Harvest an Abundance of Referrals

By Glenda Key, PT and Beth Winkler, FAAOMPT

It’s no secret that to grow your business, you must ensure a positive experience and lasting impression for every patient, to, in turn, reap the benefit of their recommendations to others.

However, additional patient-generated referral sources are plentiful and must be cultivated and nurtured. Done correctly, they can produce more direct payment by expansion of your business model to include programs that are based on your patients’ connections. The seed is your patient!

Patients’ Employers: A Fruitful Referral Source

Your patients are a deep well of connections with employers. Record each patient’s employer and type of work as part of your intake process. Continue this discussion during your treatment sessions. Your patients’ workplace day-to-day activities will affect their recovery and are critical to address to prevent future injuries. Along the way, you may discover that your patient has a position of influence so as to make an introduction and recommendation of your services, particularly those that are focused on injury prevention and functional testing. Develop a standard operating procedure where this information is tracked and channeled to your marketing director. Their role is to follow up and uncover opportunities that will garner exposure for your practice and introductions to key people such as HR professionals and safety officers.

Employer-sponsored health fairs are an excellent way to jump start a relationship with an employer and their employees. Providing a screening that is customized to the needs of each employer is an easy and effective way to demonstrate your value and what you have to offer in terms of injury prevention and care of their injured workers. Parlay this success into the opportunity to present injury-specific educational sessions that address the employers pain points and to provide walk arounds, casual teachable moments with employees who are asking questions or demonstrating self-made work modifications or signs of body-part stress. Expand your program to provide job analysis, post-offer, and return-to-work functional capacity testing and ergonomic assessment, all paid directly to you by the employer.

Once you are onsite, although these employees are not technically your patients, each one is a potential patient and the conduit to many other patients. As you move about the plant, office, or worksite, you are building trust with many employees. When they see results from your education and consulting, you will become their physical therapist of choice for their work and non-work-related injuries and their extended families’ and friends’ physical therapy needs. With how many employees you are touching, your name and practice will become a household name in your community and your direct pay revenue will grow! It begins with asking the right questions to just one patient.

Getting the Most Out of Patients’ Referral Sources

Each new patient is a gateway to a referral source. Making personal connections with every referral source will guarantee new patients. Taking the time to update your referral sources on their patient’s progress shows your commitment to their care. This is your chance to nurture your relationship and share the quality and breadth of your services. With little time to read lengthy reports, your quick call, text, or email can make your referral sources’ jobs easier, which will be remembered next time they have a patient in need of physical therapy.

When we think of patient-generated referral sources, we think physicians. Yet there are SO many more, particularly if you are treating patients who have been injured at work or in an accident: claims adjusters, nurse case managers, vocational counselors, auto insurance carriers, and lawyers. Your treating therapists foster these relationships with their communication regarding patients’ progress, and your marketing director takes them to the next level. Armed with a list of referral sources from current and past patients, they should be out and about making personal connections and highlighting your outcomes and track record with their patients and clients. If a visit to their office or a lunch out is still not possible, a virtual meeting is an excellent alternative and may be preferred due to time constraints. Capitalize on this opportunity to explore their pain points and respond immediately with specific solutions and services offered by your practice.

Last, facilitate patient-generated feedback … the best fertilizer of referral sources!

Patient-Generated Feedback Sprouts Referrals

  • Offer each patient a notecard with your logo and a stamped and addressed envelope and ask them to write to their physician, updating them on their progress and thanking them for the referral to your clinic
  • Have patients track “Wins of the Day” on a form and send or deliver to their referral source

The Low Hanging Fruit: Current and Past Patients

Seeking opportunities to grow your patient base through your patients’ employers and courting your referral sources is time-consuming work. Don’t get so caught up in your outreach that you ignore the low hanging fruit: the patient who is right in front of you! This is especially true of patients who are already very satisfied with your service. ASK the magic question: “Who do you know that needs our help?”

There are several optimal times to do this. One is when the patient returns to your clinic and is boasting about how amazing they feel while expressing how incredible you and your team are. Share their enthusiasm, specifically asking if they know anyone suffering from the same or similar condition. Your patient now holds you in such high regard that they will be happy to help you just as you helped them. How you pose this question is very important. Asking “do you know anyone who could use our help?” leaves the possibility for a yes or no reply. Asking “who do you know that needs our help?” narrows their choices to “no one that I can think of right now” or “yes, my neighbor, friend or family member.” Another optimal time to make the ask is on their day of discharge. They will say how far they have come along, the perfect segue to “You’ve been a fantastic patient … who do you know that needs our help and can replace you?” The ask comes best from their therapist; however, an aide or receptionist can easily inquire, procuring a name, contact information and permission to reach out. Your patient may feel more comfortable making the contact; have a process in place to follow up to secure the lead.

Calling past patients who haven’t been to your practice for a while can also be productive. Set a target for calls your marketing director should make each week. Design a script that sounds natural. We frequently use “Hi Miss Jones, this is Blaine from Magnolia Physical Therapy. Just checking in. How has your shoulder been since we discharged you from our care?” Occasionally, patients will have had a flareup or a new injury and our call motivates them to return for another course of care. If not, this is a perfect time to tell them about any new services you are offering and ask them the question. “Miss Jones, you did so well with us, who do you know that we can help to get the same results you did?”

Another way to get both current and past patients to refer is to reach out to your “promoters” – those who have given your practice raving reviews online and/or in satisfaction surveys. Call and thank them for their praise, asking them who they know that needs your help. Brandon Buehler, of Courey and Buehler Physical Therapy in California, promotes his Care to Share program, encouraging patients to refer friends, family, and neighbors. The patient who refers is acknowledged with a hand-written thank you card. Market your referral program in your waiting rooms, on your social media channels, and in print and email newsletters. Build loyalty, creating champions and word-of-mouth referrals by “wowing” patients with personal attention as Steve Rapposelli of Performance Physical Therapy & Fitness in Delaware recommends. At the second visit, he sends each patient a gratitude email, offering them a choice of several highly desirable therapy-related gifts. Track these activities and every referral and include in your marketing metrics, so you can evaluate the effectiveness of your efforts.

Make your organization’s social media campaigns blossom! Connect with your patients online. ASK your patients to write online reviews, making it easy for patients to post their successes and satisfaction. With proper waivers in place, snap and post photos and videos of patients and therapists having fun and celebrating successes, participating in innovative treatments, winning prizes, reaching goals, birthdays, holidays, and upcoming sports events (tagging them of course!). Post educational content tailored to your audience that will engage them in your social media and services. ASK your patients to check in, follow, share, like, and stay active with your organization on social media, even after discharge.

It all starts with a few simple questions to that new patient. Each working-age patient in your clinic is a connection to an employer and so many downstream referrals. Every patient is a path to new patients. Avoid making the “leaving the fruit on the tree too long” error of waiting until they have completed their care and are out the door. Catch them “mid-air” when they are very excited about their progress! Think of all the donuts, candy, and, of course, fruit baskets that patients have brought you in gratitude. Imagine if every cookie or orange were another referral!


1Martinez C. Referral source customers: The high-value customer you haven’t thought of. Impact. http://www.ppsimpact.org/referral-source-customers/. Published April 1, 2020. Accessed April 1, 2021

2Rapposelli S. Create a WOW experience by visit #2 and generate a raving fan. Impact. 2021;4:15.

3Salvatori S, Zitnik A. Inviting customers to be brand ambassadors: Everyone is a marketer. Impact. 2020;10:55-58.

Glenda Key, PT, a PPS member, is the CEO of KEY Functional Assessments Network and editor/author of the book “Industrial Therapy.” She can be reached at gkey@keymethod.com. Beth Winkler, FAAOMPT, a PPS member, is the owner of Magnolia Physical Therapy in New Orleans and a coach for private PT practice owners. She can be reached at bethw@magnoliatherapyla.com.

Copyright © 2018, Private Practice Section of the American Physical Therapy Association. All Rights Reserved.

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