Podcast Episode 7: Building Your Practice Through Referrals

Enlightened Practice Podcast

Getting started in private practice is an exciting yet daunting venture. In this episode, Dr. Ken Braslow and Dr. Kari Kagan discuss the importance of establishing a network, integrating into the clinician community, and maintaining connections.

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Transcript of the podcast

Ken: Hi Kari, welcome back.

Kari: Hi Ken, thank you. 

Ken: It’s great to have you here today and to be talking about a subject that’s near and dear to my heart, and that is building your practice through referrals. 

Kari: Yeah, I’m excited to be talking about it. It’s a great topic. 

Ken: It’s a big topic. It’s really important when you’re starting out, and not only when you’re starting out but also down the road the work you do in this area at the beginning often multiple downstream benefits later on when you’re not actively looking to fill your practice as hard. The work you do at the beginning of setting up your practice to establish a good referral network can come in really handy even later in your career. 

Kari: Yeah, absolutely. 

Ken: So, what I was thinking of breaking this down into today was, ways that you can spend money that leads to more referrals and ways that you don’t spend money that leads to more referrals. There are probably other ways to breaking it down but that’s what jumped into my mind. And when we think about paid methods, what comes to mind for me is advertising and marketing. And I guess, within the free realm you’d also be thinking about advertising and marketing but we can start off talking about in the paid world. I think before we talk about that you have to think about your brand as a clinician. And whether you’re paying or not, what is that you’re putting out there? 

Kari: Hmm.

Ken: And being able to have a mission statement or an elevator pitch, maybe a paragraph that you can convey to colleagues and in other ways of spreading the word so that people know who you are as opposed to just saying you’re a therapist and you’re looking for referrals. There are a lot of therapists looking for referrals and I think you’re more likely to find success if you’re a real person and someone that your colleagues or other referral sources feel like they can have a connection with. 

Kari: Yeah. I absolutely agree and just wanted to add one thing to that which is, working through that process of figuring out, who do I want other people to see me as? What’s my brand? It actually can help a clinician as well to figure out what are they interested in and what are they not interested in. So, actually it’s good work to do on a personal level as well. I think you can get a lot of clarity about what you want and who you want to be as a clinician and of course you can rethink that down the road but it’s a useful process for that reason as well.

Ken: That’s a great point. It serves multiple functions. So, let’s start off talking a little bit about advertising, which is perhaps a paid advertising, it’s one of the fastest ways to broaden your outreach but has pros and cons. So, what comes to mind for me is advertising on Google in Psychology Today or other kinds of websites like that and also just setting up your own website. So, when I think about Google ads, I don’t know how to set that up but there are people who could probably set it up for me pretty inexpensively. A Google ad is like only 10 – 20 words, what are you linking people back to? So for sure you’re going to need your own website, or own portal, or own way of capturing that interest. I think part of the challenge with Google ads is who is seeing your ad? 

Kari: Um hmm. 

Ken: What are they typing in order for you to appear and is that the audience that you’re looking to attract? It may be, it may not be. You may get a lot of interest by posting on Google or wherever, but, one, are you able to handle that kind of traffic? It’s a lot of screening that needs to go on to make sure that those folks are a good fit for your practice and you’re a good fit for them. And also, do you have the administrative resources and the time to devote to that process in general? 

Kari: Right. 

Ken: Yeah. Any thoughts about Google ads pe se or online advertising?

Kari: Yeah. I think Google ads in addition to what you already brought up is just, you know how much it costs to set that up and not knowing if paying for the ad will lead to getting the referrals that you want or that you don’t want. So, I think of any these can be good strategies for marketing but I think something like, if I had to pick where I would put my money in terms of paid marketing, something like Psychology Today for me as a psychologist feels a little bit more personalized and a little bit more like the type of people that might be looking on Psychology there, are people that are really serious about wanting to connect with a therapist. For people who don’t know what Psychology Today allows for, it’s basically like a website but it’s a detailed description of who you are and what kind of clients you want to serve and so you know that the people who are reaching out to you have already done that work and think that you might be a good fit. So, I think you might not get as many referrals or as frequently but I think there’s a greater chance that the ones that do reach out to you would be a good fit, not always but I think it narrows the field a little bit better.

Ken: That’s a good point, Psychology Today is relatively affordable. I think with Google or any other online advertising you’d have to test, test, and test to make sure that the keywords that you’re linking to your advertisement are on target and that your spend, which you can put in a limit how much you want to spend, but is actually worth the cost in terms of the dollars you’re spending, on Google but also whoever you’re paying to manage the advertising whereas Psychology Today is set it and forget it. 

Kari: Hmm.

Ken: One of the challenges that come to mind with Psychology Today is that it’s not HIPAA compliant. So, if you want to have more layers of communication with people who are requesting your services through Psychology Today then you want to do it in a HIPAA compliant way. You need to have other resources in place and that there’s a lot of therapists on Psychology Today and a lot of clinicians. I’ve always wondered, when potential clients and patients are looking at that, are they sending a message to 100 clinicians at once and just hoping for a few of them to respond. 

Kari: Yeah.

Ken: How much time are you spending responding to those when they’ve been messaging everybody in the community?  

Kari: Right, that’s a good point.

Ken: But it’s a way to get your name out there and to have an online presence in addition to your website. 

Kari: Right, exactly. And speaking of your own website, I think that’s where I personally have spent the most time building… I don’t know if people are familiar with this word but, what’s called as search engine optimization. So, that’s where I spent the most time kind of figuring out how to build a website in such a way that it would attract the kind of clients that I enjoy working with. You can actually pay people to do that for you. I actually happened to do it myself in that situation because it was early on and we had the time to Google, how do you optimize your website? Then, from there really putting the time into personalizing the website through for example, blog writing. I think that was another way that has helped to make the website popup in Google when people search for a therapist. And also, another way of letting people know what I’m interested in and what kind of clients I enjoy working with. What was your experience in building your website? 

Ken: Well, back in the dark ages, more than 10 years ago, they didn’t have readymade sites like they do now. You actually had to work with a web designer and they built it for me and I learned a lot in the process of how to WordPress and how to be a web master because for every little spelling change I wanted to make, I didn’t want to have somebody else go in and do it. They I think having your own website is almost essential now. I convey a lot of information about my practice and my policies that I want out there. It saves a lot of time in the getting setup process. And once you’ve set it up, similar to Psychology Today, it’s pretty much set it and forget, it other than small updates that you make over time. And now there’s so many different service platforms where you can create your own website with a bunch of clicks. They automate a lot of the technical prostheses that used to be painful. 

Kari: Hmm.

Ken: The cost of a website is… it’s not zero but it’s relatively inexpensive. You wouldn’t not have a phone because of the cost and similarly with a website you have to have it and yeah, you have to pay yearly hosting fees here and there but overall it’s very affordable the challenges driving traffic to your website. And that’s where you’re talking about search engine optimization. Why don’t we come back to that when we talk about free ways of building your network?

Kari: Yeah.

Ken: So, I think advertising actively in search engines, paying for listing on certain websites and having your own website. I would put those as those as the major ways to build your referral base under paid area for advertising. And now, let’s talk a little bit about marketing which is similar to advertising but it’s more general. It’s more about your brand than about specific advertisement that you’re looking to place. And I guess you say Psychology Today and having your own website fall under both advertising and marketing. But I’m also thinking more about that human connection that I started talking about earlier. And that would be things like, going out to lunch, meeting people for coffee, and getting to know potential referral sources. One of the things that I did when I started out was, I offered to give a talk to different primary care groups on medication management, anxiety, depression, and ADHD. 

I came in and they were eating their lunch and I gave them a half hour talk on that and now they could put a face to the name and they knew that I was a reasonable person, so that led to referrals pretty quickly after that. Similarly, when I started doing med management for patients who were already in therapy, I would of course always reach out to the therapist, just for good trim and planning. Then I would say, by the way, I’d like to learn more about your practice. And what kind of patients do you like to get referred? I found that would always lead to them asking me about the same. Some of those therapists that I first started working with are still in my inner circle today all these years later. 

Kari: Um hmm.

Ken: And you know, lunch is not free but it’s not that expensive and I found it to be well worth it in the long run. Did you try anything like that when you were starting out?

Kari: Yeah, I would say this is probably the number one thing that I did. A lot of coffee dates and lunches and I think this is also a time to get to know the other therapists in the community, and also do some of the interdisciplinary networking like you’re talking about where it wasn’t just connecting with others psychologists but also psychiatrists, and social workers, and that’s important to have a network around you to know who you can be referring to and for them to also know that you exist. And I found it to be not just helpful from a referral’s perspective but also early on in a career of being in private practice it can be kind of isolating. So, it was actually really comforting to know who was around me and what they were doing and it really did help me to feel that I was part of a community and that I was not alone. So, it was beneficial from that perspective as well.

Ken: That’s such a good point. Being part of the community is so powerful. It’s really the antidote to feeling the isolation of private practice. I think when I started out, I didn’t realize how meaningful for psychiatrists to have a name they could trust, that they knew. I mean, the best way of course is to collaborate together clinically. 

Kari: Right.

Ken: And to have the proof be in the pudding. But even if that hasn’t already happened and I feel the same way when I’m full and I’m not taking patients or if I’m working with somebody with meds and I don’t have room to see them for therapy. I have a short list of people that I can refer out to, of course you want the patient or client to get the best care, it also adds to your credibility to be able to say, oh yeah, I know three people, here’s some names and numbers try them. So, it’s really mutually beneficial. 

Kari: Absolutely. Yeah, so that I would put high on the list of ways to spend time and money to get referrals because I think it has many benefits and it’s definitely helpful to put a face to the name. 

Ken: Did you ever host an open house or an open office, meet and greet anything like that?

Kari: I didn’t but I’ve been to them and I found it very helpful from a referral’s perspective it was great to understand what a clinic was about and what they specialized in. So, I knew of them as resources to refer to. Did you?

Ken: No, I didn’t. But again, I know a lot of organizations that would host a barbecue or get together and I thought that was really smart of them. You want to make these positive associations of this organization and unconsciously I love their chocolate chip cookies, so it’s pretty smart of them to host that kind of thing. And then on expanding your network level there’s local organizations that might be worth joining. You’re joining to be part of a community to enhance your skill set but also they’re very much about networking. What’s been your experience with that kind of endeavor?

Kari: I’ve had a great experience with joining local organizations. It is usually an annual fee, also usually affordable and it’s been invaluable as far as referrals go. Usually, you’re joining an organization that… you’re going to be joining other clinicians that specialize in a similar area or have similar expertise so you know that it gives some kind of credibility like you’re saying. If you never met the person before that at least they’re practicing in an area that you’re familiar with or that you’re looking to refer someone to or they’re looking to refer you to. For example, cognitive behavioral therapy, you can join an organization that has a bunch of therapists that specialize in cognitive behavioral therapy or there are organizations that specialize in a specific clinical area like OCD. First of all, all the time on those organizations people are asking for referrals so it’s a great place to be scanning those emails and letting people know you have availability and just introducing yourself to the community. A lot of times these organizations host in person, well, before COVID they host in person networking events as well. So you can meet them and they can meet you. It’s again a great way to get into more of a community and to build a referral network, and to let the community know that you’re around and available. 

Ken: Yeah, and maybe even one further step if you’re really motivated would be to give a talk to the organization. They’ll often have an annual get together and they will offer some continuing education units or CMEs and if you’re a featured speaker your name gets out to the community. Other organizations meet for a monthly dinner or lunch, or something like that and sometimes they have talks, presentations. But even just being able to lend a little bit of your expertise in one particular area can go a long way even if it’s not a formal presentation. So, I’ve definitely found a lot of benefit from being in those local and regional organizations, one other way that comes to mind which I don’t think you would traditionally think of as marketing but working with a supervisor or a consultant who you are paying. 

Well, I guess you could say it could be a group consultation in which case you’re likely not paying for it and that in itself becomes a referral network. But when you’re first starting out and you’re wanting to get some supervision anyway, I started off doing that and I definitely got referrals from my supervisor that way and have reciprocated the same as I’ve taken on that role. And that person knows your work really well, so that’s a great way to build confidence and the supervisor can also recommend you to their colleagues, and the network effect grows. Curious to know if you found that useful in your experience? 

Kari: I did. I’ve done both group peer to peer consultation setting as well as paid consultation settings and they’ve both been fruitful from a referral standpoint as well a clinical standpoint and just learning. And I guess, to the extent that you can integrate marketing into your day to day experience. Like things that you would want to do anyway, like go to a consultation group where you can really learn from peers or get help. It also happens to be a place that you can refer to or people can refer to you. It makes it so much easier and less stressful and more genuine too. I think there are a lot of opportunities in private practice to find a way of integrating marketing so that it’s not something that you not having to think extra about, but it’s just happening as you’re doing things that are important to you anyways. 

Ken: That’s a great point. You know, most of us are not going into therapy or medicine because we like marketing and it’s certainly not taught in any training program that I was in. But being to have just be part of your daily or weekly routine, I really like how you put that. I think that’s a really nice approach. Let’s talk about some free-ways. The best things in life are free. When you’re starting out cash can be hard to come by and so being able to have ways to spread the word that are free, are really meaningful. So, first thing that comes to mind is back to the website and writing. Now, you can say, well, that’s not free because you’re spending your time on it, but you’re not paying somebody to write, advertise. So I consider it free in that sense. And like you said earlier that’s a great way to drive traffic to your site and also to establish an expertise or at least a reputation in a particular area. 

So, I would not discount the value of having a blog. I think part of the challenge is consistency and maintaining your blog, unless you’re going to actually say, this isn’t a blog, I’m just writing a couple of articles and maybe that’s a hybrid approach. So people aren’t expecting you to be blogging more frequently, but even a monthly post could be quite useful. I know some folks who do psychoanalytic or psychodynamic work might not feel so comfortable with putting their background or their feelings, or thoughts out there in public. On the flip side, it makes you much more of an attachable object. So, I wouldn’t completely discount it even if you’re doing that kind of work. And as they say, it’s all grist for the mill. And you can process it in session if a client has any thoughts of what you posted. But blog writing takes time and one of the ways that can make it easier is if you dictate first and then you can send it out for transcription that can save a little bit of time if that helps your writing process. 

Kari: Yeah.

Ken: Another way, sometimes I find in session I’m liking what I’m saying and after the session I go jot down some notes so I don’t forget that and then I bundle it. That can make for more efficient ways of writing than just sitting down and starting from scratch with a blank piece of paper and telling yourself to go write a blog post. What’s your process, Kari?

Kari: We write a monthly blog. So, once a month me and two of my colleagues we rotate writing a blog and I actually very much look forward to it. Again, kind of similar to what I was saying before, I feel like it actually is a nice little break to take a step away from the clinical work and dive into something that’s interesting. Something that often times come up in a session or just something that’s going on in the world and just writing about it from a mental health or psychological perspective and I actually enjoy just putting on my writing hat and slipping out of my clinical work or combining the two. And from a marketing perspective I definitely think… like you were saying, it helps to establish expertise. It helps me clinically to grow a little bit too just learning more about an area, and I think it absolutely can help to drive traffic to a website.  So, I feel like it’s totally worth the time that it takes and there are a lot of ways to make so that it doesn’t take up that much time. It can be a short blog if it’s a busy month. 

Ken: Okay. That sounds good. It’s a real stretching your brain kind of activity. 

Kari: Yeah.

Ken: You can also use your blog post in your Google ads by the way, if you want to link people back to your subject area of expertise as opposed to your homepage if you think that will give it more credibility. Let’s talk about some other free things, phone calls. So, if you’re collaborating with a colleague, I know nobody picks up the phone anymore, but actually having a conversation with somebody even if it’s completely unrelated to business and it is clinically related to the patient. I cannot tell you how many times I’ve done that and then a week or a month later I get a referral from that therapist. We didn’t even talk about referrals but it just builds your network and your credibility without needing to say anything to have a treatment planning conversation. 

Kari: Yeah. I agree. I will say, early on I remember feeling like… I guess, I would describe it as nervous or anxious about connecting with other treatment providers. I remember when I would have an appointment to talk with a mutual client’s psychiatrist or something… I don’t know, for some reason it felt like vulnerable or, I don’t know if it was just because it was early in my clinical career but absolutely it was so helpful. From a clinical perspective as I keep saying, to actually collaborate in that kind of way and to come to understand a client through the lens of someone else. I think it’s invaluable. And then from a marketing perspective, I’ll say it’s like one of those integrated options where it’s something good to do anyways and it helps you to really understand who is out there for you to refer to and for them to learn more about your clinical style. And I would say, often times that’s where I’ve gotten referrals as well just after those conversations, then I know this is just another way of getting your name out there. 

Ken: Yeah. It’s a win, win, win. I mean, it’s really good for the patient and the client that the team is collaborating. Not even for people who are splitters, but just in general to know what your colleague is doing, so useful. It’s a meta-benefit of those calls. 

Kari: Yeah. 

Ken: Grand rounds. So, at least on the psychiatry training side, giving a talk at your local university or community hospital they often have weekly or monthly grand rounds and that’s a fine way to get your name out as they usually publicize it to the wider community beforehand. And if they’re offering continuing education units or CMEs that’s yet again an even bigger draw to attend. And you do have to spend time preparing a presentation. However, you’d be surprised how one presentation can go far. Meaning, you can give it to another grand rounds. You can give it a consultation group, you can give it to a local society, so it’s an investment at the beginning but it tends to pay dividends later. 

Kari: Um hmm.

Ken: It can be incredibly anxiety provoking to give that kind of talk and so sometimes collaborating with a colleague and the two of you giving a talk, great. You both get the credit and it’s only half the work. 

Kari: Yeah.

Ken: So, I would encourage that and similarly being able to just talk as an expert in any area, if you want to go on the news and be a local expert or getting reviewed on other people’s blogs, this is part of how you build that base, being able to say, oh, I’ve given these kinds of talks. Curious if you’ve done anything like that. 

Kari: No. Short answer, no. Although, I guess, I was just thinking about like in a much, much smaller setting, like peer consultation kind of setting there have been times or opportunities to present on a certain topic. For example, insomnia, it would just be three or four other people, but it was in a way of both brushing up on a clinical area as well as establishing expertise and I could have seen a way that it could expand from there because you start to lay the groundwork for some kind of presentation that could potentially be generalized into a different context. But I haven’t done any large scale speaking. 

Ken: But what you’re talking about is often the foundation of those talks that you start small and you develop confidence in it then you add the next layer and you go bigger with it. 

Kari: Yeah.

Ken: The next thing that comes to mind is social media and being a Tweeter and Instagramer, and posting within Facebook communities and just answering people’s questions generally. It’s not like you need a presentation prepared for those audiences. That’s also a way to get your name out and typically it’s free, other than the time you’re spending on it and that can be useful. What’s your take on social media for that purpose? 

Kari: I do not have personal experience of using social media. I know people who do and my understanding is that people have a professional social media account. For example, a professional Instagram account. My biggest concern there just the thing to look out for would be confidentiality. I don’t know how that factors into when people are like commenting on your social media page for example. It’s like clients might follow you or something that, but yeah, I do know that a lot of people that use it and I think there are definitely ways that you can use similar to how we’re talking about other things where you just basically establish an area of expertise and it’s a way of getting your name there, but I’m not actually too familiar on a personal level. 

Ken: Well, that’s fine. I mean, there’s so many different ways that one can approach the same. Once you start getting your name out there you often get full quickly-ish and you realize, oh, now I’ve got to be really picky and choosy about where I’m going to be putting these efforts because you have to balance the time you’re spending on this and that time could be used for clinical care. On the flip side, this is an investment, this time, and potentially spend of money leads to the pipeline that leads to long term referrals and even now I get referrals from colleagues who I’ve never met but when I talk with them they say, oh, I got your name from a colleague and that colleague I’ve met. So, those secondary and tertiary referrals is ultimately what leads to keeping the pipeline full and also that sense of community that we’ve been talking about.

Kari: Yeah, exactly. And I guess the last free way… I guess this is free, of getting referrals is through other clients, right? I remember that advice was given to me early on, like the best way of getting clients… maybe it’s a little too idealist, I do think you have to do some intentional marketing and advertising, but it’s to basically be good at what you do and then it kind of snowballs from there as people hopefully enjoy working with you and benefit from working with you, and they refer their friends who refer their friends. 

Ken: That is the perfect way to end this. I really like that. That’s the best compliment really is a referral. Well, okay, I’ve enjoyed this conversation.

Kari: Me Too! 

Ken: You’ve given me some ideas now for my own practice and I’m looking forward to having further conversations in this and related areas, soon. Thanks for your time, look forward to talking to you soon.

Kari: You too. Thank you, Ken. Talk to you soon. Bye. 

Ken: Take care Talk to you soon. Bye.

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