1. Allison McCarthy Principal Marketing Your Joslin Diabetes Center to Primary Care Physicians

2. Overview 1.Referral relationship trends Marketplace issues Referring physician expectations 2.Referral growth Approach Strategy Accountabilities 3.Internal integration Operational systems Staff involvement 4.Next steps

3. Relationship Realities Relationships are more volatile Financial and quality issues share center stage Different physicians require different strategies Physicians have high expectations of their peers Referral management practices an assumed learning Physician morale, future shortages are reality Past success is not an assurance of future success

4. Endocrine Referrals Reality for 2010 and Beyond Different practice models Fewer PCPs Varying perspectives – who manages what Old vs. Young dichotomy More Staff = More management = More other duties Clutter Opportunity to target the right patients for the practice

5. Referring Physician Expectations Accessibility Appointments Consults – inpatient and outpatient Expertise Communication Pre-consult and post consult During treatment At treatment completion Recognition of Role Referral source Care manager Expert – overall patient Trust Interest in their needs Return the patient Quality treatment Patient satisfaction

6. Building Referrals What do you need? Is your preference to build: Patient-driven referrals Referrals from colleagues Just shift patient type All? Are you prepared to accept new business? Why have you not had more referrals from other physicians in the past? Is care going unmanaged? Why? Who will you need to take the business from? What is the best approach to get that done?

7. Characteristics of Winners Focused Ability to deliver based on THEIR needs Approach that recognizes the expectations of the referring physician 1.Talk to me 2.Make it easy to get patients to you for car 3.Value my role Internal support Administrative staff Other clinical providers Consistency Sees their referral relationships as integral to the practice Measurable outcomes

8. Referring Physician Targeting Research Current referral sources Potential referral sources Prioritize prospects Local and regional IM, FM, Pedi, OBG, Other Simple vs. complex Uncover existing referral source Local practice Leakage out of community Unmet needs Design approach Marketing Priorities Pt. TypeSpecialtyGeography

9. Face-to-Face Three must-haves Necessity Affordability Accessibility Provide added value New insights Patient management resources Differentiate what you offer Set expectations on referral process Know what you want... ask

10. Consistent Attention Synergy and connection Assuring the referring physician of his wisdom Having the tough conversations Ensure that staff reflect your philosophy Demonstrate success Social events Co-present on a patient at Grand Rounds PCP group discussions Case studies Continuing education session Share an article/published research Personal Presence Beyond the Proactive

11. Other Considerations Recognize where your office staff can and cannot assist Communication practices – calls, letters, faxes – you decide by do something! Hospital inpatient vs. office based patient management Hospitalists and PCPs Nursing/midlevel providers Tracking systems Follow-up really happens Trend referrals by physician/practice Review by patient zip code/extrapolate

12. Communication Standards Ensure patient registration captures Referring physician name Address, telephone, fax number, email Prior to outpatient visit, get background on patient Prevent you vs. PCP position Positions PCP as care partner Post consult Inform on treatment plan – tests, medications, other referrals During treatment – share significant changes Post treatment – send thank you for referral

13. Sample Letter Date Providers Name Address City, State Zip RE: (patients name) Findings: Diagnosis: Treatment Plan: Thank you for your referral. Sincerely, Your Name

14. Sample Referral Slip To: ___________________________ Date: ______________ ___________________is being referred to you for _________ Please keep me informed via Telephone Fax Email Thank you for seeing this patient. (Referring Provider Name) Thank you for your referral. Sincerely, Your name

15. Involvement of Your Staff Seen as insiders – emulate your desires Administrative staff Capture referral source Record pcp even if patient self referred Schedule appropriately Send referral communications Clinical staff Hospital and practice nursing relationships Connections with referral coordinators 1.Telephone and face-to-face 2.Handouts/forms Keep good documentation for progress reports Conduct educational or in-service sessions

16. Dont Forget Referral Source Staff Copies of brochures, maps, referral pads, schedules, etc… Thank you notes/gifts Holiday acknowledgements Payer participation updates Exceptional responsiveness to requests

17. Other Areas Worth Mentioning Patient-focused marketing Media activity/PR events Web strategies Hospital referral lines Committees and meetings Managed innovation Competition

18. Next Steps Clarify referral source expectations – make adjustments Retention of existing referrals Development of new business Establish consistent approach to communication Take care of their needs – access, education, availability Take advantage of the Joslin name recognition Review with clinic staff – understand its important Track, trend, and monitor

19. Red Flags Perception – stealing patients Follow-up is inconsistent Delays in scheduling patients Sending the wrong message Telling patient PCP diagnosis was wrong Talking like an expert vs. peer-to-peer Decisions about care are made without referring physician participation Lack of availability when treatment is unsuccessful Referral sources stop referring

20. Marketing Achievement Market Share Mind Share Preference Use Re-UsePositive Word of MouthTop of Mind Awareness Name Recognition

21. Top Ten Things to Successful Referral Growth 10.Affiliate with Joslin 9.Let referral sources know your practice is open 8.Consider web site section designated for referral sources 7.Share useful articles/ case studies 6.Offer educational sessions – visibility is key 5.Provide easy-to-use referral tools, i.e. pads, forms, etc… 4. Build strong referral communication practices 3. Ensure consistent access to patients and referral sources 2. Develop a culture that embraces referrals 1. Provide great care!

22. Thanks! Allison McCarthy Principal, Barlow/McCarthy (508) 394-8098 amccarthy@barlowmccarthy.com