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Practice owners can throw boatloads of money into marketing programs with mailings, commercials and print advertisements. They can devise fully-round publicity campaigns, chock full of free screenings, giveaways and informational articles for the community bulletin. But no matter how much money and energy is invested, these promotional avenues will never have the impact of a referral.
"I don't depend on newspaper ads to bring new patients into my doors," says Barbara Jenkins, AuD, owner of Advanced Audiology Inc. in Centennial, CO. "I would rather spend my money on something to keep my patients happy, or a more impressive business card. Now, an ad may get you a quicker response, more patients in the door faster, but if your goal is long-term growth and stability as a practice, the referral is the primary base you should be focusing on."
The reason is simple: personal recommendations carry a lot of weight. When someone-be it a medical professional or one of your current patients-refers another person to your practice, they are instantly lending you their credibility and earned trust while instilling the potential patient with confidence in your expertise.
"A lot of patients have a long-term rapport with the provider, whether it's a pediatrician or a primary care practitioner. So for that person to trust you enough to refer them out, I think it creates a lot of confidence for that patient in what we do," says Rachel Anderson, AuD, owner of Anderson Audiology Inc. in Trenton, GA. "As for patients-the happy patients are your best referral source because they can actually tell somebody, 'I've been through it and this was great for me.'"
Promoting Value
In a down economy, it's tempting to begin marketing with price in mind, but while that may work in the short term, it won't help your practice plant roots in the community. Ultimately anyone can beat your price, but if you focus on value, you'll appear more referable.
"There are two types of patients-the first is going to respond to your typical media ads (newspapers, etc.) because they're looking for the best deal. They look at a hearing aid purchase as a retail issue and consider themselves the customer. Whoever has the best price at the time is the one they'll do business with," Dr. Jenkins says. "The second is the type who views their need for a hearing aid as a health issue. They see themselves as the patient and are looking to you to give them the best care. This person is searching for someone they can trust and will look to a friend or a physician to give them a referral. This new patient has already been assured of your credibility by the person who referred them."
Then when you nurture that patient with consistent and reliable care, they will become an ambassador for your practice. Dr. Jenkins says they will "be more likely to refer their friends because they know you'll treat them well." But patients aren't the only ones who will be impressed if you focus on care; medical professionals will take note as well.
"You're an audiologist. You need to be perceived as a healthcare provider, not as a sales person, and that's something you have the power to do," Dr. Jenkins says. "Healthcare providers refer to and understand other healthcare providers; the physician will understand and be more willing to refer to you if that's how you base your practice."
River of Molasses
Another advantage of a strong referral base is that it can help audiologists circumvent the low industry penetration numbers. Of the estimated 34.5 million hearing-impaired Americans, just one in five are properly diagnosed and fit with hearing instruments, and studies show that the average patient lives with hearing loss for seven to 10 years before they get their first hearing test. As a result, traditional advertising can only be so effective, because many hearing -impaired people don't even realize they have a problem.
"I refer to this time span as the river of molasses, because they're just kind of floating down this river, living with hearing loss, in denial of the problem because it's coming on gradually," says Rich Hachenburg, president and founder of Competitive Edge Healthcare Marketing and senior director, consulting services, for Practice Builders. "I've always been a proponent of educating the primary doctors about identifying the signs of hearing loss and then encouraging those patients to get a hearing test. By going directly to the doctor, you can capture this patient earlier on in this river of molasses, so to speak, and get them in for the hearing test before they're going to respond to any type of traditional type of advertising directed to the patient."
Putting in the Work
It sounds great, and yet, according to Hachenburg, cultivating referral sources, particularly in the medical community, is one of the underutilized methods of marketing for audiology practices. One reason for this is that it takes a lot of legwork, especially when compared to traditional marketing methods.
"I kind of like to refer to it as farming, with traditional advertising being more like hunting," he says. "You run a print ad and the phone rings, you book a hearing test, you dispense hearing instruments-you shoot, you kill, you cook, you eat. Whereas when you're marketing to the medical community, it really takes a lot more time and it's much more like farming-you have to identify where the sources are and, just like you would cultivate the field, you have to build relationships within the practice, not just with the physician, but also with the office manager, the referral coordinator, and even the staff, all of which are going to be an influence on the patient."
Building such relationships can take time. Since physicians are putting their credibility on the line when they refer to you, they need to be sure you can provide their patients with the best care possible.
"Trust has to be built and nurtured. You don't have someone's trust unless you've earned it. Every time a physician sends one of their patients to you, it is a direct reflection on them, so they tend to be very cautious at first," Dr. Jenkins says. "The physician has a pool of other professionals that they can refer, most notable being ENT practices. It can be difficult to get them to refer to you as an independent audiologist, but it's worth the work."
Even once you build these relationships, you need to be sure not to get complacent-continue looking for more, and also don't forget to continue cultivating the ones you have. Otherwise, your investments will wither.
"Patients move, physicians close practices, and someone else is going to do their best to take that referral base away from you," Dr. Jenkins says. "Consequently, a consistent referral marketing plan is imperative to keep your practice going and growing."
There are a number of ways to continue gaining new referral relationships and to continue nurturing ones you already have. Occasionally stopping by to drop off educational brochures or cookies or just for a chat can help keep your name in the minds of the physicians and their office staff. Even better, you should make sure to always send a follow-up report to a physician.
"Whenever a patient comes in for a hearing device, whether referred to by the physician or not, the audiologist should ask, 'May I send a report to your doctor?'" Dr. Jenkins says. "Even though it's not a face-to-face contact, the physician will see your name on the report, and you'll have separated yourself from the majority of hearing aid practices."
"I think the faster you get those results out and the more thorough you are with the examination and how it went can build credibility between you and that other professional," adds Dr. Anderson.
Overcoming Hesitancy
When it comes to cultivating patient referrals, Hachenburg says one of the biggest roadblocks can be a perceived awkwardness.
"That's one reason why patient referrals are not asked for as consistently as they should be-because the staff members, not just the audiologist, but the staff members too-they all feel uncomfortable doing it," he says. "Audiologists and their staffs shy away from it because they don't want to come across looking greedy or needy."
The best way to overcome this fear is to get into the habit of identifying opportunities when talking with a patient. According to Hachenburg, the ideal time is when a patient provides positive feedback.
"That's a great time to say, 'Thank you. We would love to have patients like you and be able to help them just like you. There are millions of Americans that have hearing loss but go undiagnosed and untreated, and we would ask if you know somebody who may have a problem with their hearing, and they haven't been tested recently, that you have them come in for a test.'"
Hachenburg suggests using a tool called a pass-along certificate when conducting this conversation, because offering something tangible-whether it is a business card, a fact sheet, or a brochure-can empower "your patients to go out and become ambassadors."
Similarly, audiologists can use the opportunity to request that satisfied patients let their physicians know about the positive experience. "A well-cared-for patient is really the only thing the physician cares about," Dr. Jenkins says. "You can give them all sorts of information, you can send them cards, you can do just about anything, but unless they've heard from one of your satisfied patients that you are a professional, they're not going to refer to you."
Sustaining Power of Referrals
It takes a lot of effort and persistence but, according to Dr. Jenkins, establishing a strong referral base will ultimately work toward economy-proofing a practice.
"Cultivating referral sources from your patients and physicians should rank number one in your marketing budget because it's going to produce a patient base you can count on, especially if the economy falters," she says. "This year we've seen more growth than ever before, and it's primarily because we have a strong base of patient and physician ambassadors who are referring to us. "It's somewhat like building a house of wood or brick. The wood house may be faster to build, but to last, it's worth the extra effort and time to build out of brick. Your business will stand the test of time and a weak economy if you build it brick by brick, referral by referral."
Frank Visco was formerly associate editor of ADVANCE for Audiologists.
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