There are three key steps to successfully building and maintaining a network of referring physicians-first one must understand his or her referral sources; second one must create and sustain an awareness of the practice; and finally, one must communicate with referring physicians.

Know your referral sources

The first step in increasing referrals to your practice is to understand the source of your current referrals. This will help you assess your referral relationships and identify areas where you can build additional referral sources.

Review your practice' s incoming patient referrals for the last few months and look for the source of high volume referrals. Do you treat a large number of patients from a small group of referring physicians? If so, cultivate these relationships by improving communication, maintaining awareness and providing superior customer service to both patients and referring physicians. Pediatricians, for example, generally make the first contact with allergic children and can be a major source of referrals. Check to see if area practices or hospitals are not referring to you. A difference in managed care networks may account for the lack of referrals but it could also be lack of awareness.

Build awareness of your practice

The likelihood of referring to a particular specialty practice is highly influenced by a physician's familiarity with the specialist and that specialty. Generalists continue to underestimate the importance of allergies and the methods to diagnose them. There are many opportunities to build awareness of your practice and educate your peers about the field of allergy and the appropriate management of allergic disorders.

Physicians cannot refer to your practice if they don' t know it exists. Develop a practice Web site or simple brochure advertising your medical expertise to patients and referring physicians. At a minimum, include detailed contact and location information (e.g., phone numbers, e-mail, driving directions, public transportation routes), office hours, Web site address, clinical expertise and any characteristics that may differentiate your practice. Include a digital map on your Web site.

Distribute business cards with your practice' s address and contact information (including Web site address) to high-volume practices. These cards can be distributed to patients needing referrals. Announce the addition of new staff or services. Send e-mail or postcards to your network of referring physicians to publicize new clinical services and advertise them on the homepage of your practice Web site.

Introduce yourself to potential referring physicians. One way to meet other physicians and build awareness of your practice is to join an IPA, HMO or hospital committee. You can also get involved with the local medical society by serving on committees or lecturing on allergy issues.

Build awareness of your practice with patients in the community. For example, give a talk on food allergies at the local PTA meeting, or co-sponsor a local health fair. Don't forget about the importance of word of mouth. Satisfied patients and referring physicians are more likely to tell friends and colleagues about your practice.

Communicate with referring physicians

Prompt and useful communication with referring physicians is a good way to ensure the stream of current referrals continues to flow to your practice. Send a timely and friendly " Results Letter" to referring physicians outlining the patient's progress. Be sure to recommend drug treatments or immunotherapy, avoidance activities and patient education materials. For example, many generalists do not have the expertise to educate an asthmatic in the proper use of an inhaler or how to make behavioral changes (e.g., the removal of dust mites). Send a (bi)annual "Thank You for Referring Letter." This letter reintroduces your practice and lets referring physicians know that you appreciate being part of their patients' care.

Solicit feedback from high-volume referring physicians. Are you communicating the right information in a useful format (e.g., phone, fax, e-mail)? Are there other services or information that you could provide? If you use e-mail to communicate with referring physicians, be sure that your e-mail server is secure and that the recipient knows that you are transmitting confidential patient information.

Involve referring physicians in any treatment decisions, including secondary consultations, because he or she may strongly prefer a particular physician. Use all of these opportunities to educate referring physicians further about the field of allergy and your practice' s services.