When he left his medical group late in 2002, anesthesiologist Michael Schneider knew he was simplifying his life in one respect and complicating it in another.

Schneider's wife is an emergency room physician who works a lot of nights and weekends, so he wanted to be home more. Quitting his hospital-based group in Southern California accomplished that. 

But it also forced Schneider to find his own referrals; he decided to market himself as a "doctor's doctor," pinch-hitting for colleagues at hospitals and outpatient surgical centers in his area, picking up work per diem where he could while maintaining control of his lifestyle and schedule.

"I definitely had to get my name out there in the community," Schneider says.

He leveraged his contacts with his colleagues at his former group by picking up some work for them, talked to surgeons he knew, applied for privileges at several area hospitals, and in some cases cold-called surgical centers to offer his services.

"Basically it was a matter of using people I knew, and then expanding my network," he recalls. "It was networking and marketing, and trying to identify a need and how I can best meet that need. Like anything, the best way to do things is to know someone who knows someone who can vouch for you — who can say, 'Yeah, he's a good guy, he gets along with nurses and patients, and he gets the job done.'"

But it was more than just marketing that helped Schneider succeed. Realizing that per diem physicians sometimes have a reputation as somewhat less than committed, he was determined to become known as different. He wanted to be treated as "part of the team" during his time on a job, and in turn he would work as diligently as if he were there full time.

"That's what people are looking for," he says. "When you act like you want to come in and be part of the team, it really goes over well — that you're willing to do whatever it takes."

Schneider's willingness to extend himself and his commitment to quality are the two fundamental elements to building and maintaining a solid referral base, according to physicians who make and get large numbers of referrals, as well as practice management experts.

Clever marketing tricks are fine, but physicians who get the most referrals are known more than anything for efficient business practices, a friendly and courteous staff, and good patient relations.

Say hello

When family physician Christopher Crow was starting out, he spent two months walking the halls of the large medical office building he works in, visiting colleagues, introducing himself, and talking about himself and his practice style.

"Just fostering relationships," he recalls. "'Here's who I am, here's where I come from, who my family is, what would you like to know about me? I'm going to offer these services and if I can help y'all out in any way, let me know.'"

Now that his practice in Plano, Texas, is established and refers a lot of its own patients, Crow says he expects new specialists to extend him the same courtesy of a personal greeting. He won't refer patients to a physician he's never met, or one who hasn't made an effort to establish a relationship with him.

"I want them to come to my office and say, 'I'm the new doctor in town,'" Crow says. "I don't want their representative; I don't want their office manager. I want them personally to just stop by and say hello. A new gastroenterologist might want to say, 'Hey, y'all want to go to lunch?' It's worth it to that GI, because we refer a lot of colon screens, and we want to know whom we're referring to."