Joseph R. Sanok, MA, LLP, LPC, NCC is a licensed counselor and owner of Mental Wellness Counseling in Traverse City, MI. What have you learned from these podcasts? Will you comment below or email Joe? If you want to take your private practice to the next level, check out the paid e-newsletter subscription.

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Increasing Counseling Private Practice Referrals from Doctors, Pastors, and the Community

Welcome to the Practice of the Practice Podcast with Joe Sanok, Session 4.

I’m Joe Sanok, your host, and I’m so glad that you are joining me today in this Practice of the Practice Podcast. The amount of downloads has just been overwhelming to me, to see how many people are tuning in. Thank you so much for taking time out of your day to let me join you in your ears and brain.

I hope you are taking action on the stuff we’ve talked about. In first the podcast, we talked about developing your niche and focusing in on how you can grow your private practice through focusing on a specific area. That doesn’t mean that’s all you’re going to do, but when people know you, for one thing, they then assume that you’re good at other things. We talked about that in the first podcast. The second and third podcast were a two-part series. I just had way too much to say and it wouldn’t have been fair to put that all in one podcast. We talked about websites, we talked about SEO, and we talked about how much you can do yourself if you put your mind to it and you learn just a few key things within WordPress.

Again, thanks for joining me, and let’s dive right in. Today we’re talking about building referrals from doctors, pastors, and your community. The reason that I picked doctors and pastors is that, in a lot of ways, they’re at opposite ends of the spectrum. I’ll tell you why, and I’m not talking theology here. I’m more talking of techniques in regards to connecting with them for referrals.

How to Be Your Own Counseling Private Practice Consultant to Gain Ground in Building Your Practice

Let me just tell you a little bit about when I first started doing counseling. This was when I was down in Kalamazoo, when I first started doing counseling at a private practice. It was really difficult because what I had to do was figure out how much time to put into trying to get onto insurance panels, and then match that with (what I hoped would be) what people had as insurance when they came into the private practice. There was always this dance of, “Hey, I just got on this insurance panel!” but nobody from that insurance panel seemed to want to come and see me. It’s all people from this other insurance that I just happened to not be on.

There was always that dance there and it was really hard and frustrating because I would get calls that said, “Oh, so and so referred me” and well, I didn’t take their insurance which was a total bummer. For me, when I moved to Traverse City, I really wanted to try and avoid that. Initially, I wasn’t on any insurance panels. I just couldn’t get on to them because I was brand new to the area. But then, as I thought more and talked to some friends and some other counselors, I realized that I really just didn’t want to be on insurance panels because this is how it would continue to play out for me.

So, say there was a client that was giving between $50, $60, $70 a session for their insurance. So, depending on what insurance company they had, they’d pay anywhere from probably $53 a session, that was the lowest insurance that I took, all the way up to $107, I think it was. Let’s take a look at that lowest end client. At $53 a session with some of those insurance companies that pay less, they don’t allow you to charge for no-shows. So, maybe for every three or four sessions, I would get a no-show. For that no-show, I’d be fighting on the phone with an insurance company for an hour (if I was lucky).

Many a time, the insurances would lose paperwork, misplace it, say that I never faxed any authorization paperwork. Let’s say it’s five hours and for those three sessions, I get $150. That means that if I could charge $150 and have one person see me at that rate, I could take on four free clients and come out exactly the same. Maybe I would even charge $20 or $30 for those additional clients. When I started to do more of the math and think about doing just private pay, for me, that was where I wanted to focus my energy so I could do less time, less hassle, and actually get to do counseling.

When I explained this concept to people in that way, they seemed to be more than willing if they were able to pay that amount. When I first moved to Traverse City, I looked at the market and saw that the going rate was around $80 a session for people with my licensure, so I started at $70 a session. I just wanted to undercut the competition and go from there. Over time, as I grew my expertise, became better known in the community, as I was writing more and doing more to build my image in the community, I slowly moved up to my current rate, $150 for a session and $200 for an intake. That is almost double what the average counselor is charging.

Honestly, I don’t feel bad about that because people are voluntarily coming to me and saying, “I will pay this.” It has also given me the ability to see other people for a reduced rate and to take on people that maybe I wouldn’t have been able to afford taking on in the past.

I’ve been able to really focus in on the type of client that I want to work with. Other people have completely different philosophies, and that’s fine. You’ve got to figure out for yourself what your philosophy is going to be in regards to how you structure your billing.

What Are the Keys to Getting Referrals from Doctors?

What Are They Looking For?

Let’s talk about doctors. In a lot of ways, I think they are like spam email. Actually, they’re like the receiver of spam email that says it’s someone from Kenya that has a million dollars and if you just help them, you’ll get a cut of it. When I first got that email, I was so excited. I couldn’t believe that a prince over in Africa was in the situation where I was going to be able to help them out. I almost got sucked in and I’m embarrassed to even think about it now.

But then, I realized it was a total hoax and everyone has gotten this email a million times. It’s the same thing each time and you just disregard it. I think the same is true with doctors. There are so many people that are trying to get the doctor’s time. Everybody is pitching at them and saying, “Hey, check out this new drug. Check out this new therapy. Checkout this, this, this”. It’s easy, as I’ve talked to a number of my doctor friends, for counselors to just be lumped into that same kind of mental space.

When I was at community mental health back in Kalamazoo a number of years ago, I did a few different roles there. I was a school-based counselor and then I was also a wraparound coordinator. It was amazing how we often we were pitched to by local counselors that had just gotten to the CMH contract. Honestly, about 90% of our referrals went to only three people. Those three people did an amazing job of marketing themselves and not in the way that we often think. It wasn’t that they had fancy business cards. It wasn’t that they had fancy handouts. It wasn’t that — I didn’t even know what their websites looked like. And, yes, a website, especially now, is important, especially to the client that’s making a decision.But to the referral source, it’s a lot less important.It’s all about the relationship.

So these were people that, oftentimes, would just stop by our office. They would chit-chat and they would be around so we could ask questions. They would send reports. They would do follow-up phone calls. They were easy to get a hold of. All these things made my job easier. I knew that when I made a referral they were going to make it happen. I wasn’t going to have to follow up a second, third, or fourth time. They were going to make it happen that day. They were going to go visit the students in the school. They were going to document their time. They were going to submit their billing and, honestly, I would see results with these kids and families that I didn’t see with other referral sources.

The big tip in regards to doctors is to figure out a way to make their lives easier. As I was talking to a friend of mine that’s a doctor, I kind of went over what my talking points were because I don’t want to just lump together all doctors. They’re people too and to just say, “All doctors refer this way” wouldn’t be accurate.

There are some things that definitely can help you and your clients have an even more successful doctor-counselor-client relationship. One thing is to encourage your client to update their doctor. Have them talk to their doctor. I’ll often ask my clients, “Have you talked to your doctor about what we’re working on here?” when I know there’s a certain doctor that referred them. I also give my cell phone number out to the doctors so they can just give me a call if they have a client they want to talk about or if they have a client that they need to refer.

Also, as I talk to my friends that are doctors, they talked about how, especially as the primary care physician, oftentimes, they have a handful of patients that just need someone to talk to. Whenever they come in to talk to that doctor they just take up so much time. Of course these doctors are going to give them that time because they want to help people. That’s why they went into medicine. Work with a doctor on transitioning some of those difficult patients to counseling rather than doing that with their primary care physician.

The big takeaway is that, often, primary care physicians’ work is so hectic. The easier you can make it by giving them stacks of cards or making it easy for them to refer, the better.

A Proven Plan for Connecting with Doctors

That brings me to strategy 1 with doctors. Make a handout aimed at those that are being referred. Oftentimes when counselors write a letter to the doctor, they might do all sorts of different strategies, but framing a handout to the person that’s being referred makes it so much easier for a doctor. I have a link to my doctor handout and a few extra strategies that can help you out. It’s in a .doc format so that you can change it and manipulate it to turn it into whatever works for you. Just make sure it easy for them to give this handout to that person.

Second, strategy 2 is to start with your own doctors. I went to my ophthalmologist in early December, so just a couple of months ago. As I was talking to him, I said to him, “You know, one thing” — because they always ask you how your life’s going. Like, “How’s life going?” They do that chit-chat and I often talk about how my daughter’s doing great and my private practice and counseling is doing really well. I’m getting lots of referrals and then, as we’re talking, I weave in, “If you ever have a client that has a new diagnosis, is dealing with parenting issues or any kind of stress and you’re just not sure how best to help them, by all means, feel free to refer them to me.”

This is what my ophthalmologist said. These are his exact words. He said to me, “I had someone this morning that just got a new diagnosis and I wish you had been here. I totally would have referred him.” I don’t know if he said “totally”–“I would have referred him.” I can’t see an ophthalmologist saying, “I totally would have referred him.” That would be unprofessional. Something like I just was, which I don’t mind because I guess whatever.

Strategy number 3 for giving doctor referrals. Follow up with your own clients’ doctors. Of course, you need the release of information. You need to ask them if they want you to coordinate with them. I think this one way that you can really meet those new doctors. It’s so hard to do a cold call and show up with doughnuts, or flowers, or whatever it is that you think is a good idea. But when you have a mutual client and you’re trying to focus it on “How can I make your job easier?”, that is a great way to meet them in person, to talk to them, to make their job easier, and to give your recommendations and respectfully say, “I know you’re the doctor, so I’m not telling you what to do, but here’s what I’m seeing.” It really, really, really makes their life easier.

How to How to Determine Whether Someone Has Been Over-Pitched or Under-Pitched

So, on one end we’ve got people that are over-pitched, doctors in particular, especially because of the pharmaceutical reps and all sorts of other people that are just vying for their time.

On the other end are pastors, not that people don’t want their time, but they’re not getting pitched to as often. I know pitching your practice sounds like super marketing and sleazy. Maybe, not sleazy. That’s a bad way of saying it. No, maybe that’s the best way of saying it.

It’s not that you’re pitching in the traditional sense. You’re sharing your passion with these people. Remember that you need to be authentic about who you are with all of these, which goes back to your niche and your passion and all that. My assumption is that you believe in counseling.

What Are Pastors’ Greatest Worries in Making Counseling Private Practice Referrals?

In talking to pastors, oftentimes they’re worried about kind of bad theology, that you would get in the way of something they’re doing. Understand the unique role of a pastor. Oftentimes it covers counseling, but pastors don’t always have the emphasis in counseling in their master’s program. Some do. I don’t want to say they all don’t.

Emphasize partnering with the pastor, and really emphasize partnering when a client gets referred to you. Also, in talking to pastors, have a dialogue and discussion in person if it’s possible. Sometimes this is initially hard to do, but ask if there are situations they aren’t sure how to handle that have to do with therapeutic issues.

I asked a pastor this question and he brought up depression. He actually invited me to speak at a monthly pastors’ luncheon about depression. There were probably 25 pastors there. My goal was just to speak about depression to this group of pastors and inform them that, when it’s too much, they should think about referring to someone. It doesn’t have to be me. I may not be the best fit for their congregation.

Have open communication, open questions with pastors. Really take the time to sit down with them. With doctors, it’s often hard to have that one-on-one time to sit down, but I think that the nature of a pastor is to connect with people. That’s typically why they went into being a pastor. They want to have these deeper relationships with people to show God’s love or whatever their theological viewpoint is.

Take the time to sit down with them. Really understand what their congregation is like. Do your research ahead of time to understand their theological viewpoint. Listen to a couple of sermons so you go in educated when you’re talking to them. Then genuinely try to help them. As we talk in future podcasts about developing a referral network, all this comes down to is relationships. Counselors should be the best at developing relationships, listening, asking engaging questions and going deeper with people, maybe quicker than the average relationship. When you use those skills to get to know people, whether it’s taking them out for breakfast or just going to their office and connecting in a deeper level with them, both sides, both the counselor and the pastor, will see the others as being important and I think it’s going to just significantly increase your referrals.

Engaging Your Community and Clients to Build Your Referrals

Getting referrals from the community — that’s such a huge topic. There’s a few things that you can do to continue to grow your referral sources from the community.

First, again, is being known for something. Whether it’s writing articles, going on the radio, any advertising you pay for, focus in on that one niche.

Second, really look at why your clients would refer friends or family to you. That’s not something that I know. I mean, I honestly can’t tell you how to make that happen. I know what’s worked for me and a lot of what I’ve learned has come through the annual survey that I do. I’ve referred to that in a prior podcast, but pretty much what I do is create a Google Document in Google Drive, I think it’s called now.

They have a forms section where you can create a form. It can help you find out if people would refer a friend or family member to you. I always ask that question in my annual survey. “Would you refer a friend or family member to Mental Wellness Counseling?” Or to Joe Sanok, or however you want to frame it.

Thus far, a hundred percent of my clients that have answered the questions have said yes, which blows my mind. That tells me that I’m on the right track, at least with those that took the time to fill up the survey. Those that didn’t, maybe they were mad or something.

If you can — and then the next question is, “If yes, why? If no, why?” To really try to understand what helps people refer and continue to add value within your counseling session. So if I find an article, a great TED talk, or if I read a blog post that specifically pertains to something we talked about in counseling, I’ll follow up with my clients, email them and say, “Hey, I saw this video. I thought you might really connect with it.” Oftentimes, they will then forward that with my information at the bottom that says, “Joe Sanok, Mental Wellness Counseling and blah, blah, blah.” They’ll forward it on to their friends, their family members and say, “My therapist sent this to me, and I think you guys would love it.” I have gotten referrals that way because of things I have passed on to people and that they then passed on to somebody else.

Tips, Advice, and Ways to Continue to Grow Your Counseling Private Practice

Those are just a couple strategies. Throughout this podcast, we’re going to go deeper and deeper and deeper, but I hope that those thoughts, those ideas of how to connect with doctors, how to connect with pastors, and how to connect with the community (with the help of your clients) will help you.

But let me just remind you that the number 1 thing in counseling is your client relationship. And so, even as we talk about all of this marketing, as we talk about business ideas, your relationship with the client has to be number 1. If getting referrals gets in the way of your relationship with the client then you have failed and I have failed. Number 1 in counseling is that client-counselor relationship, and you never want your clients to feel like you’re using them to grow your practice or things like that.

That’s why things like referral bonuses are definitely talked about as not being a best practice. Always keep that in the forefront of your mind. I’m sure you do, but I just wanted to remind you of that because, sometimes, I’ve had people email me that when we talk about these business principles, they feel like I’m missing the point of counseling. We have to focus on making sure that that client counselor relationship’s number 1. As we do these things, all of it is just a reflection of our feelings, of connection with our clients, of helping them, and helping them to help themselves.

If you’ve questions, by all means, please send me an email, [email protected]. We’d love to talk with you more. Also, if you haven’t checked out my eBook, there are a bunch of great ideas in there that I think you might connect with. It is available here on Amazon. There may be something there that you might be able to use to fast-forward and speed up your counseling private practice even faster.

We’d love for you to connect with me through the eBook. Thank you for letting me help you make your counseling private practice even more awesome. Have an awesome week and thanks for taking time to listen.

I really want to thank the bands, Silence is Sexy, The Easton Ellises, and Thoola. You three have kicked off some sweet music for us this week, and we really just thank you for making your music free for us to utilize within this podcast.

This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It’s provided with the understanding that the host and the publisher are not engaged in rendering legal, accounting, counseling or other professional services. If a legal advice or other expert assistance is required, the service of a competent professional person should be sought. Thank you.

Joseph R. Sanok, MA, LLP, LPC, NCC

Joe Sanok is a private practice business consultant and counselor that helps small businesses and counselors in private practice that are starting a private practice. He helps owners with website design, vision, growth, and using their time to create income through being a private practice consultant. Joe was frustrated with his lack of business and marketing skills when he left graduate school. He loved helping people through counseling, but felt that often people couldn’t find him. Over the past few years he has grown his skills, income, and ability to lead others, while still maintaining an active private practice in Traverse City, MI. To link to Joe’s Google+ .