How to build profitable referral collaborations.

It goes without saying that having a successful private practice is all about getting those dreamy patients booked into your clinics.

Whilst I’m a passionate believer in reaching out directly to patients (millennial patients are huge on-line researchers of their healthcare), it absolutely makes sense to also build strong referral relationships. I’d go as far as to think about these as being collaborations.

It’s a privilege to receive referrals from another clinician and the referral process should also benefit them in some way, too. Now I’m not talking about a mercenary attitude of “let’s refer each other as many patients as possible”, and nor do I think it should be ‘tracked’ (e.g. send me one surgical patient and I will send you five physio patients”). I have seen some people acting in this transactional manner, but it feels a little forced and not necessarily a very natural way to refer patients whose needs should be our primary concerns.

Let’s have a think about the kinds of collaborations and where you might want to place a little bit more focus.

  The obvious collaborations.

These are the referrers you are currently receiving patients from and with whom you may frequently return the favour. Interestingly, even if you think they may know “all that you have to offer”, chances are, they might not know that you can also help the patients with “X” in addition to “Y”. This is why you need to regularly nurture these relationships, as they may potentially lead to you receiving patients who can benefit from all your talents.

For instance…

I had a spinal surgical colleague who wasn’t aware the best way to rehab a patient with a rib stress fracture, until the patient was presented at an MDT meeting that I attended. Now he sends patients to me.


Because I have worked with lots of Olympic rowers, whereas previously he’d send them to rheumatologists to investigate whether or not they had dicky bone mineral density. MDTs are a brilliant way to showcase your skill set and to demonstrate your breadth of knowledge, so find out where MDTs are going on around you and get yourself invited.

  The less than obvious collaborations.

Can you hand on heart say that you are awesome at treating every kind of clinical condition in your discipline? (Yes, I know that you think that you can probably help everybody, but in reality we are sometimes more competent at sorting out one kind of clinical situation and other times it feels a little bit rusty.) I’m talking about collaborating with the ‘competition’. In other words, clinicians who do and treat the same things that you do.

Seems nuts?

Patients are actually enormously impressed when you reach out for “a bit of input”, from another surgeon, osteo or physio.

Not infrequently, I’ll divert a footballer with a stubborn achilles issue to an SEM colleague, who also sends me tricky hip patients.

  The lateral collaborations.

Some referral relationships seem natural. For example, physiotherapy and orthopaedics. Others may seem a little more ‘lateral’ in nature. Think of the last time you had a patient with some slightly obscure symptoms and after investigating them, you went on to refer them to a very different discipline.

For instance…

Imagine you are a neurosurgeon with a patient whose thoracic pain checks out normally on an MRI scan, but a gastric ulcer was then confirmed by the gastroenterologist you then referred them onto.

In that kind of situation, you may well have future patients who have similar symptoms.

When you notice these clinical scenarios coming up, reach out to meet up with that clinician to see where you can take that relationship. Don’t just let the opportunity pass by.

Other examples might be…

Rheumatology and Dermatology (for those psoriasis and lupus patients),

MSK and endocrinology (for those over-trained patients with clapped out thyroid glands),

Gynaecology and hip Orthopaedics,

Physio and sleep Neurologists (for when it’s not just pain that’s keeping your patient awake at night).

The list is endless.

  Knowledge-for-referrals collaborations.

This is an interesting situation and one which might be going on without you realising it. Many physios say that they feel awkward about connecting with Orthopaedic surgeons, because they might only have the occasional surgical patient to send to them. As an SEM consultant, I see both sides of the situation, and I know that having excellent therapists to send my patients to is just as important as receiving patient referrals. If you are an awesome osteo or physio that can help my patients return to marathon training, stress-free, then I want to seek you out, even if you may not have anyone to send me in return. At the end of the day, it’s all about the patient care and part of my ‘expertise’ includes knowing who the best therapist with an interest in trapeze artists with shoulder problems are.

And it works both ways. I have some wonderful collaborations with therapists that I can rarely send patients to, because either the geography or the insurance situation does not permit it.

So how does that relationship work?

Well, I promise to make myself freely available to their text/email/phone calls/MRI-second-pair-of-eyes-opinion, and I turn around those responses, super-fast. If they have a patient with them in clinic, they know they can pretty much rely on saying they will be able to get back to the patient, with an answer from myself, a little later on in the day. Although it may not seem obvious to the person giving the advice, it can be hugely reassuring for the recipient when they know their next best move.

If you feel you are the ‘last chance saloon’ provider of patient care (e.g. if you work in pain medicine) this is a way to be super-useful to your peers and it makes for wonderful collaborative relationships.

Make yourself very contactable and it’s a win-win situation.

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