Ditch Dependence on Docs: Why You Don’t Need Physician Referrals to Get More Patients

For a long time, getting more patients meant you had to get more physician referrals. That’s why, historically, PTs in the USA have put nearly all of their eggs in the referral basket—because it was the only basket we had. We relied almost exclusively on physician referrals to keep our doors open—and some of us still do. The problem with that relationship is that it undermines PTs’ position as doctorate-level healthcare professionals who are not only capable of acting as primary care providers for patients with neuromuscular issues, but also best suited to sit in the driver’s seat for those care episodes. That’s why, in the eyes of other members of the healthcare community, PTs still appear inferior to their physician colleagues—more like subordinates than peers.

The Direct Access Debacle

Even though our industry has fought long and hard for patients to be able to seek physical therapy first—some form of direct access now exists in all 50 states—many therapists are hesitating to capitalize on that victory. Instead, they are continuing to rely on physician referrals for the majority of their business. Some are even turning direct access patients away—requiring them to obtain referrals from their physicians before they can even get an appointment on the books.

Now, I get that there are still restrictions to direct access—and we must continue to fight to remove those barriers. But, we also have to own the power that we do have. Otherwise, the rest of the healthcare community will continue to pigeonhole us as adjunct providers who do not deserve primary care status—and who are incapable of serving as care coordinators. And that couldn’t be further from the truth.

The Payment Reform Predicament

Furthermore, with payment reform and other regulatory initiatives putting more of a squeeze on our reimbursements, we have to start thinking about innovative ways to tap into new sources of revenue. Otherwise, if referrals dwindle, we could find ourselves in an uncomfortable spot. One way for us to build a solid foundation of financial security that’ll hold up regardless of whatever payment reform curveballs come our way is to market directly to consumers—whether those consumers are looking for physical therapy treatment or simply wellness-related services (more on that below). That’s not to say we should stop cultivating relationships with referring physicians. In fact, a major part of healthcare reform is the move to a more coordinated, collaborative model of care delivery. So, those relationships will continue to be important—and physician referrals will continue to be a major source of new business.

The New Patient Path

But, there’s no longer a single path to PT, and we can’t ignore that. We’ve entered the age of consumer-focused health care. Patients increasingly are taking their health into their own hands, extensively researching symptoms and vetting treatment options before they even consult with an actual practitioner. Plus, with healthcare reform efforts shifting a greater portion of the cost of care to patients, they have a lot of incentive to make sure they receive the most valuable care possible.So, what are some things you can do immediately to capitalize on this new market of patient-consumers? Well, you can start by:

  • Making sure you’re up to speed on the direct access laws in your state and the rules for each insurance you accept. That way, you can (1) feel confident in accepting any patients who come directly to you, (2) avoid sending patients to obtain unnecessary physician referrals, and (3) start changing the public’s perception of PT. In some cases, you may be able to evaluate and begin treatment entirely without a physician referral. Or, you might have to get a physician signature following the initial evaluation. It all depends on where you practice.
  • Ensuring your practice is visible online. That means that if you haven’t done so already, you need to invest in a website now—as in immediately after you finish reading this blog post. If you need some help getting started, head to Squarespace or Wix, both of which allow you to make a beautiful site on your own. It doesn’t cost much, and you’ll get your clinic online in a matter of minutes. Remember, if you don’t have a website, you’re missing the opportunity to tell millions of healthcare consumers—in other words, potential patients—that the services you provide are valuable and that they can access those services directly.
  • Soliciting patient reviews and testimonials. Peer recommendations form the cornerstone of consumer confidence—especially on the web. So if you’re going to steer people to physical therapy, you need other people to recommend PT—specifically, the PT services you provide. Start by soliciting reviews from current and past patients and sharing them on your website. The more testimonials you make readily available to your online visitors, the more those potential clients who are on the fence about PT will actually make the leap and seek out your services.
  • Adding cash-based services to your practice’s offerings. Lastly, even if you are somewhat hindered by restrictions to direct access, there’s no stopping you from providing non-clinical services to those consumers in search of wellness services. I’m talking about things like personal training, massage therapy, and yoga instruction. Health services like these comprise a $22 billion industry—and that’s almost exclusively cash-pay. If you’re looking for a way to slowly transition into offering wellness services, consider providing them as a continuation of care for patients whom you’ve discharged from formal treatment. Often, they are more than willing to pay out-of-pocket to continue receiving instruction and guidance from your staff members. Just keep in mind that there are some regulations around providing wellness services in a therapy setting—some of which differ from state to state and payer to payer. So, you’ll need to get those details ironed out before you get going.

By fully embracing our role as the go-to provider for patients with neuromuscular issues—and doing everything we can to make sure those patients recognize our value and thus, seek out our services first—we, as therapists, can set ourselves up for success in the rapidly changing healthcare landscape. Hungry for more tips on how to get ahead of the healthcare curve? Be sure to check out my upcoming free webinar, Breaking Bad Habits: The Modern PT’s Formula for Success.

About the Author
Heidi Jannenga is co-founder and president of WebPT, the leading electronic medical record solution for physical therapists and a three-time Inc. 5000 honoree. She has more than 15 years of experience as a physical therapist and clinic director, and she’s an active member of the sports and private practice sections of the APTA as well as the PT-PAC Board of Trustees.