While speaking before a group in New Orleans, I was asked several questions and fielded even more comments about “care to share” programs and how they were illegal or a waste of time. I wanted to take the time and dissect this great internal/external outreach program.
Just the Facts: Generally the care to share programs we have seen and used in our practices involve encouraging a satisfied current client to make referrals and at the same time receive a gift or reward for doing so, while also insuring a discount or gift for the patient they referred — the ultimate win/win scenario. It is usually designed around a brochure or card stock that allows you to not only present the concept to your current patients, but also give them something to walk away with that would encourage them to follow through. Sounds like a simple, can’t miss, everyone should be doing this strategy. If so, why did I get so many negative comments and questions? Let’s take a moment and cover each comment and question.
1. It is illegal to offer something in return for a patient referral. True, maybe. 39 States have dental practice acts that enjoin you against fee splitting. In other words, if you reward a staff member or referrer with anything of monetary value (meals, cinema tickets, gifts, or money discounts), you may be at odds with the dental board in your state. In some states it doesn’t matter at all. The problem is that most dental boards (you will notice that I did not capitalize the name, because it reflects my opinion of their status in our field) are very arbitrary about how and when they decide to apply the “letter of the law” as opposed to the intent. Let’s say you send a patient flowers after a successful clinical result. Probably the state board would let it slide because it is a grey area. Pay them for a referral and you have got problems, but not every time. It seems that most boards fluctuate with the members of the board and with the reputation of the doctor having made the supposed offence. Bottom line is that any complaint made to the board must be investigated and resolved. My suggestion is to take the strategy and send it to your state board for a decision on whether you are violating the dental practice act for your state. I would send it registered and I would include a statement that said: “We will assume that if we do not hear back from you within thirty days that the afore mentioned “care to share” program meets the legality to use it in our state.” In this way you have covered yourself. I have never had our astute Texas dental state board ever reply to my registered request or phone inquiry in thirty five years. With that being said, I have never had them challenge anything at a later date either.
2. Care to Share programs just don’t work. Wrong, they do work and they work well, if done correctly. One of the reasons they work is that you actually have a plan and maybe for the first time you are working it to ask for referrals. In every office I visit, I fail to see anyone ask for a referral. This eliminates asking for referrals being just “somebody’s job” and never getting done, to using the “care to share” program to systematically and consistently guarantee over a 50% referral rate for new patients. So how could you mess this up or have it not work?
a. There is no formal brochure designed to hand to the patient. Take the time to design, print, and distribute it to every patient you see. The sample shown below (click to enlarge) is a tri-fold and was designed so that it could be mailed, although we never mailed any of them. Much more effective if used in a face-to-face encounter.
b. The offer is just not enticing enough to get patients to want it. It has to benefit both parties, and have an offer that they actually want.
c. There is no urgency tied to the action you want. Like most marketing, patients are fickle and need a little prompting to make this work. Give them a deadline or mention the value to both them and the patients they refer.
d. It is not presented to every patient that comes in. Bottom, line: Everyone is presented the “care to share” program.
e. The patients don’t like you in the first place and no matter what you do they would never refer to you for any reason. You have heard it before but there are those of us who try to give patients what they don’t want and they choose to go elsewhere or at the very least make sure no one else makes the same mistake they did.
f. Patients don’t refer to you because they think you are too expensive and they don’t want to be embarrassed when their referred friends can’t afford your treatment suggestions. It is often not the individual fee for a particular service, but the fact that you presented too much too soon in a way that makes the patient feel like you are trying to just sell them something.
3. I can’t get my staff to ask for referrals or pass out the brochure. If you are spending your life negotiating with your staff to do their jobs, think about another career. I’m sorry, but each and every staff member needs a job description, some way to track their progress, and consequences for not following through or delivering. One of the biggest problems I see in staff relations is a lack of leadership from the doctor and a corresponding set of consequences if someone fails to follow through. The second thing I see is the doctor not modeling the action they want to take place. It’s this easy. Just ask every patient that comes in: “Have you heard about our “Care to Share” program?” Patient: “No.” You say: “It’s terrific!” and then take a moment and open the brochure and walk them through it. NO ONE LEAVES WITHOUT THE CARE TO SHARE BROCHURE!
4. Doctors don’t reward staff for doing what they are asked to do. If you want staff to do something, make it a game that rewards the winners and embarrasses the losers. Whether it is a bonus or a one time “this or that” to reinforce the action you want, try something and then make sure you do it too. Habits are formed through repetition after helping your staff understand the benefits to the team.
A “Care to Share” program is foundational to picking the low-hanging fruit in our dental practices. Direct referrals are less resistant to treatment recommendations, show up, and pay for their treatment. Best of all, they came because of a referral and they will now happily refer others.
As always, just contact me directly if you have questions.
Michael Abernathy, DDS