interview with Dr. Debbie Luk (Calgary, Alberta) – 06-28-2023. 2023.
  8. Chai N. Interview with Dr. Natalie Chai (Edmonton, Alberta) – 07-10-2023. 2023.

 

 

 

 

 

 

 

Dr. Sophia Leung, OD, FAAO, FCCSO, Dipl ABO, Dipl Ant Seg

Dr. Sophia Leung is a residency-trained and fellowship-trained optometrist with a clinical emphasis in cornea, advanced glaucoma, and anterior segment disease.  She is currently practicing at a surgical referral center in Calgary, Alberta performing surgical triage, secondary and tertiary medical management, and surgical co-management alongside ophthalmology.  Dr. Leung is also the current President-Elect of the Alberta Association of Optometrists.

 

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Tips to Generate Positive Referrals from Friends & Family

Digital Marketing, Marketing, Resources

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Generating positive referrals from patients is a key to practice growth. Since the inception of our practice in 1969, referrals of family and friends have been the greatest contributors to new patient growth.

Measure to Improve
Like any other marketing technique, measuring and quantifying is a must. Measuring enables us to see what works and what does not work. In the case of referrals, specifying who referred a new patient to our practice lets us further develop our “referral tree.”

Certain patients, whom I refer to as “mover and shakers,” will always be more likely to refer than others. Having a feel for this can help us and our staff cater our language and diction to capture more referrals, especially from our more vocal mover and shaker patients.

Consider a 1.4 million gross revenue per year. Average revenue of $350 per patient with 10% attrition = $140,000 or roughly 400 patients in loss.

We currently average five new patients a week: 5 patients x 52 weeks = 260 new patients x $350 = $91,000 in growth.

We can break this down further. Let’s say we have a mover and shaker patient who loves our practice, and gives us five new patient referrals a year (and in fact we have multiple patients that do this). And then let’s say we have a patient who is warm to the practice, but not as passionately supportive, who may give us one new patient referral a year.

Considering our average per patient in our area is about $350, if we have five patients generating five referrals each, that results in 25 new patients. So, 25 x $350 =$8,750 in extra revenue growth.

To get that growth with our other patients, we would need 25 non-mover and shaker patients to refer an average of one new patient. In addition, these patients would need significantly more resources invested into them to get that “push” to refer vs. our mover and shaker patients who only need the regular excellent service and care we give.

With that math in mind, you can see how quantifying and qualifying your referral sources is much more efficient and effective than blanket-marketing campaigns.

The thank-you letter Dr. Neufeld sends to patients after comprehensive exams. He says sending this type of letter encourages referrals.

Impress Patients with Service
We shy away from signage or incentives for referrals. In our opinion, this appears superficial, and thus, we believe patients may view it as superficial as well.

The process of making a good impression starts the second the patient enters our practice. The tone of our receptionist’s voice, the tidiness of the reception area, and the overall ambience of the practice instantly starts to mold the patient experience. This then continues into the exam room.

In fact, the experiences at the front desk, in the exam room, and in the optical, are paramount for satisfying the patient and starting the referral engine. If I have a pleasant patient (which tends to be the majority of my patients), I often mention that I would love to see more individuals like themselves, such as friends and family. I try to link a personal attribute to this, whether it be the ability to consistently arrive on time, pleasantness, or an interesting personality. Our opticians also will often compliment patients who are easy to work with, or have great taste in optical wear, saying that they wish to see more individuals like the patient.

Incentivizing a patient to refer comes down to appealing to the patient. This stems from allowing the patient to develop a deep appreciation for your services and you as an individual. Once this is established, referrals become second nature and nearly unconscious. To do this, both the staff and practitioners must regard the patient as the highest entity, and center their actions on the patient’s welfare. Most important in this – the patient must be aware that this is how the doctor feels about them.

We feel that generating a deep-seeded appreciation for our services and products produces the most genuine reaction from patients. Referrals “from the heart” are more likely to follow through. More so, we believe that incentivizing through discounts or free material may actually hinder an organic progression of referral due to its “gimmicky” nature.

Dale Carnegie’s “How to Win Friends and Influence People” and Robert Cialdini’s “Influence: The Psychology of Persuasion” are two fantastic books that I recommend every private practitioner read. Understanding the psychological science of how an individual develops fondness and appreciation for another is pertinent in developing a consistent patient who will bring their family and friends to see you.

Ask Patients to “Like” Your Practice Facebook Page
We have invited many of our patients and friends to like our Facebook page. We try to post updates twice a week on social media. Most of our updates are informative in nature or relate to community service. We have found that this style of social media posting (rather than just straight advertising) is most likely to inspire a positive interaction and get shared.

As with our other marketing tactics, we measure by survey how many patients we have seen who heard about our practice through Facebook. We have found that boosting informative posts has helped us gain new patients from social media. We recently had a new patient explain that she viewed us as the “most competent eye doctors in the neighborhood” because of the amount of informative material we publish on social media.

About 90 percent of posts are informative in the sense that they give education on eye conditions, eye health, ophthalmic materials or trivia related to optometry. A little less than 10 percent of our posts focus on local community service such as our work with the Rotary Club. By sending messages from both the educational and community service front, we believe that we can project a more well-rounded sense of caring and expertise to our audience

Send Welcome-to-the-Practice Letters
I send a “Welcome to the Practice” letter to every new patient whom we see. Many patients will respond, and a few have even come back in to tell me how nice and personal the letter was.

Turn Frame Selection Into Referral Generation
Our opticians ask the patient if they would like a family/friend “frame consultant,” when a patient is shopping for frames. This can happen one of two ways:

PUT FRAMES ON HOLD. A few frames are put on hold for the patient, and the optician tells the patient to come back with a trusted friend or family member to provide a second opinion and help make the final decision.

SEND FRAMES HOME TO DECIDE. A few frames are sent home with the patient in one of our boxes. The patient is to have a family/friend help them decide which looks the best. (If you do this, remember to always document thoroughly – we have never had a problem with loss doing this).

The frame consultant scenario enables that person to feel like they have an important role in choosing our patient’s glasses, and subsequently, their style. That transfer of authority and responsibility generates interest in our practice, and many times the person serving as a “consultant” will choose to schedule an appointment with us.

 

AARON NEUFELD, OD

is the owner of Los Altos Optometric Group in Los Altos, Calif. To contact: aneufeldod@gmail.com

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Install a Referral System–and Track Your Growth

Marketing, Practice, Practice Metrics & Benchmarks, The Patient Journey

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Referrals are a key driver of practice growth. At our practice, our five ODs and support staff of 18 conduct about 7,500 comprehensive exams annually.
When new patients come in, we ask how they came to us, and an average of 50 percent are friends of patients, and 65 percent are family of patients. Surprisingly, about 25 percent come from search engines, and the remaining from insurance lists, and passersby. Before the advent of search engines and social media, our second-largest source of referrals were insurance provider lists.
Tracking referrals from patients to friends and family, and delivering service that impresses patients enough for them to spread the word about us, continues to bring new patients into the practice.
We started our practice cold 28 years ago. We started with the referral of our very first patient by a friend of a friend. Since then, we have always placed a high value on referrals. I believe it is the best way to bring in patients who are most likely to be loyal over time. We make a concerted effort to treat each patient like our only patient and try to make everyone feel like family.

The patient intake form Dr. Smith makes available for patients on her practice web site. Dr. Smith says it’s important to ask new patients how they found your practice, and to encourage those who had a positive experience to let their friends and family know about your services.
USE EVERY OPPORTUNITY TO ASK FOR REFERRALS
Many patients make comments like, “I should bring my husband/wife in” or “I should bring my kids in.” This reassures us that we did a good job of marketing our practice during their visit because they want their family and friends to have the same experience.

When a new or existing patient calls for an appointment, our front office staff asks if there is anyone else in the family we could help make an appointment for. If a patient expresses appreciation for a job well done, then our staff says, “Thank you! It has been our pleasure, and if you or any of your family or friends need our services, we would be happy to help them as well.”

To increase the likelihood of people wanting to tell their friends and family about a business, that business should excel and stand apart from the norm. People vary in what things and experiences may impress them most. However, If you look at the most successful businesses, especially service-oriented businesses such as restaurants, hotels, and healthcare practices, it is undoubtedly the service that drives the most referrals.

Our practice mission statement is “Focused on your needs. Committed to excellence.” Our goal is to have our patients tell others that they had excellent, thorough care and that we provided great service.

We e-mail thank you notes and surveys to every patient after their exam. We currently have a 95 percent satisfaction rate with a “yes” when asked if they would refer others.

TRACK CONSISTENTLY
For the past 23 years, we have tracked where our patients come from. We have a Welcome Sheet, which we ask every new patient to fill out. If the answer to the question of how the patient found us is left blank, the front office staff is responsible for asking the patient directly. On the rare occasion that the response to that question is still blank by the time the patient reaches the exam room, I ask the patient directly myself. It is really a pleasure to hear that most of them are referred by friends, work colleagues and family members.

OFFER EXCEPTIONAL SERVICE & SAY THANK YOU
In California, where our practice is based, it is illegal for any healthcare professional to offer incentives for referrals. However, we make sure our patients are thanked and appreciated verbally for their referrals.

By focusing our efforts on providing exceptional care and service to our patients, we hope to earn their loyalty and the referrals of their friends and family. You can’t put a price on service and building relationships with patients. It is like putting a price on friendships. I believe that as old fashioned as this may seem, building a practice based on loyalty and referrals is far less expensive and time consuming than the cost of any type of ad marketing or media advertising. Our practice has not had much response from paid advertisements. It may be that the public does not respond to objective ads anymore with the advent of more subjective, personal internet ratings.

We used to have a large ad in the yellow pages, which was astronomically expensive. It was a big book of large ads for businesses, which made it difficult for consumers to decide where to go for services. Now, with internet reviews that are free for consumers to use, we virtually have free advertising by the reviews placed by our patients.

Approximately 25 percent of our new patients find us directly through internet search engines and reviews.That is a lot more than the number of patients who came in after seeing our yellow page ad, which was only about 5 percent.

TRAIN STAFF TO OFFER A MEMORABLE EXPERIENCE
The majority of patient referrals are from happy, satisfied patients who report having had the most thorough exam, or best service, ever. We also receive many referrals from long-time patients. Other popular referral sources are patients who have not received successful contact lens fits elsewhere. Many refer their friends, colleagues and family members simply because our staff has shown them great customer service, and were able to develop a strong rapport with them.

I cannot over emphasize the value of a well trained staff in order for patients to want to refer others. The staff actually spends more total time with our patients than the doctors, so it is imperative that our staff is on board with our goals and objectives for growing the practice. Patients will stay with a practice or leave a practice very easily because of their interactions with the staff.

TAKE OPPORTUNITY TO PASS ALONG PRACTICE BUSINESS CARD
When a patient compliments our office, a front office staff member might give them a business card and say, “Thank you so much! We appreciate your compliment! Please take a business card in case you know someone who may need our services.” Most of the time patients take business cards, or ask us for our business cards, without any prompting, and this is really the best compliment they can give us!

BEVERLY JUE-SMITH, OD, MBA

Beverly Jue-Smith, OD, MBA, is the owner of San Ramon Family Optometry, Inc., in San Ramon, Calif. Dr. Jue-Smith also is owner of Optometric Consultants, a private practice consulting firm. To contact her: srfoptometry_drb@yahoo.com

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Install a Referral System–and Track Your Growth

Marketing, Practice, Resources

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When new patients come in, we ask how they came to us, and an average of 50 percent are friends of patients, and 65 percent are family of patients. Surprisingly, about 25 percent come from search engines, and the remaining from insurance lists, and passersby. Before the advent of search engines and social media, our second-largest source of referrals were insurance provider lists.

Tracking referrals from patients to friends and family, and delivering service that impresses patients enough for them to spread the word about us, continues to bring new patients into the practice.

We started our practice cold 28 years ago. We started with the referral of our very first patient by a friend of a friend. Since then, we have always placed a high value on referrals. I believe it is the best way to bring in patients who are most likely to be loyal over time. We make a concerted effort to treat each patient like our only patient and try to make everyone feel like family.

The patient intake form Dr. Smith makes available for patients on her practice web site.

Dr. Smith says it’s important to ask new patients how they found your practice, and to encourage those who had a positive experience to let their friends and family know about your services.

USE EVERY OPPORTUNITY TO ASK FOR REFERRALS

Many patients make comments like, “I should bring my husband/wife in” or “I should bring my kids in.” This reassures us that we did a good job of marketing our practice during their visit because they want their family and friends to have the same experience.

When a new or existing patient calls for an appointment, our front office staff asks if there is anyone else in the family we could help make an appointment for. If a patient expresses appreciation for a job well done, then our staff says, “Thank you! It has been our pleasure, and if you or any of your family or friends need our services, we would be happy to help them as well.”

To increase the likelihood of people wanting to tell their friends and family about a business, that business should excel and stand apart from the norm. People vary in what things and experiences may impress them most. However, If you look at the most successful businesses, especially service-oriented businesses such as restaurants, hotels, and healthcare practices, it is undoubtedly the service that drives the most referrals.

Our practice mission statement is “Focused on your needs. Committed to excellence.” Our goal is to have our patients tell others that they had excellent, thorough care and that we provided great service.

We e-mail thank you notes and surveys to every patient after their exam. We currently have a 95 percent satisfaction rate with a “yes” when asked if they would refer others.

TRACK CONSISTENTLY

For the past 23 years, we have tracked where our patients come from. We have a Welcome Sheet, which we ask every new patient to fill out. If the answer to the question of how the patient found us is left blank, the front office staff is responsible for asking the patient directly. On the rare occasion that the response to that question is still blank by the time the patient reaches the exam room, I ask the patient directly myself. It is really a pleasure to hear that most of them are referred by friends, work colleagues and family members.

OFFER EXCEPTIONAL SERVICE & SAY THANK YOU

In California, where our practice is based, it is illegal for any healthcare professional to offer incentives for referrals. However, we make sure our patients are thanked and appreciated verbally for their referrals.

By focusing our efforts on providing exceptional care and service to our patients, we hope to earn their loyalty and the referrals of their friends and family. You can’t put a price on service and building relationships with patients. It is like putting a price on friendships. I believe that as old fashioned as this may seem, building a practice based on loyalty and referrals is far less expensive and time consuming than the cost of any type of ad marketing or media advertising. Our practice has not had much response from paid advertisements. It may be that the public does not respond to objective ads anymore with the advent of more subjective, personal internet ratings.

We used to have a large ad in the yellow pages, which was astronomically expensive. It was a big book of large ads for businesses, which made it difficult for consumers to decide where to go for services. Now, with internet reviews that are free for consumers to use, we virtually have free advertising by the reviews placed by our patients.

Approximately 25 percent of our new patients find us directly through internet search engines and reviews.That is a lot more than the number of patients who came in after seeing our yellow page ad, which was only about 5 percent.

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Cultivating Patient Loyalty: Five Steps to Success

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TRAIN STAFF TO OFFER A MEMORABLE EXPERIENCE

The majority of patient referrals are from happy, satisfied patients who report having had the most thorough exam, or best service, ever. We also receive many referrals from long-time patients. Other popular referral sources are patients who have not received successful contact lens fits elsewhere. Many refer their friends, colleagues and family members simply because our staff has shown them great customer service, and were able to develop a strong rapport with them.

I cannot over emphasize the value of a well trained staff in order for patients to want to refer others. The staff actually spends more total time with our patients than the doctors, so it is imperative that our staff is on board with our goals and objectives for growing the practice. Patients will stay with a practice or leave a practice very easily because of their interactions with the staff.

TAKE OPPORTUNITY TO PASS ALONG PRACTICE BUSINESS CARD

When a patient compliments our office, a front office staff member might give them a business card and say, “Thank you so much! We appreciate your compliment! Please take a business card in case you know someone who may need our services.” Most of the time patients take business cards, or ask us for our business cards, without any prompting, and this is really the best compliment they can give us!

BEVERLY JUE-SMITH, OD, MBA

Beverly Jue-Smith, OD, MBA, is the owner of San Ramon Family Optometry, Inc., in San Ramon, Calif. Dr. Jue-Smith also is owner of Optometric Consultants, a private practice consulting firm. To contact her: srfoptometry_drb@yahoo.com

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