Ash welcomes Dr. Dave Rominski of the Doctor Referral Institute to discuss how dentists may be missing a huge amount of profit and the ability to have a more sustainable business. They talk about a common challenge many dentists face: having a packed schedule without seeing that busyness translate into greater profitability, and why it can change your practice by having intentional referral relationships. Plus, they discuss why these referrals attract not just more patients, but the right patients and cases for your practice.

Dr. Dave shares why simply filling your calendar doesn’t guarantee financial success, what truly influences provider-to-provider referrals, and how you can create a predictable referral system that improves both your case mix and your bottom line. Several points were raised, including how to identify your most valuable patients, the role of practice data and KPIs, and strategies for building and maintaining strong referral networks. Tune in to learn how shifting your focus from patient volume to relationship-driven growth can set your dental practice apart.

To connect with Dr. Dave, visit: https://referralsfordoctors.com/

Key Topics Discussed:

• Impact of referral quality versus patient volume on profitability
• Identifying and tracking ideal patient profiles and referral sources
• The role of KPIs and practice management software in monitoring referrals
• Value of consistent, dedicated efforts in referral relationship building
• Common mistakes in managing referral systems
• Importance of educating and communicating with referring providers and their staff
• Strategies for diversifying and maintaining referral sources

Welcome to Beyond Bite Wings, the business side of dentistry, brought to you by Edwards and Associates PC. Join us as we discuss how to build your dental practice, optimize your income, and plan for your future. This podcast is distributed with the understanding that Edwards and Associates PC is not rendering legal, accounting, or professional advice. Listeners should consult with their business advisors before acting on any of the information that is shared. At Edwards and Associates PC, our business Hello and welcome to another episode of Beyond Bitewings, where we explore the business side of dentistry and help practice owners build stronger, more profitable businesses. My name's Ash, and today we're talking about a challenge many dentists face having a packed schedule without seeing that activity translate into greater profitability. My guest is Dr. Dave Ruminski, president of the Doctor Referral Institute and founder of the Referral Growth and Profit System.

After more than 25 years as a healthcare practice owner, Dr. Dave now helps providers build intentional referral relationships that attract the right patients and the right cases. Rather than simply adding more volume. Today we'll discuss why busy practices can still struggle financially, what actually influences a provider's referral decisions, and how dentists can create a predictable referral system that improves both their case mix and profitability. Dr. Dave, welcome to Beyond Bitewings.

Thank you for having me. I appreciate your time.

Of course. Now, before we get into the referral strategy, tell us about your background and what led you to create the Doctor Referral Institute.

Yeah, no, I appreciate that. So I practice in the Chicagoland market in the physical medicine arena. So we did pain management, physical therapy, and chiropractic. And actually how this came about is we were saving up for a big local publication. And at that time, that publication went to like 70,000 female households, which was a big target for some cases that we were dealing with. So we saved up, the ad was ran, and every week at that time I had 8 people that were working with me. So every Friday we would have a team meeting. So we meet on Friday and I'm like, hey, how's— I asked my office manager, how's that ad running? She goes, it's going awful.

I'm like, what do you mean? The phone's ringing off the hook. She's like, yeah, it's ringing off the hook, but we've only had 2 patients that are actually the patients that we really want to see. So I'm like, well, geez, this is ridiculous. So I said, why don't each of you take your top 10 favorite patients? Don't share them with anyone else, and then come back next week and let's see who those people are. So fast forward one week, we have 80 names. Of the 80 names, 62 of them were the same people. Everybody loved these 62— the front desk, the office manager, the billing person, the assistants. Everyone loved these 62.

So I'm like, okay, well, that's it. Let's find out where these 62 came from and let's focus our efforts on that. So when we actually researched it and found out, 58 of the 62 had been referred by other healthcare providers. So I'm like, well, that's it. If everybody loves to see them from the billing side to the staff side, let's focus on that. So that's exactly what we did. We worked on it for a few years, got, you know, good on it, you know, good at it. We stumbled our feet for our toes for a little bit trying to figure it out and what's the best way to do it and got good.

And I sold my practice. And for the last 20 years, that's what Dr. Referral Institute does is help build relationships between healthcare providers.

Wow, that's fantastic. Now, would you say that by focusing your time and energy onto patients that were mostly liked by your staff members equated to profitability?

Well, I think what happened is, is that when you look at not just the staff on the likability side, but on the office manager on the billing side, on the profitability of those cases also. So it wasn't just that everybody liked them, it's that even, you know, On the billing side too, they were our best cases and they were following through with care. So yes, that turned out to be a very good fit.

Excellent. Now, this is just out of my curiosity. Did you also have some kind of a bonus system in place for collections for the front desk team?

Yeah, so our front desk team had a— it was all set on parameters of overall growth of the office itself, not individual side, but on the business side. But yes, absolutely, I think you have to have some type of thing besides for, you know, my office manager was about, you know, do your job well, Because that's what we're paying you for. But at the same point, having a little, you know, cherry on top, so to speak, when things go well.

Okay, okay. Yeah, so now, now I can see why they would like those, you know, caseloads or patients with those caseloads, because it's also beneficial for their bonuses. Now, what did you learn as a practice owner that you wish someone had taught you much earlier?

You know, so here's the thing, and that's a great question. Actually, it's why I have my whole business, right? Besides for Doctor Referral Institute, where we do the work, or my coaching program where we help coach liaisons. It's like, you know what, if I was starting out, what would I want? And the thing is going to be, as I remember too many times constantly trying to chase to find out where next month's new patients are coming from, right? And I was looking at the line and being busier than you, you know, could be, and but not making any more money. It was really frustrating. So I really think looking forward, it's, it's making sure they know their numbers, understand the numbers, and then develop systems that actually drive the ROI you're looking for. I think that would be the biggest thing.

Good point. Now, a lot of practice owners, uh, have this assumption that a full schedule equates to a successful practice. Why isn't that necessarily true?

Yeah, so it's not. So I'll just give you an idea. So each of our practices, when they come on board with us, the first thing we do for everybody is something called a referral evaluation, right? Learning more about them and their practices and what they're doing. So I'm going to share an example with you from a client This is probably 2 weeks ago now.

Oh, that's great.

And so, he calls and he says, hey, listen, you know, I'm 63 years old. I want to retire in 5 years. I have a 2-month waiting list in my practice and I'm not making any money. So, when we started looking at his practice and doing some analysis of it, we found out that 35% of his practice was full of a procedure that frankly someone else could be doing. And at the same point, it was probably the least profitable of what he was seeing at his office, but it was filling up his staff with everything else. And if you think about it, the patient who walks through the door, the only one affected by the quality of that case is you, the owner. Everybody else gets paid the same. The front desk is paid the same, the assistants get paid the same, the billing person gets paid the same.

You are the one that's affected. So that's why it's so important to pay attention to that. So our objective for him was going to be is to build these referral relationships, to educate them on truly the cases that they want to see that they're good at and paid well for, and fill that case— fill that caseload with those Versus just filling up your books.

Now, I, I would assume that goes hand in hand with knowing your numbers as well, like which procedures have the better margins.

Yep. And actually, on this item, as you talk about that, so the one— their main items that they do, the main procedures, he was getting an ROI between $2,300 and $3,400. The one that was filling 35% of his schedule was worth $375. So, big difference.

I see. Now, wouldn't the fixed expense portion, uh, have an impact if you're focusing more on quality than quantity?

Well, they're going to have— as far as when you're coming in and what you're seeing as far as the cases go, right? As far as the ROI for those and the reimbursement for those cases, that is affected, right? So, those education, those providers on which you're actually seeing for those is much more valuable to make sure it's going to follow up with those versus the other ones that are just filling the books.

Let's see. Now, are there any warning signs that a practice is busy with the wrong patients or the wrong procedures?

Well, I think that that's a good question too, and I think it goes— it should go for everyone, right? They have, you know, everybody understands how important, you know, a practice is to have a good high-quality case, to make sure you have good referral systems in place, yet 95% of people don't have any systems in place to do those checks and balances. So that's something really important for us is to really look at that data. A lot of them will pretend and be like, oh yeah, they're worth whatever, but they don't actually have hard data looking at those analytics of those KPIs, right? And frankly, for your business, I mean, it matters, right? You need to set aside a dedicated amount of time. And that's what we teach and manage with a lot of our clients is what does that look like, right? What do those parameters look like? What should you be looking for and understanding in your practice? And by, you know, As you think about anything, the more you pay attention to something, the better shot you got of it being successful. And that doesn't matter what it is. So that's why this needs to be something that people pay attention to.

That makes sense. Now, most of these KPIs that you speak of, can they be just accessible from the management software or would they need to maintain some internal charts?

Yeah, good question. So I think that most of the— all right, so it depends, right? And this is what I'll say with some of the HRs that are out there. You know, and this is no disrespect to all those that are out there, but a lot of them will do the bare minimum, right? They don't want to dig into it. So a lot of times it's the responsibility of the providers to call them. If there's certain metrics that you want to be able to measure, tell them that you want to have that in your system, in your software. They have the capabilities of it. It's just whether they turn it on or manage it or those types of items too, right? So for example, one of them is making sure that every patient walks through the door You didn't know who their primary provider is, right? You need to know who that person— if you're a specialty dentist, you need to know who their general dentist is, right? Whether referred or not, it's important to know that because that's either A, something you need to thank for referral, or B, someone new you potentially go after to build and nurture a relationship with. So a lot of those, those KPIs we talk about, it's understanding what they are and making sure you're utilizing your tools that you have that most times can do it.

If you do work with them on getting those things taken care of.

I see. Now, most of these EHRs, they do have a profile for each of these patients. I'm assuming they could just have the front desk person put down a note.

It is. Yep, they can just put up a separate column on whatever you're looking for for those items. If it's, uh, making a mandatory requirement, uh, of those fields when they're filling them out, and the staff can easily do that for them. That's right.

Okay. Yeah. Okay. So now let's say, you know, the, the business owner, the practice owner has started doing that, has the data for about 30 days, uh, what, what can they do with that?

So the biggest thing is going to be is when you look at the, uh, where your patients are coming from, right, is everything. And the reason I say that, when you know that, like, let's say for example you saw 50 new patients, just for easy number's sake, right? You should have a list of 50 provider names that you're able to go and analyze of whether these people were referred or they just got to you somehow. Don't they mean the whole putting in Google or Facebook or wherever else they came from? That's not helping you with the deep dive as far as As far as a referral relationship goes, right? It can help you statistically as far as what those other media spots are going to do, which is fine. There's nothing wrong with that. But you want to make sure you're understanding those basis of it to understand what that workflow is looking like. Because if you're not going after that relationship, someone else is, right? And there's— and statistically, this is another thing too. We see that a patient referred by another provider will follow through with care, not just come in the office, but follow through with care 83% of the time. Wow.

Wow.

Yet someone sent by social media will fall through about 21% of the time. That's a huge difference.

That is.

So that's why attracting the right cases is so important.

Now, do you think it's because the dedicated marketing company is keeping an eye on that, especially on the leads that are coming through social media versus, let's say, on a referral source?

This is this analogy we use all the time. Let's say something happened unfortunately to you or a loved one, right? And something's wrong that you have to go see a provider, right? Doesn't matter whether it's medical, dental, wherever it's going to be, you got to go somewhere. And maybe you got an email from somebody, maybe you saw a direct mail piece, you heard something on radio, you saw something on Facebook, or you were referred to somebody. Well, who are you going to go to? 9 times out of 10, you're going to go to the person you're referred to because they're trusted and credible. And that's exactly why building relationships with referring providers is so valuable, because when that patient's referred, they're going to follow through with that care, which is really what we need as providers.

That makes sense. Yeah, the credibility and the—

It is. It's proof. Yep, credibility and proof.

Now, how would you suggest, uh, the specialist, right, maintain these, uh, referral relationships? With the general dentists?

It's, it's okay. So a general dentist, if you think about it, really could care less who that specialty dentist is, right? They want to know what are you going to do for me and what are you going to do for my patients, right? And then it has to be with the relationship on communication. There's never any monitoring or anything, or money's even given, none of that stuff, right? That's all illegal and things that won't be done. What they care about is, are you going to take care of my patients when they send, and are you going to communicate back to me what's going on? They want to be part of that loop and understand what's going on. So from a referring provider, when you're Right. Share with you who you are, but just don't go there beating your chest on how wonderful you are, right? Because that's not going to help either. You want to be an asset for them. You want to be something of value.

You want to be someone they can trust. So that's really why it has to be consistent on doing this process. And that's even with the systems and items that we do. We have what's called the representation timeline. So it helps guide them, whether our team does the work or we help coach someone on their team that's doing the work on each visit, what your goal and objective is. And then we have a timeline that we follow. should be of that relationship, right? To make sure you're getting out of it what you need. And in addition to that, this is something that has to be consistent.

You're not going to show up every 6 months or during the holiday season and think you're building a relationship, right? That doesn't work that way. Even like people like us, our normal lives and who we deal with and interact with, we're closer to the people that we see more often, that we interact with. So same thing when we're building a relationship for referring basis. We need to be there consistent, creating that value and creating that top-of-mind awareness.

Yeah. So you're saying just sending some Tiff's Treats cookies or some edible arrangements isn't going to cut it?

Not gonna work. No, no, not gonna do it.

So how can one make this a consistent thing? Is, um, is it— should it be like a discussion with the staff, um, or maybe with the office manager to send out emails once every week or a month, uh, to all the referral sources, or to maybe host a dinner where they can talk about this?

Good question. So it's got to be consistent. It's got to be in front of them, right? People aren't— phone calls and emails doesn't work, right? You need to be actually in those offices in front of— but here's the other thing too. You need to have someone in the office that has a dedicated amount of time to do this work, all right? All office managers out there, it is not you. Don't worry, you are not the person to do this work. Why? Because you have a ton of other things you're doing, right? And by you getting busier for referral sources, all that does is add more to your plate, and this is going to fall to the wayside. It cannot be that. It's got to be someone that has dedicated amount of time to actually do the relationships, okay? It's not someone in the office that's a manager, got 17 other things on their plate.

That doesn't work. Because this will always fall to the wayside. So, you got to make sure it's someone that is dedicated to do this time. Now, our coaching clients, the people that we coach that have someone on their staff and we walk them through our systems and process, we tell them we need a minimum of 8 to 10 hours a week. Okay?

Wow.

8 to 10 hours a week is what we need of someone to do this if you're going to do it the right way. Or if they have someone that, you know, hires our team to do this with one of our liaisons around the country, you know, but it's really got to be someone that is going to be dedicated to this. Um, and put that time in because it's well worth it. It is so worth it. Um, you don't waste all that money and other, you know, things that are going on there from marketing side of it. You have consistent, steady relationships with these providers. You have cases that are going to actually follow through. Your profitability increases, and the stress of wondering, you know, where your next patient's at goes away.

So it's well worth it.

Wow, 8 to 10 hours. Now I'm assuming for it to work the way it's supposed to, again, it needs to operate in a system, right? An intentional referral system. What, what, what does it mean to build one? Or—

Yeah, so it's got to be— so we've developed our own custom CRM to isolate as far as visits and logs and things like that. People can use some of their own, but it's really got to be about Okay, well, where'd you go? Who did you see? What was said? What was during the visit? What movement are you getting from that office? Is it— and the other thing is, be a full-visit office, meaning you got to build relationships with everyone that's there. You can't just think you're going to talk to the provider every time because it's never happening. And let's be frank, most times the office, a lot of, uh, the staff is extremely influential in the referrals. So you want to make sure you're building relationships with each of them. Right. So it's understanding that process and who you're talking to and what you're going to do. And that's the thing too.

This is not something you're gonna throw against the wall and hope something sticks. This is going to be consistent, but it is also the most rewarding way to build because then you do have that framework, that stability to grow whatever size practice you want. And frankly, keep the competitors, you know, out of your way also, because if you're consistent, they're going to go to the people who are in front of them, who are consistently in front of them.

I see. Now, when you mentioned the staff, are we talking about the staff of the practice owner or are we talking about the staff of the referring provider?

Referring provider.

Oh.

Yeah, the referring provider. Yep.

Okay.

Very influential. Yeah, so that's when we're in the offices. That's part of what we call that full visit office, right? Understanding who's in the office and what the dynamics are. Yep.

I see, I see. Okay. Well, yeah, that would certainly take some time.

Well, and if you think about it too, right, so 2 of the largest and deepest pockets in the world do this constantly. And if you take a look at the— and which is really what we separate ourselves from this— so you look at the pharmaceutical and the medical device world, right? The most successful of those companies are in those referring providers constantly, right? Hey, use our stuff, keeping that top of mind. Now if you think about it, and, and not disrespectful anything they do, I have tons of those That worked for me. But there's— in that office, whether they use one device or a different device usually isn't that much different for the patient, for their provider, really. There's not much difference between them, right? Same thing on the, the medications, right? A lot of them are very similar if they're talking about 2 competitors. The only thing that's gained is actually from the company selling it or that rep, that they get more out of it. Versus when we're talking about building a relationship with a provider, we're there for the patient. Making sure they're seeing the right provider to take care of them and creating that top-of-mind awareness.

So the consistently being in front of that relationship— you take a look at a lot of providers statistically. Tell me right now, Ash, what is the— if you take a general dentist right now, general practitioner dentist, on average, how many patients a week does that provider see in their office?

Depending on the time, I would say between 20 and 36.

That they see for a week?

Mm-hmm.

Okay, because they're statistically— what we're seeing right now for general dentists, so your average volume, they're going to see about 10 to 15 patients a day, right, that they'll see during the day, or that 40, 50. But either way, let's just say it— let's say it's 30 or 40, whatever number you want to come up with. Okay, so now the average number of times that they are seen per year, right? So take a look at this. What'd you say? You said 30? A week, most of them see?

Yeah, yeah.

Okay, so if they see 30 a week, most general dentists, let's say, say 30 a week. Okay, so in a year they're gonna see about roughly 1,500 patient visits, right, give or take. Now, that 1,500 of those patients that were seen during those times, those are patients that could absolutely qualify for a specialty dentist to see, right? And we know the conversion rates is high. So now you take your 1,500. Now let's say you're marketing 20 or 30 dentists in your area. You have thousands of patients that may qualify for your services that have a huge conversion rate for coming to your practice. That's why the ground's so fertile, right? You're not good. You're already having people that are pre-qualified for your services, not someone thinking that they may be a good fit, but someone that's truly been told, hey, guess what, your condition, you go see them.

That's why it's so valuable. That's why it's so worth the time and dedication you put into it. Because of what you're getting on the back end.

Okay, so just, just for my understanding, so the conversion rate is already high because these patients are coming through a referral source, a trusted— so 1,500 conversion. Okay.

You know, I mean, so if you see 1,500 for the year and you have 20-year marketing, that's, you know, that's 30,000 patients.

That's right. Now, do we also need to pay attention to the kind of, uh, you know, treatment plan each of them will need, and then filter out the ones with the higher margins so we can stay more profitability with less volume.

Yeah, I mean, there's, there's gonna be— okay, so I mean, there's a line there, right, between making sure— so that's gonna be on you what you're going to do. The more you ask for what you want, the more you're going to see it, right? But it's really making sure that, um, you can't just remove them all and say, yeah, we don't treat any of that stuff because of whatever that may look like. But within reason, you want to make sure you're educating referral providers on what you truly do want to see.

Right, right.

But there's a basis there in ethical ways too.

I see. Of course, of course, of course. Now, uh, you know, bringing insurance into the picture, should your referral provider also be network with the PPOs you're in network with, or—

Well, that's going to be an individual basis of what you're going to do, whether you're in and out of network with them. You do want to make sure the referring providers know what you're in, right, and what that looks like. So they're educated on that basis too, so you're not seeing a bunch of patients that aren't a fit for what you want to do, right? So that's part of the education basis you want to do. But that's up to you whether you, you know, are in-network or out-of-network, whatever is best for you and your individual practice.

I guess I'm trying to look at this from the referral provider's perspective as well. Aside from the amount of face time they receive, Is there any other factor that they may consider before deciding, okay, I'm going to refer these patients to, you know, Mr. A as opposed to Mr. B?

Yeah, I mean, a lot of it has to do— not only the consistency is a big deal, but, you know, how are you taking care of those patients? How do you communicate? How's your front desk answering the calls when they get there? What kind of feedback are they getting back from their patients that are going to you? Do you have the qualifications and the knowledge to handle the cases that are being sent to them? I mean, those things are all a factor.

Right.

And those things— and the thing is gonna be too is that by having the consistent education in front of a referring provider, that's also where the staff likes it because they know, gosh forbid, I mean, it's healthcare, let's be honest, some things aren't going to go right, right? It just happens. So if they do, they know they have someone they're communicating with. They said, hey, listen, so-and-so said they waited too long, or this is what happened. Well, they already know you, you already have communication with them. It makes it very easy to fix that situation and make sure it's not a festering bigger issue.

Yeah, that makes sense. So it's like a 2-way street.

Yeah, you want to make sure you're helping take care of their patients. That's right, that's right.

Um, now would you say there's a difference between having a large number of referral sources, uh, versus having the right referral sources?

Well, right referral source is always premium, right? But you gotta— it just— it's a numbers game, right? So for example, let's say that you come up with whatever list, and we do this in your free evaluation, kind of see see what it looks like for your particular practice and growth and aspects of it. Now, if you have a provider you're going to and they just don't have the volume, right, that you want— maybe they're only sending you a few patients a month, right— well, that still might be worth it. Depends on what you're doing and where you're at with them, right? I mean, again, the end of the day, it's making sure patients are going to the right providers and providers are seeing the right patients. So whether that group has, you know, 30 patients a month that are fit for you, or they have 3, Right. I mean, obviously there's a difference there, but it depends on what aspect and what network and what you have that you're growing in your particular area. And that's part of what we go over in those KPIs too, in the analysis of those referring providers, is to see the validity of what you're getting out of them, what value is going to be, and what we call a referral rating, right? We rate them as A's, B's, and C's and where they're at, what you're doing with them. So there are, there are parameters on the business hat side that you do want to take a look at.

Let's see. Now you mentioned ratings, A, B's, And Cs. If you see that a referral source is dropping in rating from A to, let's say, B or C, what should be looked into?

Or— You need to find out why. Here's another example. So we just had an endodontist last week, okay, that we were doing a referral analysis for them. Now, this group is a multi-location. They have 3 liaisons right now that are all building relationships, okay? The reason they're bringing us on board is because they know— they've been told by somebody else the systems that we have in place and what they're able to see and the results that they're getting. So we did an analysis for them. We compared the last 2 years' numbers. Okay, there was 53 of their referral sources that had dropped by 60% or more.

Wow.

That is a lot, right? So something's obviously not right. Something obviously not, you know, not going on that, that should be as it is. So that's what we're in the middle of right now, is finding out why that is the case. What happened? What do we need to fix? But again, those referring providers, if you're not consistently in front of them and building those relationships, most times we find out that people took them for granted. The number one mistake in referral, uh, relationships is taking for granted existing relationships, being like, ah, don't worry about so-and-so, they send to me all the time, don't worry about them. No, no, let's worry about them. Let's protect that relationship. Think about it.

If you got 15 referrals from them last year, and by you consistently being in front of them, you got 25 referrals. Guess what? You just increased by, what, 40% your business from that one source. So yes, it's well worth putting that dedicated time in front of them and not taking them for granted. And most times, which we don't know yet because we just got done doing the work with them, but I bet you I find out that they, they left these alone and didn't start taking care of them, and competitors came in and took that business.

Hmm. It's, it's like, you know, when we see a commercial for Coca-Cola, right? We know that Coca-Cola is well known by everyone around the world, yet we still see the commercials.

Yeah, you gotta stay in front of them.

Yeah, yeah. Now, why might someone who appears to be an ideal referral partner not be sending patients to the practice? Education.

That's it. There's— they're not educated on why they should send to them, right? There's no one there consistently in front of them. We just had a group a few weeks ago, um, that— so when a client comes on board with us, we go through and, and come up with a targeting aspect of it, right? We have data of every provider in the country, so we can do some analysis and see who might be a good fit and not a good fit and all those types of things. And there was a wish list on those items. And, and we got to— our team got in front of them and said, hey, listen, you know, we really want to share who this person is. Like, you know, we had no idea. We thought they were, but we didn't understand really what they were doing and where they were at. And frankly, they've been there forever and never really came over and said hi to us.

So we really appreciate it. And next thing you know, they're getting referrals from them, you know what I mean? So a lot of times it's just because they haven't been communicated on what they really do and built that relationship.

I see. Now, speaking of communication, is there a way the dentist can communicate the practice's ideal case profile without making the conversation feel, let's say, overly transactional?

That's part of what we do when we're there, is just that, is help them understand exactly how to do that without sounding salesy, without putting it in a format, but understanding exactly what the avatar is, so to speak, right? What does that really look like that they want to see in a professional manner, not sounding salesy, but allowing to understand exactly where the client is and what they're looking for. That's very important.

Let's see now, um, again sticking with communication, um, how frequently should a dental practice stay in contact?

That's awesome, I love that question. And every time— so you think about it, so they have— if the example you just gave, that those general dentists see 30 patients a week, okay, is what they see, and then next week they're going to see 30, and the week after 30, so they see 120 20 patients a month, right, that may qualify per provider. So with anything that we do, it is twice a month that you're in front of that referring provider. Twice a month.

Nice.

Now, down the road, as we do that and establish it, it may go down to once a month, but it's for sure twice a month to start. You gotta stay in front of them. You gotta create value for them. You gotta know— let them know you're gonna be there consistently. You gotta let them know that they're creating value for them. And there's a way to do it without bothering them, and there's a way to do it that creates value on the other side also. And that's what's really important.

Now, I also have a little note here that says, uh, you distinguish between getting referrals and controlling referrals. What does controlling the referral process mean?

Well, controlling referrals, that's not, um, what you want to be able to go and do, right? You want to be able to provide a solution for the referring provider on why they should pick you versus everybody else, but they can obviously send it wherever they want. It's up to them right now. Most times you'll see they'll give you a list and they'll give a patient a list of 3 different providers that they can go to, right? That they can say, hey, listen, you pick whoever you want. Here's 3 of them that's in the area. And then what do they do? They point to like, this one we've had really good results with, right? That type of thing happens all the time. So you can't control the referral as far as what's going on with them, but you can definitely help give them a solution that allows them to drive that referral to you.

I see. Now, is there a way a practice can reduce its dependency on, let's say, these one or two major referral sources?

Yeah, go to more other ones, you know what I mean?

They have—

because we'll get, we'll get those frantic calls too, Ash. We get those frantic calls also where they'll be like, hey Dave, I need your help, I lost 35% of my business. I go, what happened? Well, I lost my two main referral sources. I'm like, well, you probably should have taken care of them, right? It was nothing more than they got a different office manager who didn't know them, right? But they weren't there consistently understanding what's going on. So, you got to stay in front of them. So, that's really what to do because you don't want all your eggs in that one basket, so to speak, right? You want to make sure you have some diversity in there to be able to drive that value, drive that volume.

I see. Now, I know earlier, uh, In our episode, we started talking about looking at the patient profiles and looking at, you know, who referred them to you, using as the initial data source to kind of see who you need to network with, right? And who you need to maintain a relationship with. Well, let's say we're in a situation where we've been actively doing that, And, you know, you just use that example of the one of your clients calling you and saying, hey, we just lost one or two of our major referral source, um, you know, what should we do? And, you know, we need more referral sources. In a situation like this where, you know, your data isn't enough to find new referrals, is there another platform or place where you can find more referral sources?

Oh, it's going to be as far as pulling data on the market, right, of who's around and what you're doing. And this is the thing too, so I actually got this question yesterday. So you're never at a shortage of referring providers. There's plenty of them out there. It's finding the right ones. And there's no magic pill that says, hey, these are all the ones that have exactly the demographic of the patient that you want. It doesn't work that way. You need to be able to go out and build a nurture in front of them to understand who they And what that office looks like and what opportunity you may have to build and grow that referral relationship.

So if you have a list right now and you've lost a bunch, or hey, I need to add more of them out of there to grow that list, you look at your— because frankly, a lot of providers don't, before they work with us, record that every patient walks through the door, who the provider is, whether referred or not type thing, right? They don't do that. That's number one, whether we work together with them or not. That's number one. You've got to do that, right? Yeah.

Yeah.

And that's one of the biggest basis of, you know, for doctor referral. And see, we looked at is, okay, well, understanding the framework of the actual workflow of a patient is essential to understand that where they came from and what you're doing with them and where they're going to. But that should— all businesses should really know that, um, as far as where they're going into. But that will give you a good parameter of where to go to. And then there's other data sources and areas you can go and pull from different markets and different things. We just built ours over, you know, doing this for decades that allows us to understand exactly who's in the market and what opportunities may be there.

And there's nothing wrong with reaching out to, let's say, a market that can provide them with that list and then making cold calls, or, or just have one of the teams—

I don't know, they can pull— they want to pull a data list, yeah, go ahead, pull. You can pull a data list from people. I'll tell you right now, most data that's out there is worthless. Um, they're, they're very inaccurate. Um, make sure if you truly are going to go buy data from somewhere that you have several different parameters to engage and make sure it's accurate, because most times it's not. Um, you know, and most times data lists is bought from one person who buys it to another, and, you know, I mean, they're handed down numerous different times. Um, so yeah, if you're gonna go buy data, um, in an area, make sure you double-check the source and where it's going to be at, and it's not going to be cheap if it's good.

Okay, that's a great tip, and that leads me to my next question. What are the 3 biggest referral mistakes you see healthcare practice owners make?

Uh, the 3 biggest ones, I'd say number one is not recording who walks through the door. That's number one, right? Number 2 is taking for granted existing relationships, being like, hey, listen, don't worry about so-and-so, you know, I already know who they are. That's number 2. And number 3 is not putting the time into this, right? Being able to go and show up Well, you know, we try to do that referral thing and we just couldn't get through the door, and then that was it, right? Nothing else happened after that. Well, you got to be systematic about it. You got to be able to create value, and there's ways to do it the right way. Those are probably the 3 biggest things that I see, um, is the mistakes that they go and make is those.

I see. Okay. Now, earlier also in our episode, you, you were pointing out that, hey, this is not something the office managers need to do. Um, if I had to ask you, who would you think would be the right person to keep track of all of this? Would be—

yeah, so there— yeah, so really it depends on the office. So what we do with our— so we have 2 different programs to work with. We have where doctor referral into our liaisons do the work for you, right? Just depends on the market where you're located at. Our team probably averages 10 years in healthcare sales, right? So they go and do the work for you. Or we have our referral growth and profit system where we actually coach and manage your team for you or help you hire someone for this role in your market, right? So we do those types of things. So one of the biggest things to be is analyzing who that person is, um, is part of that process, right? To make sure it's going to be a good fit. And really, the person that's going to be a good fit is someone that can actually document, right? They'll put down the visits as far as what's happening, what's going on, because you as an owner need to understand that transparency of what's going on actually when they're out in the field, right? 2 is going to be the dedicated amount of time for this. They can't have 10 different things going on.

They have to be able to dedicate time to this. And the 3rd thing is going to be is you as an owner need to make sure that you set aside time to be able to review the KPIs and items that are being done with this on a long-term process to get truly a system in place that will get back to you over and over and over again. So those are the things that are really important as far as the person goes and who did it and what that looks like as far as some of the analytics go.

Let's see. Now, you also mentioned that this person would need to be able to provide 8 to 10 hours per week to do this, right?

That's what I recommend, yeah.

Could, could it be 8 to 10 hours in a single day, uh, during the week, or does it have to be 2? Oh, okay.

No, it could be, it could be 8 to 10 hours. And the reason we say that is just making sure you're able to go to enough people and get enough penetration in the market to be able to create enough value that's going to make sense for you.

Right.

And if you look at your case averages and what you're gonna go and do, that's really not that big of an investment, right, to be able to do that, to have sustainable, high-quality practices. So, but that's obviously, if they have more time, that's great. Well, we'll take more, but at a minimum, that 8 to 10 hours is what we need. I wouldn't recommend Monday morning or Friday afternoons. Other than that, those 18 hours.

Most dentists think of Friday afternoons to do the CEO work.

Definitely don't, definitely don't do referral development on Friday afternoons.

Interesting. Why do you say that?

Because people are trying to get out of the office, and last thing they want is someone bothering them with something else.

But what if they were just internally trying to, you know, track the KPIs or kind of oversee those numbers?

Oh no, no, no, that's fine for that side of that. I'm just talking about the outreach itself. If you're in the office just doing KPIs and that type of thing, no problem, that's fine. I'm talking about the actual outreach itself I see.

Got it, got it, got it. That makes sense. Well, if a dentist is listening today and has no formal referral system, what are the first 3 steps they should take?

Yeah, so really with anything that we do, we offer a free referral evaluation. So free is a pretty good price. And this is 20 to 30 minutes to learn more about them and their practice and whether we work together or not. What it does allow us to learn, you know, ask them several things about their practice and what they're doing and where they're at and different items that can help give them some type of direction on where they're going. And framework of what it may look like for them. And then from there, we come back to them with a proposal and we'll give them kind of a bronze, silver, gold type package to see if it's something that they want to work with us or if they're going to try to do it themselves or whatever that may look like. Um, but that's really where we like to start with people is to make sure that we offer them something that's free, something that can help give them some direction, and then frankly let them find out if they may be a good fit for us or maybe they're not. Right, according to what we deal with.

Now, one thing pretty important too is that we offer exclusivity, so we don't have to worry about working with your competitor across the street. When we work with you, we are exclusive to you for your specialty in your market. That loyalty is very important for us, so we want to make sure we're building around people in that same trusted manner. Um, so those items are important for us.

That makes sense. So where, where can our listeners learn more about you and the Dr. Furl Institute?

Yeah, so Dr. Referral Agency, they can find us on, um, you know, whether it's Facebook, LinkedIn, um, our website is referralsfordoctors.com. That's referrals with an S, doctors with an S, dot com. So referralsfordoctors.com, there's a free evaluation that's on there, uh, they can go and schedule. Costs them again nothing to be able to do so, um, and really take a look at it, right? We, we are very blessed to work with many different providers all over the country, different shapes and sizes, from mom-and-pops to huge systems.

Yeah.

to multi-location franchises, to you name it. Um, they will help develop a true referral development system so you can grow the practice that you truly deserve.

Fantastic. Well, it was a pleasure having you on our episode today, Dr. Dave Rominski. I personally also learned a lot, so thank you.

Thank you so much for your time.

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