Based on a PracticeCare® podcast conversation, Mary Lou Savino on Building a Patient Referral System, with Mary Lou Savino, physical therapist and owner of Be Fit PT & Pilates in the Chicago area.
Why do referrals need a system instead of just happening on their own?
Referrals feel like something that happens automatically when you do good work. Mary Lou Savino, a physical therapist and owner of Be Fit PT & Pilates near Chicago, found out early that isn’t true. She knew a few physicians who sent patients her way, but it was patients telling other patients that actually built the practice.
Without some kind of system for handling intake, scheduling, and follow-up, you get chaos. And chaos that isn’t organized is harder to fix than the kind you’d expect, because nobody can point to what’s actually broken.
What’s the first touchpoint that decides whether someone becomes a patient?
The front desk. Before anyone meets a provider, they’re calling or emailing with questions, sometimes because they’ve had a bad experience somewhere else. Savino trains her patient care coordinators on exactly what to say and how to say it, because that first conversation decides whether someone books an appointment or hangs up unsure.
People are already looking at your website and your reviews. But in medicine, most of them still call. Get that phone call right and you’ve done more for your referral pipeline than any amount of advertising.
What happens between that first call and the first appointment?
Savino built three more touchpoints into the process before a patient ever walks in the door:
- A confirmation email with registration forms and directions, sent right after the first call.
- A liaison who calls each new patient the day before their evaluation to confirm.
- A follow-up call the day after the evaluation to make sure everything went smoothly.
None of it is complicated. It’s just consistent, so no patient falls through a gap that nobody was watching.
Why write a patient’s plan of care in plain English?
The clinical plan of care lives in the EMR, in medical language, for documentation. But Savino also gives the patient a separate version, in plain terms, with simple checkboxes: here’s what you’re dealing with, here’s how we’re going to treat it, here’s how many visits a week for how many weeks.
Patients who don’t understand what they just agreed to don’t come back. A plan they can actually read is also what gets them scheduled on the spot instead of walking out to “call later.”
How do you decide when a system needs to change?
Savino’s managers meet weekly, and the whole system gets reviewed monthly and quarterly. But a lot of changes come from somewhere else: a patient complaint. Even when the practice didn’t do anything wrong, a complaint is a reason to ask whether something could run more smoothly.
That doesn’t mean every piece of feedback gets acted on. Sometimes a suggestion just doesn’t fit the practice, or it’s something she’s already tried and knows won’t work. She still thanks the patient for it. She just doesn’t change the system for it.
How simple can a referral system actually be?
Savino’s has four steps: intake, evaluation, plan of care, therapy. Written down, the whole thing is less than a page. A system doesn’t need to be a manual. It needs to be a short list of steps that everyone follows the same way, whether you’re a solo practice or you have five thousand employees.
How much of a small practice’s new business actually comes from referrals?
For Savino, about 70 percent, and she’s in one of the most competitive physical therapy markets in the country, the Chicago area. On the orthopedic side, it’s almost entirely word of mouth, internal referrals, and online reviews. She does get physician referrals on the pelvic floor side of her practice, but for general orthopedics, patients are the ones bringing in other patients.
What’s the simplest way to start if you don’t have a system yet?
Write it down. Pick the most repetitive, most painful part of your day, the part where you’re already doing the same thing over and over, and put the steps on paper. How are you actually doing it now. What’s working. What isn’t.
Once it’s written down instead of just living in your head, you’ll see the gaps and start building from there. There’s no point systematizing something you only do once. Systems are for the things that happen every day.
A final note from Carl White
This isn’t a physical therapy story. Every private practice has some version of what Mary Lou describes: a first phone call, an intake, a follow-up, moments where a patient decides whether to trust you. Most owners never write any of it down, so it lives in someone’s head and falls apart the day that person is out sick.
You don’t need a big system. You need a documented one. Pick the part of your practice that runs the most, write down the steps, and build from there.