Building Relationships

[ldsrmdude]

The doctor I am currently rotating with makes it a point to shake hands with every physician he sees on rounds and is always going out of his way to please the physicians that he interacts with and gets referrals from even if it is inconvenient or means more work for him (or me). As a result he gets a lot of referrals and direct admits from PCPs offices and it got me thinking about building relationships with other physicians. It's not always a huge concern as a resident, but as a practitioner, I think it's very important. So I wanted to present a scenario and get everyones thoughts (attendings, students, residents, pre-pod, etc):

You're starting your new job and you go to the hospital you will be working out of. In the doctors lounge are physicians from each specialty imaginable. You don't know any of them since you are new. Who do you sit down and have lunch with day 1? The family practice doc who will be an important source of referrals? The vascular surgeon so you can get a "toe and flow" thing started? ER with the hope of picking up the foot and ankle trauma from the ER? If you could only choose 1, who would it be?

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[MaxillofacialMN]

The room staff (custodians, etc). You gotta get the low down on the hospital
dynamic!

 

[PMSIII]

Interesting question - I will be starting my new position soon so I can certainly relate. The answer to your question is really "all of the above". You really have to make an effort to meet them all and be visible. During my residency and especially fellowship, I spent a lot of time meeting and introducing myself to various specialists to the point that I know many of them on a first name basis. I think the best way to establish a relationship is to let your work do your speaking - always respond to consults and calls in a very timely manner, be efficient and confident in your treatment plan, always have a clear short term + long-term treatment plan documented in the chart, and finally relay the plan to the other specialists working with the patient --> regardless of the specialty. Believe it or not, in doing so, they appreciate your input and are more likely to send you referrals down the road.

 

[ldsrmdude]

Ok, ok, both valid points. But for the sake of conversation, who would be top on your list? Besides hospital staff. Which specialty? And yes, I know the question isn't how it works in real life

By the way, PMSIII, thanks for the great answer to a non-so-great question. It's nice to get the input of someone going through this right now.

 

[NatCh]

Of course like you said in the OP, it depends on the type of practice you want to build but if I could pick only one I would focus on Family Practice. They have the biggest volume of patients coming through their offices and they do not have any issues about referring patients out. Their patients tend to be generally healthy (or at least not morbidly ill like the patient population of other specialties). Other specialties are often "end of the line" so therefore they focus strictly on the immediate problem for which the patient was sent to them and then they send the patient back the primary care provider for any further referrals. The primary care provider is the "hub of the wheel" who is most likely to send patients out.

One thing though, in my community the hospital has hospitalists on staff so therefore the primary care doctors do not hang out at the hospital or eat lunch in the physicians lounge. Even if they do admit their own inpatients, they most likely round either in the early morning before their clinic starts or in the evening after their clinic ends. Lunch is theoretical. Hanging out in the physicians lounge of the hospital would be very low yield for me. Besides doing good work and having a good community reputation, I find it is more productive to find common ground with your referring physician. For example, do you have a mutual hobby or activity? Getting to know a referring physician on a social level rather than strictly a professional level brings a lot of referrals.

 

[jonod1107]

...Getting to know a referring physician on a social level rather than strictly a professional level brings a lot of referrals.

The surgeon I shadowed told me to learn how to play golf or pretend to like playing golf.

 

[pacpod]

I think I would start with the PCP. I believe that a strong relationship with PCPs will help build a new practice the fastest, volumewise. Once the practice builds volume (or day 2 at the doctor lounge), then focus on specialty relationships. Just a thought.

 

[NatCh]

Also, don't neglect non-physician referral sources. I get quite a bit of referrals from PAs and PTs.