Growing Your Practice Through Patient Referrals

Lee Ann Brady, DMD

March 2018 RN - Expires Wednesday, March 31st, 2021

Kulzer Online Learning Center


Practitioners seeking to grow their practices may not be putting enough of their marketing efforts behind attracting the patients likely to be most valuable—ie, those who come into the practice as a result of referrals from established satisfied patients. While marketing focused on social media or traditional media may cause the telephone to ring, practitioners can take special steps to attract patients who will schedule and keep appointments and accept the treatments their practitioner presents.

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Just one among many strategies for growing a dental practice is to make a concerted effort to increase referrals. While nearly all aspects of marketing seek to attract new patients and make them aware of the services the practice has to offer, there are many good reasons to focus on referrals from existing patients and use special approaches that should be defined and quantified like other segments of the marketing budget

Define New Patient Acquisition Goals

Clinicians seeking to grow their practices should examine their motivation, formulate concrete goals, and gear their marketing plans toward achieving those goals. Depending on their goals—eg, being busier, more productive, or more profitable—they need to determine the number of new patients needed each month. While some practices thrive adding five to 10 new patients a month, others need 40 or 50 or more new patients a month to drive their business in the desired direction and meet the economics of making their business successful. It is, of course, important to differentiate between patient flow needed to sustain a practice so it can meet its economic responsibilities and that desired to grow in keeping with a specified growth curve. They also need to realize that a practice can improve its profitability in ways other than adding patients—for example, by investing resources in the outcome of the new appointment in terms of treatment planning, case presentation, and case acceptance.

Current Referral Sources

Once the goal of adding a specific number of new patients is quantified, the next piece of the puzzle is determining where those new patients will come from.

Internal vs External Sources

Referral sources may be either internal or external. Internal sources include people such as current patients, physicians, dental specialists, and the dental team members; but they also encompass anything within the office that serves to project a positive image of the practice, including its appearance, its equipment, and brochures or digital signage explaining services and incentives for referring others to the practice. External sources include traditional marketing such as direct mail, magazines, local television, and newspapers. They also encompass online sources for referrals—including not just the practice website and Facebook page, but other sources such as Yelp.

Taken together, these channels of marketing can feed off each other and help practices increase the number of new patients.

To find out which are most effective, clinicians should print out a report with patient referral information. In the process, they may identify unexpected sources, which they may then pursue intentionally.

Maximizing the Impact of External Marketing Channels

The key to optimizing external marketing channels is active management. This is particularly the case with social media, which must be regularly updated with fresh content to maintain interest. Therefore, it should be either handled by someone in the practice with the desire and ability to update it regularly with interesting news about the profession or practice, or it should be outsourced to a professional trained to manage it properly.

Considerations with traditional methods, such as direct mail—including doorhangers—must focus not only on the message but how often it will be distributed and to whom. It must also take into account marketing by competitors—specifically, who they are, their practice location, and the specifics of their message, including special pricing.

Maximizing the Impact of Internal Marketing Channels

Everything about the office environment should support a positive image of the practice and its staff. The waiting room should be up to date and well cared for, and patients should be made aware of the special services and state-of-the-art equipment from displays, brochures, and digital signage, plus discussion with the staff.

Beyond that, all members of the dental team should make a conscious effort to seek new patient referrals using a variety of approaches, including incentives directed both at the referrer and referred, as described below.

The Value of Patient Referrals

While the quantity of new patient inquiries may technically be the objective of a marketing program, not all new patients have the same value to to the practice in terms of dollars spent and commitment to treatment. All marketing efforts should be ultimately evaluated in terms of return on investment (ROI)—that is, whether the dollars spent are worthwhile in terms of the monetary value of patients brought in.

Healthy patients often just need the office to help them stay healthy. Others need significant dental work. But, first of all, they need to make and keep their appointments, the likelihood of which may be determined by their referral source; those referred by enthusiastic longtime patients are highly likely to become enthusiastic longtime patients themselves, while those attracted by direct mail or a call-in service are likely to be on the low end of the bell curve of prospects who become future patients.

Getting New Referrals

First of all, patients may not be aware that their dentist is actively seeking new patients, no matter how happy they are with the practice. For that reason, it is important for the dental team members to make it clear that they welcome referrals by specifically mentioning it at each appointment. It makes sense to “change up” the message request, partly to keep it fresh for staff members who are delivering it, and for patients, who may tune out an often-repeated “spiel.” Staff members should also demonstrate that they appreciate receiving referrals in numerous ways, including incentives such as gift cards and expressions of gratitude—both verbal and written.

Another excellent source of patient referrals is the dental team itself, who should also be rewarded for referring friends and family members to the practice.

Creating Incentives

An incentive is a call to action to encourage desired behavior—in this case, to refer friends, family, and coworkers to the practice. Some typical incentives include gift cards for movie theaters or coffee shops. One method used in the author’s practice is giving all patients a physical reminder of the value of their referral—ie, a “share a smile card”; when a new patient presents that card upon this or her first visit, both the referrer and the referred patient receive a $50 credit.

There are many types of inexpensive and popular patient giveaways to remind patients of your practice—eg, branded sticky notes, lip balm, pens. The staff can experiment with different giveaways, as well as high-value rewards for referrals that become patients—eg, offering whitening services—but should also vary them.

Targeting Your Best Patients

Part of growing a practice with intention is to make a special effort to recruit new patients from among the practice’s best patients—including those the entire team enjoys, those who are active in recall, and those who seek and accept the treatments proposed. Staff members can help identify these patients during morning meetings, mentioning by name patients they believe merit special attention for recruiting referrals.

In general, all patients who are active in recall are good sources for referral; a referral from a patient with a longstanding patient has more “stickiness”—that is, a high likelihood of becoming a patient—than one inquiring based on insurance accepted or an impersonal door hanger. These patients place a high value on their oral health, so their care entails not just maintaining their health, but replacing restorations that have completed their lifespan. They also are known to the staff and likely to be aware of the many new treatments that are available, including smile improvement and tooth whitening.

Practitioners should consider, too, the direction in which they would like to take their practice in targeting specific types of patients. Part of being intentional and specific about growing a practice concerns focusing on specific types of patients. An especially valuable source of referrals would be a patient who is happy with a treatment in an area the practitioner would like to expand. For example, patients with veneers are walking ads for their dentist: they can tell not just about practice, but a specific service. Conversely, practitioners who want to minimize a specific type of dentistry—eg, emergent or pediatric—should not be encouraging referrals from those types of patients.

Managing New Referrals

Getting the phone to ring is only the first step in growing a practice. Managing those phone calls is a key element in determining whether the caller actually schedules and keeps that all-important first appointment. Therefore, those who answer the phone should have very consistent skills, so no matter who answers the phone, the caller will get a very consistent response.

Staff members who respond to these calls should receive specific training on how to handle them to take advantage of their motivation for calling. Generally, immediate scheduling is an effective strategy for this. Because it is desirable to get a first-time patient in as soon as possible, the appointment schedule should be designed to accommodate this. However, their reason for calling and referral source should be taken into account in how a given phone call is managed.

In general, the most powerful—ie, stickiest— referrals are those coming from an existing patient who endorses the practice. These prospective patients aren’t shopping; they already have a level of trust, and are already motivated to become established patients. Therefore, unless they mention a specific issue, waiting for an appointment with the doctor is not normally a deterrent.

Gauging the Success of New-Patient Marketing

All marketing efforts—including time spent on the phone, brainstorming with staff, managing social media, etc—should be measured and monitored, so the practice can know what is or isn’t working and how to improve. Key measures include: the number of new patient calls; the number of new patients scheduled; and how many patients keep their appointments.

A high rate of attrition—ie, patients who schedule but don’t keep appointments—suggests more of the marketing budget should be devoted to improving the interaction that occurs during the initial call or perhaps improved scheduling—eg, offering new patients the next available open hygiene appointment, and otherwise addressing specific concerns.


The objective of marketing a dental practice is to turn those marketing dollars into patients—recurring, repeat, regular patients who remain in the practice long-term and encourage friends, colleagues, and family member to do the same. The ultimate goal is the topic of another discussion—keeping patients happy and increasing practice profitability by having these patients accept the recommended treatments.

Related Sources

1. Best practices for generating dental referrals. Dental Heroes. January 1, 2010. [Guest post from Millennium Dental]. Accessed August 26, 2014.

2. Buber L. How to keep a steady flow of new patients. Marketing for Dental Specialists. May 19, 2010. Accessed August 27, 2014.

3. Buber L. Make a dental patient a referral source. Marketing for Dental Specialists. March 1, 2010. Accessed August 27, 2014.

4. Clark M. How to increase your patient referrals. October 30, 2010. Dental Heroes. Accessed August 26, 2014.

5. Dental patient & office referrals marketing ideas. [with video: Master the 3 Rs of referrals] Smart Practice. Accessed August 26, 2014.

6. How to ask a patient for referrals. The Curious Dentist. Posted July 29, 2011. Accessed August 26, 2014.

7. How to grow your practice with patient referrals [video] Dental Product Report. January 2014. [compiled 1/23/14 by :oesle G]. Accessed August 27, 2014

8. Kantscheff M. Getting referrals for you dental business. Conscious Dentist. January 30, 2011. Accessed August 26, 2014

9. Krause J. How you can get more patients. Ezine Articles. January 30, 2011. Accessed August 26, 2014.

10. Levin RP. Building and sustaining a referral network. Compend Contin Educ Dent. 2013. 34(7):486-487.

11. Levin RP. Customer service as an internal marketing strategy. Inside Dentistry. 10(6): 26-27.

12. Levitt M. Keeping patients happy, asking for referrals: the best ROI for dentists! [Posted by Nastasia J, September 23, 2010]. MDM Consulting. Accessed August 26, 2014.

13. Patient Letters: Thank you to patient for referral. Kansas State University. Accessed August 26, 2014

14. Patient referrals.

15. The easy way to more patient referrals. Deliver Me Patients. Posted January 22, 2013. Accessed August 26, 2014.

16. Want to attract new dental patients? Think about a referral contest. Articles Factory. August 20, 2008. Accessed August 26, 2014

17. Tumminello M. 10 tips for encouraging dental referrals. Accessed August 26, 2014.

COST: $0
PROVIDER: Dental Learning Systems, LLC
SOURCE: CDEWorld | September 2014

Learning Objectives:


  • describe ways to increase referrals via internal marketing
  • discuss strategies to evaluate patient loyalty
  • discuss strategies to grow the practice via nurturing relationships with existing patients


The author reports no conflicts of interest associated with this work.

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