The Referral Relationship: How Physician Liaison Work Shapes the Patient Journey Before It Begins

This transcript was generated automatically and may contain errors.

Melissa Gilkes-Smith: All right, so welcome back to Touch Points. In episode one, I introduced the nine pillars of patient experience, the framework that guides everything we do on this show. And the very first pillar is initial exposure, the patient’s first impression of your practice before they’ve ever spoken to anyone on your team. Last episode, we talked about what that looks like from the patient side, your digital presence, your reviews, what someone finds when they search for you. Today we’re looking at initial exposure from a completely different angle. Because for many healthcare organizations, especially specialty practices, surgical centers, and health systems, the patient’s first exposure to you doesn’t come from Google.

It comes from another physician. A referring provider who said, you need to see this person. That referral is a moment that matters. And it happens before your team has any contact with the patient at all. So the question is, how do you earn it? How do you build the kind of relationships with referring physicians that result in consistent, sustained referral volume? Not just because you sent a flyer, but because a provider trusts you with their patients. My guest today has spent more than a decade answering that question. Shaida Amaya is a healthcare business development leader with over 20 years of experience across healthcare continuum. For the past 12 years, she’s focused specifically on business development, leading strategic initiatives, building referral networks, and working at the intersection of operations and strategy to remove barriers between providers and patients.

What I appreciate most about Shayda’s work is that she never separates the business goal from the patient goal. For her, a stronger referral relationship means a more connected, less burdened patient experience. And that is exactly the lens that we need for this conversation. Shayda, welcome to Touch Points. Thank you so much. And what a lovely introduction.

Shayda Amaya: I appreciate that.

Melissa Gilkes-Smith: Absolutely. So let’s start at the beginning because I think a lot of people hear physician liaison and picture someone dropping off lunch and leaving brochures. Can you tell us what this work actually is and what it takes to do it well?

Shayda Amaya: Yeah, I think that’s probably the biggest misconception, right? That um it’s very marketing-based when really it’s meant to be strategic. So I think that a really strong liaison, and I actually try to shy away from the word physician liaison. Um I like liaison or consultants because oftentimes um the big one of the biggest things that they are going to have to uncover is who are the decision makers within the practice, the organization that they’re interfacing with. And oftentimes, yes, there’s gonna be a physician that is part of that equation, but there are also other people that are gonna influence um that referral journey for the patient. Um, so you know, the the liaison role is really strategic.

It’s uncovering where pain points exist for that practice or their organization and where the pain points exist for the patient, their family when they’re navigating through the care continuum. So, although interfacing during a lunch in service can be very, very helpful and definitely something that we know that liaisons and consultants do, it is a very small part of what their role actually should consist of.

Melissa Gilkes-Smith: And that distinction between a liaison who is transactional and then one who’s truly strategic, I think that’s that’s everything right there. And I imagine that the practices that treat it as a sales function versus a relationship function get very different results. What does that look like from the inside?

Shayda Amaya: Yeah, I think it first and foremost, it’s how you’re coaching the liaison or consultant, right, into what this role is actually gonna consist of. And so I put a heavy emphasis on consultative approaches and really getting to know the full account structure and not treating each practice the same. So you could have, for example, two orthopedic practices who are practicing basically the same type of medicine. But if you go in treating each one exactly the same, you’re not going to achieve the results that you’re looking for because you’ve lost the point of getting to know that individual practice and the way that they operate and what their problem areas are when they’re looking for, you know, a provider that offers the services that you’re representing.

So I think we have to work with our consultants and our liaisons to understanding that first and foremost, their role is to go out and learn about the practices that we need to partner with and understanding how they operate, how they function. Who are the key decision makers within that practice? And also who are not direct influencers of the business? I think we we lose sight of you know a lot of the team members within that practice, although they’re not directly influencing where that patient referral goes, they definitely understand and are very competent about the different options out there for the patients. What organizations are gonna provide care at the top level, which ones are actually creating more stress and burden for them and work for them?

Um, and they’re talking about that with the key decision makers. And so um, the consultants that I see that are extremely successful are the ones that understand that. Um, and when they go in to work with the account and the organization, they are learning about them first and learning how to navigate through them individually, not like the other practices that they’re visiting or working with.

Melissa Gilkes-Smith: So you’ve led, you know, physician liaison, liaison and consultant teams. Sure have. So from a leadership standpoint, what does it look like when you’re building or rebuilding a liaison program?

Shayda Amaya: Yeah. So I think the one thing leaders tend to focus on, which I actually do kind of the opposite of, is they want somebody with a strong sales background. That’s what they’re looking for, who has a strong sales background. And I don’t think that that’s at the or that’s the most important piece to it because I think you can coach to and and train on industry specifics to, you know, different techniques. And obviously they are gonna learn the industry that they’re representing, the service that they’re representing. I actually look for a couple of things. I I look for emotional intelligence. Um, I look for strong communicators, somebody who is able to, when I say strong communicator, it’s not just be able to articulate well, but who listens more than speaking.

And that’s really important because people who are natural salespeople tend to like to talk a lot. They like to talk a whole lot, but they don’t necessarily listen a ton, right? So one of the examples that I use the most is, you know, that uh historical and it’s used so often, sell me this pen, right? And most salespeople will go right into all the great things about the pen, but they don’t ask and they don’t listen to what you are actually looking for. That’s consultative, right? I can’t help you if I don’t know what you need. So I’m looking for somebody who’s a great communicator and can listen. And then I look for somebody who has a lot of curiosity and presents like they have an appetite for curiosity because that curiosity is what is gonna lead them to really qualify their account, understand what the account needs, and not again, going back to what I said previously, not be cookie-cutter about it, right?

Like approach each individual practice, each individual decision maker with a way of a solution for them individually, not because every other practice that operates that specialty needs the same thing. So those are the big points I think that I look for when building a team. And then also, lastly, I think when you think of a team, this is another thing a lot of people I think forget to do. They want salespeople who are going to operate autonomously and competitively because they think that that’s really important. I think there’s a little bit of that that’s important, but working together as a team is also really important. Yeah. Because you’re representing a service and you need to build trust with your referral partners.

And the better your team is, the better that’s going to be represented. So I like to build teams that are going to work as a team.

Melissa Gilkes-Smith: So you mentioned that not necessarily, you know, individuals with sales backgrounds, you know, are always the best. Is there a specific industry that you find that some of your best team members have come from?

Shayda Amaya: So I think if they’ve had some exposure to healthcare, they tend to do really well. But if they’ve worked in any industry, including like uh veterinary practices, things where that things that require a lot of empathy and compassion. Because the reason for that is, especially in services, healthcare service, sales or business development roles, you know, and that’s really been my background, is because what’s being transact, the transaction, right, at the heart of that transaction is a patient. And so I think that if you have somebody who has a heavy sales background, even a heavy sales background in something like product sales within healthcare, so DME, pharma, um, they they tend to struggle.

And I’m not saying all the time, but to see that in the middle of all of this is now a patient. And what is that patient experience through the continuum of care that you’re representing? Um, so I look for people who have backgrounds in, you know, service industries where uh customer service and compassion and empathy are at the heart of what they’re doing because it will translate well into one, understanding how important the communication is, but two, that there is a person involved in this process.

Melissa Gilkes-Smith: Absolutely. I I teach a culture of care and the four values are accountability, compassion, empathy, and collaboration. So, you know, the the values of just being a part of a team also absolutely. Yeah. Yeah. So then when you bring on that liaison into the role, you know, what does that coaching look like once they’re on that team? Because I imagine that even strong hires still need the guidance on how to navigate some of the harder situations.

Shayda Amaya: Yeah, absolutely. So I think obviously it goes without saying, you know, really understanding and coaching to the service that they’re representing. And not just like the the book smart of it, right? Like, okay, you’re representing, let’s say, what I’m, you know, the industry that I’m currently in, you’re representing hospice. So you need to understand what that is and and what are what are the regulations that we follow. But understanding and seeing firsthand the work being done is really important because they need to be able to connect what they’re going out and trying to get and what that’s gonna look like for that patient and that family. So um, that’s the first thing is they need to know intimately the services that they are representing.

And I think a lot of business development leaders and organizations, one of the things that I’ve noticed is that they don’t feel that if somebody isn’t clinically trained or licensed, that they have the aptitude to speak to the clinical offering, right? And so that goes back to that marketing piece. They put them into a very confined swim lane of you are a marketer. Yeah. So you’re gonna go out and you’re gonna speak to this on a very surface level. You’re gonna hand out brochures. Um, but that’s not gonna build trust from a decision maker who is a physician, a nurse, a nurse navigator, a social worker, discharge planner, right? Um, so I feel like that does a disservice to your team. And so I coach my liaisons and consultants to feeling confident with the clinical information, being able to speak intelligently to it because you’re representing it.

So you don’t need the clinical license to speak confidently about the, you know, the clinical, you know, nuances of what your service is. You should actually, in fact, be able to, because that’s gonna build the trust that, okay, if I send my patient to them, they really know what they’re doing because the person that’s representing them knows what they’re doing. So that’s the first thing that I think is really important. Um, second to that is an understanding of healthcare and, you know, both from a broad perspective, but you know, getting down to to a micro level of like what that means for, you know, the industry that they’re representing, you know. So again, going back to where I currently sit, you know, there is a big difference in how physician practices operate versus senior living and skilled nursing facilities and a hospital system.

And they need to be knowledgeable on that because they’re the way that they’re gonna interact and look to the different decision makers, they’re it’s gonna be very different. So they need to have a generalized understanding of all of that so that when they go out, they have um, you know, they have the best success when when interacting with those different individuals.

Melissa Gilkes-Smith: So let’s move over to the provider side and let’s talk about building that trust because I think this is where the patient experience and business development connect most directly. A physician who for who refers their patient to you is making a trust decision. They’re saying, I’m confident enough in this organization to send someone I am responsible for. So, how do you build that confidence? You know, of course, understanding the, you know, healthcare, understanding the what you’re selling, you know, the procedures and everything, you know, so how do you build that confidence for that liaison that’s going into that practice and also the the provider?

Shayda Amaya: Yeah. So I think first and foremost, that trust is built off of operational moments and not presentation moments. And a lot of times your sales teams are meant to be presenters, right? So I’m gonna present this information and that’s what’s gonna lead to this referral pipeline. And that’s not how it’s going to work. A provider, and when we say provider, that can be any key decision maker, right? So it could be an actual physician or nurse practitioner who’s a provider, but again, it could be a lot of other people within that practice or that organization. They could love you personally, they could think you are great. Um, they could go and talk and chat you up at networking events, but that is not gonna equate to them trusting you clinically with their patient, right?

And so exactly, how do we get to build that trust? So I think it’s clinical competence and knowing the industry and the services that you are gonna provide. And it’s being able to navigate the difficult situations and help them through those deficiencies for their patients through that journey, right? So communicating heavily, problem solving with them, reporting back on outcomes for that patient, right? And I think that’s one of the biggest missteps that consultants and liaisons, because again, and it’s it’s not because they don’t know to report back or they don’t want to report back on the outcome of the patient referral. It’s because their organization has limited them to you’re not capable of being able to report back on that, right?

Well, if they’re not the ones doing that, then who’s responsible for it? Because the person that trusted us with the patient, they want to know what happened. So we we need to make sure that we’re going back and saying, you know, thank you, um, you know, Dr. Smith, for trusting us with, you know, patient so and so. I know that that was a really tough, you know, process for us to get them onto service or, you know, whatever. That was a tough insurance that we worked with. But I wanted to let you know that we were able to navigate all of that. We’ve worked it all out. And that patient received our services last Thursday. What reassurance for that provider that they trusted you with this patient?

And now they are getting report, you know, report back that from somebody, not just a faxed orders and notes, clinical notes and stuff like that, but somebody coming by and giving them that reassurance. It’s huge. Um, and you know, a story comes to mind where um I had we had a very difficult patient uh case, and uh there was heavy, heavy caregiver burden for this particular family and a lot of complexities, right? So we worked one very quickly to navigate this for the pay the for the provider who had trusted us with the patient. So there was a very quick response to the need. And then, you know, I was able to get with with my consultant several other team members because again, going back, this is operational.

Business development in healthcare settings is very operational. So working as a team along with the clinical team that would be doing the care for the patient. So coordinating all of that was part of the consultant. And in me, you know, that was part of what we were doing. And when I went back to the provider, you know, what he said stood out for him, what it was had nothing to do with anything promotional or marketing related. It was, you know, that one, he never he was communicated with. So he never felt disconnected to what was happening with his patient. Nice. And that’s what he remembered, right? Because we gave him the consultant, you know, along with me, gave him updates and what we were doing to coordinate for this patient.

And so he never felt disconnected from his patient because it was his patient first.

Melissa Gilkes-Smith: That’s that’s an amazing story. Thank you for sharing that. So, but on the other side, of course, now you are sometimes in the line of fire if operations do not work out well. And you know, there there are hiccups in healthcare, there are things that are missed. We’ve got a lot of patients that are coming through our clinics, you know, and it’s just mistakes are going to happen. So when you do have to do some cleanup, you know, what does that look like, you know, to you, to your team? You know, can you share a story where you’ve had to do some cleanup? And, you know, what was that? And, you know, what did that cleanup, you know, entail? What did that look like?

Shayda Amaya: Yeah. Yeah. I mean, service failures are gonna happen because healthcare is fragmented and there there are deficiencies that exist. And so I think first acknowledging that is the best possible solution you can have. So I and my, you know, the teams that I work with, I have them address that on the front end before the first ref patient referral ever even gets sent. So, you know, because again, you’re trying to build trust. And so calling out what some of those hiccups could be, and how are we gonna partner and navigate them together? Because it’s it’s not, it shouldn’t be a blame game. It should be, okay, how are we going to fix this for the patient and their family? So um I think that’s first and foremost, and then I’ll get to the story in a minute.

But then, second to that, again, I can’t, I don’t want to keep harping on it, but when we when we put our business development team in a box and say, you’re just a marketer, so you stay right here in this box, and we don’t engage them into their operational team members and look at that as a major partnership and don’t allow them to understand the operations behind the service that they’re representing, then we create a divide, right? And when you talk about a service failure and that’s happening operationally. That’s not something the salesperson or business development person did. That’s something that happened clinically in the operation, right? And so if they’re gonna have to clean up that mess, they need to be part of the solution and part.

Of how this team operates and works. So, what I really try to do with my teams is create that partnership, that interdisciplinary partnership between the business development consultant and the clinical team that’s doing the work so that they can work together on that. And that allows when the problems arise, that consultant can go back to their clinical team and say, okay, this was brought to my attention. Can we dig in? Can we figure out what happened? So that I can go back and present the solution appropriately. So going back to one of the stories, when I started in my current role in hospice, one of the providers that we work heavily with in hospice are senior living communities. And when I sat down with the senior living community and a new consultant that I had hired, we did what was called a kickoff meeting to the relationship being built, right?

So we haven’t worked in this building and with your residents before, you haven’t worked with us before. And so what is this going to look like? And then at the end of that, I said, let’s talk about the what-ifs. Let’s talk about what if you call one of your team members call in the middle of the night to get a hold of one of our on-call team members, and we don’t show up as quick as you wanted us to. How are we going to work together on something like that? Right. So addressing some of the service failures that you know could happen operationally in your in in the service you’re representing. And then how do we work together to navigate those? I like that. The proactive what ifs.

Melissa Gilkes-Smith: Absolutely. That’s a good, so you’ve established credibility with these, these, these practices and everything, or you know, these these communities. Um and then there’s the there’s always the ask for referrals. And like the presentation is sometimes the easiest part. And it’s kind of like, okay, so let me show you. And you know, you’re you’re talking about what, you know, what you offer, you know, um, you know, all of the service lines, you know, how to how to submit referrals.

Shayda Amaya: And then there’s kind of like then the so how do you how do you make that ask? So I think the biggest thing is to not expect to have to ask because this isn’t transactional, right? The the this isn’t transactional. So somebody who is trans is trained in a more transactional, uh traditional sales role would say, you know, um, okay, so now can I can I go ahead and get one referral from you? Right? That’s a good point. They’ve missed, they’ve missed the point. Okay. Because because they’re trained. Um so I always say, my, let me back up. I always tell my teams, you your job is to become valuable before you become visible. So, what do I mean by that? How can you earn a patient referral? Because again, this is a patient before you’ve given them a reason to trust you with that patient.

So you have to earn the trust, you have to earn the right to ask for the patient, right? Because this is their most important person, right? A practice that that is everything to them. Their patients are everything to them. And you’re asking them to trust you with that patient to provide some kind of service to that patient. You have to earn that right. So, um, you, you know, the better way to do it is to start asking, how can I help you? What are some of your difficulties when it comes to referring out for vascular care, referring out for uh home health care, referring out for radiological services, right? Like, what are the difficulties there and where can I help fill some of those gaps and start to provide resources to them and things like that, or resources to their their team members, their clinical staff.

And then that starts to earn the the referral, the patient referral. And I think you also say, you know, I’ve I’ve showed you all of this. I I’ve come in a few times. Give me one opportunity to show you that everything I said, I will follow through on. Right. Because that first patient referral is it, that’s not your finish line. That’s the evaluation period for that practice. So, you know, you’re asking for that that first opportunity to prove everything you said, you’re gonna stand on. So um, yeah, I think it’s not about the ask. I think it’s about earning the right to ask.

Melissa Gilkes-Smith: So, what about those offices that are a little bit harder to crack? I mean, they’re constantly sending to a competitor, you’ve done everything that you would normally do to, you know, earn trust. You’ve, you know, and but they’re still not sending referrals. What how do you open up that conversation a little bit more?

Shayda Amaya: Yeah. Well, I think that having the attitude that a practice has a preferred agency partner, you know, service provider that’s your competitor is a bad thing. And we look at that so negatively. And I think when we’re interacting with the key decision makers, that comes across. And it’s not a bad thing, right? Um, I often say to providers, I’m actually really happy that you have found a service provider who you trust with your patients because there are bad actors out there, there are providers out there that that you know you’ve trusted and then they’ve continually failed you and failed your patients. And so the fact that you have a meaningful relationship established actually gives me a lot of reassurance about how you see your patients.

And so I’m not asking to be your number one, but what I am asking is that when there is a patient who maybe that service provider for some reason cannot help you with, um, that I can be an alternative option for your patients for those situations. Or, you know, let’s say their preferred partner doesn’t take every patient insurance, or, you know, that I’ll partner up with your preferred agency or preferred service provider and see how we can serve more patients for you with really high quality of care. So I think when you start to speak like that, and again, adding the human back into it, there is a person involved here. This isn’t transactional, right? And so when you start to speak that way, you earn a lot of confidence and trust because they realize you’re not out for numbers, right?

You’re out to just help them and help their patient.

Melissa Gilkes-Smith: That’s a really good approach. I like that. So you’ve you’ve done this for a while. You’ve been inside, you know, a lot of healthcare organizations over these years. What is the most common mistake you see when it comes to a physician referral strategy?

Shayda Amaya: Making it marketing. Making it marketing. It’s all about brand awareness and marketing, because that again is not going to earn the trust trust. It’s very operational and strategic. So I think that if you are looking to build a um a business development team, um, you’re looking to coach your teams. One of the things that you can, if you can avoid putting yourself in that mindset that this is my marketing team, and more of this is going to be the consultant who builds the bridge between our referral partner and our service. And so they need to know everything about how you know operationally this organization is going to work. They need to understand clinically what’s going on. When you start to see them as the bridge, the operational bridge, then um, that is how you’re gonna build strong referral partnerships.

Do not box them into the marketing category. There is part of that, they will naturally market for you, right? They are the face of the organization. They’re going to, you know, be branded maybe in a certain uniform or with badge, you know, a badge, or, you know, they have collateral pieces. They will naturally build your brand for you, but you need them to be able to be a strong image of what your services are and how you can help that referral partner.

Melissa Gilkes-Smith: So you’ve kind of led into my next question. So you have a practice that, you know, they they they want, they’re gonna start from scratch. They have no liaison program, no formal referral strategy. Where do they begin? What’s the very first thing that they need to do, other than, you know, not making it marketing, but the very first thing that they need to do to get it right?

Shayda Amaya: Yeah. So I’m gonna kind of it’s gonna sound so opposite of what I just said. Before you can hire a business development person or team, you need to understand from a leadership perspective. So looking at your operational um leadership, where do our patients come from? Like where, what does the market analysis say, right? Um, in terms of how are we seen? Is our brand strong? Do people know about us already organically? Or, you know, what does the compet, like what does the competition look like in the area? Um you need to understand that first because that is gonna tailor the kind of team that you’re trying to develop. So, for example, are you gonna have a liaison who goes and targets all different types of referral partners in and throughout a territory?

Are you going to have, you know, different liaisons targeting different types of referral partners and being the subject matter expert on orthopedic practices? And then one is the subject matter expert in, you know, neuro practices, right? If if you know you’re getting referrals from all different types of specialists, but you need to understand first and foremost where your referrals would come from so that you can design a team that’s tailored around that.

Melissa Gilkes-Smith: Thank you. Yeah, it’ll be extremely helpful to you know, to listeners who are looking to build a program. There’s there’s actually a handful of practices that I’m aware of that actually have uh liaisons out there. So, but this conversation has been exactly what I was hoping for because I’ve named something that I think gets lost in a lot of uh patient experience conversations because the patient’s journey starts before we ever touch the patient. And it starts with the relationship between the physician and our organization. And if we haven’t invested in that relationship with integrity, integrity, with trust, consistency, we’ve already created a gap before the patient even, you know, comes in the door.

So before I let you go, is there anything you want to leave our listeners with, something that you wish more healthcare leaders understood about this work?

Shayda Amaya: Yeah, I think the last thing I would say is always put yourself in no matter what your role is within healthcare, whether it’s business development, whether it’s, you know, C-suite leadership, um, a licensed clinician, always put yourself in the seat of the patient, you know, and or their family and try to navigate your decision making from there. Because for the patient, this is a continuous journey, right? They they see healthcare as a continuous journey, whereas those of us that work in it, we realize it’s fragmented. So when you realize that for them, they don’t understand the difference between going through a hospital system to a follow-up appointment to a primary care. Why doesn’t my primary care know what happened in the hospital?

You know, to them, it’s one continuous journey. So when we are trying to think about things, we’re trying to bit bridge the gap between all healthcare um entities because it’s fragmented, but for the patient, it’s a continuous journey.

Melissa Gilkes-Smith: I love that. Thank you. That was cool. So, Shaded, thank you so much for being on touch points. This is the kind of conversation that makes the framework real. And I’m grateful for your time and perspective. And for our listeners, if today’s conversation sparked something, I want to do you to do one thing this week. So identify your top five referring providers and ask yourself honestly when did someone from our organization last have a genuine non-transactional conversation with that office? Not a drop off, not an email, a real conversation. And that’s your starting point. So thank you all. Thank you, Shada. Thank you.