A two-step process for gaining new referrals


Bill Lavinder, is a senior business development manager with American Hearing Aid Associates (AHAA), West Chester, Pa. He works out of his office in Marietta, Ga.

Marketing to physicians takes initiative and work. It is also probable, however, that your competitors are not doing this type of marketing, so you can seize an advantage. Moreover, when a physician refers a patient to another specialist, the patient usually takes action, so physician referrals can yield high dividends.

It is highly probable that persons with hearing loss will come in contact with their primary care physicians (PCPs) or specialists before coming in contact with a hearing health care provider. So how do we establish contacts with these physicians in our local markets and motivate them to refer patients to us?

While any physician is a possible source of referrals to you, this article will focus mainly on marketing to primary care doctors as recommended by AHAA. Hearing loss problems should be of more concern to PCPs because their “mission in life” is to look at all kinds of medical problems, resolving the ones they are trained for and referring out the ones they are not.

It would be nice if PCPs would give just a simple test during their patients’ annual physicals to determine if the person has a hearing loss that is not the result of congenital or traumatic deformities in the ears. However, we know that most PCPs do not discover simple hearing loss on their own during a patient visit. In fact, MarkeTrak VII shows that hearing loss screening by physicians dropped to 12.9% for the total US population in 2004, with declines in every age category except young adults.1 This data was backed up by a study by Cohen et al2 that showed physician hearing screening of 11.8% by PCPs during annual physical exams.

What is even more unfortunate is that most PCPs do not even look for hearing loss, and if it is revealed, they usually refer the patient to an ENT. In most cases, audiologists and hearing instrument specialists can also serve these patients, which is why physician marketing is so important.

Part 1: Tapping into the Primary Care Physician Market

So how do we tap into the PCP market? How do we motivate them to look for hearing loss? How do we gain their referrals?

The important first step is to go into this marketing effort with a very positive attitude. Resolve that you have to dedicate time on your schedule to make personal calls on the doctors. Accept that it can be a long, tough process, and that you must stick with it.

Next, identify key primary care physicians—especially the ones in group practices—within a 5- to 10-mile radius of your office. Start with the doctors of patients you attracted on your own, not through referrals. It is easier to identify the doctors with whom you share patients because you can get their names from your patients. Next, identify physicians who are on the same insurance provider panels as you.

Concentrate on these two groups first before expanding to others. As you go about planning your marketing tactics, remember that physicians today are busier than ever before. They are under pressure from shrinking insurance payments and HMOs, and they are forced to see more patients in less time. Time is of the essence to them, so you need a clear, concise entry message.

In planning your message, one key point will be to create an awareness of the pervasiveness of hearing loss in our society, with the certainty of huge growth of the problem in coming years. PCPs should be interested in knowing that many of their patients have hearing loss, even if they do not bring it up in visits. Paying more attention to this problem will enable the physician to serve patients even better, helping them resolve those problems by referring them out to your practice.

The First Call on the Physician’s Office

Physician contacts, of course, should be made in person. As you prepare for your outreach, understand that it may be a two-step process. The first step is to get in the door, make contact with the “gatekeeper,” and convince the gatekeeper that you are a person fully capable of treating hearing loss that is not medically induced—and that it is to the physician’s and your advantage to partner in providing treatment to your mutual patients.

So, prepare a letter of introduction and a simple piece about you, your educational and professional training, and your practice. Send out the letter around 10 days in advance of your first visit. Tell the doctor that you will be coming to their office on a specific date to meet the staff and to set a follow-up appointment with the doctor at a mutually convenient time. Consider sending a fax the night before confirming the first visit.

Bring your schedule book to the visit and look the part; doctors and their staff are familiar with pharmaceutical representatives and other allied health professionals, meaning you must look professional in appearance. When you encounter the gatekeeper, don’t go empty handed. The drug reps frequently use lunch (or food of some sort) to help promote their products; bringing candy or a treat to help them “get through their busy afternoon” goes a long way. Our sense is that lunch still works to capture in-services, as long as it is not overdone.

If you can get the attention of the gatekeeper long enough, explain that you, too, are a practitioner in the area and that you would appreciate an opportunity to discuss your services with the physician. Explain that your practice can help make their patients better patients through hearing health care. It helps if the gatekeeper can understand that some of their own patient frustrations and inattention to important instructions might be attributed to hearing loss.

During this first visit to the physician’s office, you may be bold and ask if the physician can see you then. If not, find out if they have typical meeting times, and ask how you can follow up.

Still on the first visit, find out (again, probably from the gatekeeper) if the physician already has an individual dedicated to hearing within the practice. If not, does the possibility for an in-service arrangement exist? Do they have a practice or referral manager (who should be included in the follow-up visit with the physician)?

Setting the appointment with the physician. If the gatekeeper is still with you, ask for an appointment, and find out how much time the physician usually gives pharmaceutical reps. Get the gatekeeper’s name and write it down. Gather the business cards of all the physicians in the practice. Set up a file for that office, and begin recording all activity and contacts with that office on a “Call Sheet” for your files.

Part 2: The Visit with the Physician

If you have been successful in your initial visit, you will have scheduled an appointment with the physician and other key employees. Capturing this undivided time-slot is worth the price of lunch in or out of the office

But wherever you meet with the doctor, be yourself. Review your educational and professional qualifications and the quality of experience that you have treating hearing problems.

Concentrate on what the physician sees in older patients related to hearing loss. Identify what steps the doctor takes when they discover a hearing problem. Discuss the growing problem of hearing loss and some of the examples of how devastating it can be to individuals and their families when it is not treated. Give examples of how, in most cases, the quality of life of your mutual patients can be improved by diagnosing the problem and taking steps to resolve it.

Ask the physician if they would be amenable to setting up an in-service arrangement with you on a regular basis. Also discuss a referral process with the doctor, emphasizing that it can be a two-way street, with you referring patients to them when you discover that patients have medical problems that you cannot treat.

Following Up

Lunch and Learn: Private Practice Marketing to Physicians,” by Mark J. Sanford, MS, & Beth Kiekhaefer, MS. October 2001 HR Archives.

BHI Pursues Physician Referrals with Innovative New Program,” by Ben Van Houten. February 2002 HR Archives.

After your visit with the physician, take action on the arrangements that you both agreed to. You would benefit, too, from trying to get the physician and key employees to visit your office to meet your staff and see your facilities.

And, throughout the year, maintain communications with the physicians you begin to work with and their staffs. For example, make repeat calls to their offices to get to know them and their staffs better. Provide them with reports on your mutual patients. Send them periodic newsletters with updates on hearing health problems and the hearing aid industry, including new devices and treatments. Describe your own professional development efforts.


Marketing to physicians takes initiative and work. It is also probable, however, that your competitors are not doing this type of marketing, so you can seize an advantage. Moreover, when a physician refers a patient to another specialist, the patient usually takes action, so physician referrals can yield high dividends. Having in-service days at the physician’s office is even more beneficial. And, finally, physicians in your camp who are impressed with your services will bring other physicians to you, creating a ripple effect.


  1. Kochkin S. MarkeTrak VII: Hearing loss population tops 31 million people. Hearing Review. 2005;12(7):16-29.
  2. Cohen S, Labadie R, Haynes DS. Primary care approach to hearing loss: the hidden disability. ENT Jour. 2005;85(1):26-31,44.

Correspondence can be addressed to [email protected] or to Bill Lavinder at .