Building Relationships with Patients and Practitioners

As someone who has spent nearly two decades marketing myself, my practice, or practices for employers, I have learned a lot of skills by trial and error. One of my favorite strategies to expand my professional network is to “Follow the Patient.” By this I mean to follow the patient to a specialist consult, to a procedure, or to a referral that you helped to coordinate. This must be done with the patient in mind, first and foremost, and then also the provider and their practice environment, so as not to have that practice shut the door on you in the future. Of course, this process can look different if you are in a health network because as an insider, you will likely be more welcome and have all the right credentials in order to simply attend a patient’s provider visit. If you are in a private practice, there are sometimes more hoops and permissions to negotiate. Following are some tips I have learned about this strategy of nurturing referral sources.

Offer the idea to the patient and see if they are open to it. It might sound like this: “If you are interested, I may be able to accompany you to your upcoming appointment. Does that interest you?” It’s very important that the patient is consenting to you being in attendance at their appointment, as the visit is for them. It may be best to not promise that you can clear your schedule, or coordinate the visit, but finding out if the patient is open to the idea is the first step.

2. Check in with the provider’s office. This can be accomplished by you or by the patient. This might sound like this: “I’d like to be sure that your provider would welcome me at your appointment. Would you prefer to contact the provider’s office or shall I?” In my experience, the provider’s office will say “if it’s ok with the patient, it’s fine with us!” Typically, a patient can bring whomever they like to an appointment, so that’s not much of an issue, unless there is close quarters or some other limiting scenario. The good thing about giving a heads up is it allows the provider’s office the opportunity to know that you may be joining your patient. I was able to follow a patient into a hernia repair surgery, and the nurses were so surprised that a physical therapist was in the prep room, they asked me “does the doctor know you are here?” in which case I was able to affirm that I indeed had permission from the surgeon.

3. When you attend the visit, allow the patient to introduce you or politely introduce yourself. Then listen. This is not the time to tell the medical provider all of the wonderful things you have been doing, or all of the things you have to offer their patients. Sometimes when reporting their history, the patient will look questioningly at me to recall details, and unless I am needed to give a brief response, I like to be quiet and stay out of the story until later. This is the time for the patient and the provider to get to know each other, establish rapport, and fewer interruptions are best.

4. Be prepared to summarize your thoughts when given the opportunity to share. Typically I have found that a medical provider will at some point turn and ask me a few questions, or simply state, “Do you have anything to add?” at which point I try to make concise yet thoughtful statements about the patient’s progress, continued challenges, and the reasoning behind the referral if I was the one to coordinate it. The summary might sound like this: “The original severe pain locations have eased, function has improved in this way, and the symptom or issue that is persisting is this. I was interested in knowing if there is potentially something else going on, or if you have a recommendation towards furthering their progress.” At this point, it’s best to not get too far ahead of yourself, or put expectations in front of the patient beyond a brief summary. In other words, don’t request specific imaging or suggest a particular procedure, as this may create an imbalance in the patient’s expectations and the reality of what takes place. If the provider wants more details or thoughts from you, they are likely to ask directly. (You can also send a progress report or summary letter prior to your visit if you have specific thoughts or concerns about what is going on.)

5. Allow the visit to unfold, listen carefully and take mental or written notes. I have often found that I recall details of anatomy, medications, or suggested interventions easily and the patient may ask about the details in a follow-up visit. This type of partnership allows the patient to have “another pair of ears” and can serve as a valuable part of the rehabilitation care planning. For example, perhaps the provider said, “Let’s try this imaging, if nothing of interest shows up, continue rehabilitation for 6 weeks. If no significant progress, I’d like to see you back here within a couple of months from today.” This allows the therapist to note that a provider visit was requested at 6 weeks following the appointment.

Marketing our services, in the long run, and especially in pelvic health, is critical in sharing awareness of the role of pelvic rehabilitation. Marketing is about relationships, and the easiest way to create a relationship is face to face. “Following” a patient along their healing journey, while it may take time out of the clinic for you, is a valuable way of engaging with providers and of being part of a collaborative process. When another provider or therapist requests that I see their patient to offer another view, I find it helpful to welcome the referring therapist to join the patient as well. This can lead to valuable discussions, sharing of information, and ultimately the patient may experience more efficient care that is directed to optimal strategies.