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In this episode, Barbara discusses: 

  • Why many successful-looking practices still struggle financially behind the scenes.
    ● How doctors canidentify the kinds of patients they truly want to serve.
    ● The hidden cost of attracting the wrong cases into a busy schedule. 

Key Takeaways: 

“A packed waiting room doesn’t mean a profitable practice — the real success comes from attracting the right patients and building the right referral relationships.” 

— Dr. Barbara Hales

Connect with Barbara Hales:  

 

 

Profitable Practice vs Busy Practice 

 

Dr. Barbara Hales 00:02 

Hi, welcome to another episode of Marketing Tips for Doctors. I’m your host, Dr. Barbara Hales, and today we have Dr. David Romani with us. Welcome to the show. 

 

Dr. David Romani 00:16 

Thank you for having me. I appreciate it. 

 

Dr. Barbara Hales 00:19 

There’s a dirty secret in healthcare that nobody talks about: a packed waiting room does not mean a profitable practice. Dr. David Romansky spent over 25 years figuring out why, first as a clinic owner, then as the founder of Doctor Referral Institute. He works with healthcare practices across multiple specialties, helping them build referral systems that consistently bring in the right cases, not just more cases. Well, let’s get into it. Dr. David 

 

Dr. David Romani 00:58 

Sounds good. Thank you for the intro. 

 

Dr. Barbara Hales 01:01 

How is it that you decided upon doing this referral system? What got? 

 

Dr. David Romani 01:11 

Yeah, good question. So, actually, is in my own practice, so this is back early, probably know, probably 2530 years ago, we were working on getting into a publication that was pretty popular for our demographic that we were looking for, and we finally got into this big publication, was actually called Suburban Women, that went to probably about 80,000 women household in the area, who was a big target for our practice. So we ran the ad, and we’d met every week with our team, and I’d had working for me, and so the phone was ringing off the hook, and I asked my office manager, So how’s that new ad going? And she said, It’s going awful. I go, what do you mean, the phone’s ringing off the hook? She’s like, yes, we’ve had tons of phone calls, but we really only had two cases that are really what we want to see, not only cases that are appropriate, but also on the business side, the appropriate payer mixes. 

 

Understanding Referral Relationships 

 

Dr. Barbara Hales 03:20 

Why do great doctors still struggle to grow even today? Despite the fact that there is supposedly a shortage of doctors, 

 

Dr. David Romani 03:30 

It’s education. It’s really what it is. It’s education of not only, I guess, from a doctor’s standpoint of it’s truly understanding the business side, because if you think about, as a provider, we’ve always been taught, you know, patients first, patient everything, which is exactly what we’re talking about. We want to make sure patients are being taken care of, but on the business side, we need to take a step back and look at our actual practice, right? Because if you think about the person who walks through the door as an owner of the practice, whether it is exactly the case you want to see, or if it’s something that maybe is not an appropriate fit for what you’re doing, either condition, pay, or mix. You’re the only one affected. Everybody else makes the same amount of money, right? Whether it’s the front desk, referral coordinators, office managers, assistants, or whatever else, everybody gets paid the same. You do not. 

 

Dr. Barbara Hales 04:32 

What do referring providers actually base their decisions on? 

 

Dr. David Romani 04:37 

Good question, and a lot of it has to do with people they know and people they can relate to, right? So, we do have some people who will say, you know, I do work on those relationships, and we show up, you know, every, you know, couple of times a year and bring something to them. Well, they see patients every week, right? And so every week they’re seeing people, so we want to make sure we’re staying on top of them and communicating with them. 

 

Seeing the Right Patients 

 

Dr. Barbara Hales 05:32 

You’ve, you’ve talked about the busy trap. Why a full schedule doesn’t mean a profitable practice. What do you mean by that? 

 

Dr. David Romani 05:42 

Well, because if you think about it, I’ll give you a perfect example. We have a client who will retire in about six years. He said he wants to be able to retire in, and he says that right now in my practice, I have a waiting list of about 5 to 6 months or 5 to 6 weeks to get in to see me yet. If I actually looked at it, because one of the assignments I gave him said, Look at your practice and understand actually the demographics of it, and 35% of his practice is full of cases that are really not what he should be seeing, right? They’re not really the kinds of cases they want to see in their office. 

 

Dr. Barbara Hales 06:42 

I see. Well, you also talk about how your best referral sources aren’t sending you patients. That seems like a country contradiction. If they’re the best referral sources, how could they not be sending you patients? 

 

Dr. David Romani 06:56 

Because they don’t understand exactly who to send those cases to, right? So, this happens a lot, right? They may have the demographic that’s perfect for you, but you’ve not been there in front of them to educate them on exactly what you do. 

 

Dr. Barbara Hales 07:32 

I see. Well, how do you stop seeing the wrong patients? 

 

Dr. David Romani 07:37 

Well, and the biggest thing is going to be is that first thing again is understanding what you want to see, right, and not so much that, but really the demographic is finding out, okay, what are you good at, who has those cases, and then building and nurturing those relationships with those appropriate providers. 

 

Dr. Barbara Hales 08:30 

Well, don’t you have to see all the patients referred to you? 

 

Dr. David Romani 08:35 

Of course, you can’t go in and not tell people not to come into your practice, right? You can’t say that, but if you educate the referring providers again, of, hey, guess what, this is exactly the case I’m looking for. 

 

Dr. Barbara Hales 08:55 

And do you have a, you know, like you wash my back, wash yours in terms of you referring patients to them as well? 

 

Dr. David Romani 09:04 

No, we don’t. We don’t set that up as far as a reverse expectation for any of our clients. 

 

Building a Referral System 

 

Dr. Barbara Hales 09:38 

Well, as is, you know, with your name implying Doctor Referral Institute, this is more beneficial for the patients themselves than for the physicians. How do you get your name out there so patients at. As well as doctors know who to come to. 

 

Dr. David Romani 10:03 

Yep, good question. Yeah, so for all the work we do, we deal directly with the doctors themselves. All of our clients are specialists, so think of anyone in the medical or dental industry. Does not matter who they are; if they can receive a referral, they can be a client of ours. 

 

Dr. Barbara Hales 11:44 

Okay, so you come into an area that you may not have been in before, as you are expanding, and you, you know, go to speak to the doctors. How do you get in, how do you get in the door? 

 

Dr. David Romani 12:04 

Great question. Yeah, and remember that’s the number one question I get from everybody. How do you get in the door? Right, we’ve been there before, because you think about even in my practice, yours, you know, the gatekeepers’ responsibility is to keep you out, right? 

 

Dr. Barbara Hales 14:13 

Well, that certainly makes sense. Do you, do you run webinars or any type of educational programs to attract prospective physicians. 

 

Dr. David Romani 14:26 

Yeah, so we do different, all kinds of different items for that. We do different things with us on social media, across different aspects, and in webinars. We also offer, for any of them, which is pretty powerful, is a free referral evaluation. 

 

Dr. Barbara Hales 15:48 

Well, that certainly sounds extremely helpful. So, are what about patients that can only go to certain providers based on their insurance participation, does that enter into your service as well? 

 

Dr. David Romani 16:08 

Absolutely, yeah, that’s part of the educational process, right? 

 

Helping Doctors Grow Their Practice 

 

Dr. Barbara Hales 16:37 

I say, let’s say you are considering me as a client. Tell me, you know, like, tell me what your spiel would be that would make me just say, you know, I have to do this. 

 

Dr. David Romani 17:09 

Well, part of the difference is understanding that we’re not a marketing company that hasn’t been there, right? I’ve been in your shoes, right? As far as a provider goes to understand that nuance. 

 

Dr. Barbara Hales 20:09 

In getting to know all the doctors in a particular area. Can you help a physician who says, you know what, what service is lacking that by taking it, I would be unique, or what am I offering that is unique that nobody else is doing? 

 

Dr. David Romani 20:30 

Yeah, absolutely, yeah, we do look at that. So, we have, we have quite a bit of data as far as the market share goes, and we don’t have every provider in the country, but pretty close. 

 

Dr. Barbara Hales 21:43 

Yeah, I think that may be one of your most valuable services, like as a practicing physician. Like, I know what I provide; I don’t really know what everybody else, you know, in my specialty is providing. 

 

Dr. David Romani 22:06 

Yeah, absolutely. No, and it’s big, because if you think about it, the workflow of patients that’s out there, right, they’re looking, the referring providers looking for a solution, because they can’t treat them, they got to go somewhere, right. 

 

Dr. Barbara Hales 22:46 

Absolutely, well, this has been a wonderful conversation, and for all you listeners out there who feel this is the service for you. How can they reach you? 

 

Dr. David Romani 23:02 

Yeah, we have numerous different ways. So, our website is Referrals for doctors.com 

 

Dr. Barbara Hales 23:28 

Well, that’s great. Thank you so much for being with us today. 

 

Dr. David Romani 23:33 

Thank you for your time, Doc. I really appreciate.