Whenever a clinician makes contact with a new referral person, that clinician becomes the point person for our relationship with that referrer. I am using the term “point person” in two senses. The first sense is as the point of a wedge. The point person opens the way for others to follow. The second sense is as it is used in the military to designate the soldier who leads the troops on a particular mission. In battle, being the point person is a stressful and dangerous assignment. The role is passed around from time to time. Of course the metaphor quickly breaks down; I do not mean to imply that our referral people are our enemies! But of course, we want to bring the referral relationship to a deeper place as time goes on.
Building the first connection
From the vantage point of the referrer, the first stage of the referrer’s relationship with us is via contact with the point person. When the referrer first sends us someone, it is likely to come specifically to the point person, since that is the clinician the referrer knows. The referrer wants to be comfortable with the point person first before referring to others.
Growing the awareness of others in our organization
Eventually, if all goes well, the referral relationship moves into a second stage. Here the referrer has a sense that the office includes multiple clinicians and support staff who may be of service. Once aware of our other staff, the referrer may “try out” colleagues of the point person.
During this stage, the point person facilitates the introduction of colleagues. Once a colleague receives a referral, he or she should follow up in caring for the needs of the referral person as well as the clients. As this happens repeatedly, confidence develops and the referrer moves to the third and most mature stage.
Developing a relationship with the whole of the organization
In the third stage, referrers now see the whole practice as a resource. They trust us to make the best assignment of cases and manage the cases appropriately. In this stage, referrals come to the practice rather to particular clinicians. Now they trust all of us. We are hoping that when referring they say, “Just go to anyone there. They are all excellent.”
Different referrers will move through these stages at different paces. In some cases the referrer will immediately jump to stage three and make referrals to the whole practice. We want to inform the referrer that we have colleagues and support staff to help meet their needs. In my experience, each relationship grows at its own pace. We must be sensitive to each referrer’s desires and respond appropriately.
Are there appropriate ways to move referrers through these stages?
There are certain skills that we can develop to accomplish these goals. Fortunately these skills are similar to the ones that clinicians use daily in our clinical work. All relate to developing and maintaining relationships.
For example, to become a comfortable and skilled “point person,” one becomes good at meeting referral people on their turf. This involves helping referrers get a sense of who the point person is and what the practice as a whole can do for them. That means the point person needs to be skilled at going to lunch with referral people, speaking in settings that referral people may find valuable, or perhaps providing consults or attending staffings at schools. The goal is to become at ease in the many roles we may have with a referral person. We want to function in a manner that reflects positively on us as individuals and on the practice as a whole.
Once we have developed that initial relationship, then we need to get good at a couple of other things: following up with good case management and facilitating contact between the referrer and colleagues. In this context, following up means doing good therapy, keeping the referrer informed whenever possible, and keeping up with our paperwork. Of course we always need to do these things, but it is especially important for the point person who is trying to get things going. It is also important for a clinician who has received a referral due to the efforts of a colleague who was the point person. From a certain point of view, we are always being tested and need to live up to the reasonable expectations of referrers.
Why should we facilitate contacts between referrers and colleagues?
Because our ultimate goal is to take care of our referrer and that referrer’s clients the best way we can. If a colleague can do the job better due to scheduling, insurance, specialty, or any other reason, then we need to pass the referral on. In doing so we develop a stronger relationship with our referrers, encouraging them to develop a loyalty to the whole practice. We are showing them that our first priority is to do what is best for those they are referring to us. And if we all are doing the same sharing of referral resources with each other, each member of the practice will ultimately benefit from the loyal referrers and the better match between cases, interests, and skills. Our goal, then, is to widen and deepen the interconnections between the practice and referrers.
Lastly, to move referrers to the third stage, we need to become the mental health specialists for them. We need to be knowledgeable about good psychiatric, legal, medical, religious, and financial resources in our communities in order to be in position to make solid referrals to others outside our organization when we are not the best fit.
First drafted on 02/08/2002.