How to Stimulate Referrals to Your Medical Tourism Service



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Stimulating health tourism referrals requires planning and a deliberate system. But first, one must know what to do, how, and in which order.. In this article, Maria Todd teaches you the steps and tactics you need to succeed.

About the Author

About the Author

Maria Todd is frequently hired as a consulting expert and trusted authority on health tourism business development. She helps medical groups, individual physicians, hospitals and ambulatory surgery facilities and other healthcare providers plan marketing strategies that grow referrals through well-planned tactics and action plans.

Maria believes that reliance upon word of mouth is inadequate and that there is a right way and a wrong way to ask for referrals. Providers must understand the immutable laws of nurturing and growing a referral base. Learn why she argues that without brand equity, reputation and promotion, referrals are unlikely.

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It can take years to stimulate word of mouth referrals – even if you do everything right

Smart people work hard to develop their craft. They become doctors, dentists, and are conferred licenses, diplomas, certifications and more.  Many simply assume that these things are,  by themselves, adequate to establish themselves professionally and that referrals should come their way.  But they don’t. Especially not in the international landscape that is health tourism.

After all, who in their logical mind would fly around the world for 30 hours in one direction to seek one’s counsel if there was no reputable endorsement, no brand integrity (or awareness for that matter), no trust, no loyalty, no history, and no marketing or advertising strategy executed to create awareness that one even exists and is eager to serve?

And then to add to the mess, one relies solely upon the success of a marketing agent who markets many providers at many different compensation formulas to drive referrals to this unknown licensed and certified healthcare professional? And then make reliances on marketing agents who have no medical tourism business brand integrity (or awareness for that matter) or equity, no trust, no loyalty, no history, and no marketing or advertising strategy beyond a website and a handphone and no budget to advertise their own business so they can be found by patients and generate referrals to the surgeon or dentist or hospital.  Ludicrous! 

Tell this story out loud to a stranger as an elevator pitch and see if you don’t feel ridiculous in the process. 

So now that we have established that referrals don’t materialize from thin air or the majority of medical tourism marketing agents and representatives, what will it take? Read on.

Most healthcare professionals don’t understand marketing, advertising and public relations

They were never trained what marketing, branding, advertising and public relations are, how they work, and how to execute a plan along with tactics that drive up referrals. There’s no crime or embarrassment in that. Unless… you expect these things to occur on their own simply because you exist in the marketplace.

When you refer a friend to a colleague or to a restaurant or a holiday destination, you do it because you want that friend to have a delightful experience. You reinforced the trust your friend already has in your ability to make a recommendation to a place, provider, or destination that will suit them. And… you did it because it made you feel good too.

Do others in a position to refer patients to your service know about you? Know enough about you to refer to you and make themselves look good at the same time?

I laugh out loud when providers, hospital marketers and so-called “facilitators” contact me and request that I refer American patients to them. The offer is most often, “Let’s collaborate. You send me patients and I will pay you 20% of what I get.” Are they daft? I know absolutely nothing about them! And, their offer is illegal in my country — and several others!

They realized that I have a brand and a reputation.  Whether they realize that it was developed over decades of hard work and millions of investment and study time and experimentation with testing marketing, advertising, branding and public relations strategies. Why would I risk all that to send patients knowing absolutely nothing about them, their clinic, their destination, their policies and procedures, their expertise, their personality, their bedside manner, or their clinical and patient satisfaction outcomes? Why would I do this in exchange for an illegal 20% kickback and risk civil monetary penalties, scandal, reputation damage, and criminal prosecution? Why would I bother?

Either there’s a better way that’s more deliberate and reliable, or that provider, hospital marketer, or marketing agency of providers and hospitals are doomed and will never realize success in medical tourism. I say this in all seriousness after 40+ years in the business. Take this prediction to the bank.

Reliance on Word of Mouth Doesn’t Work

As a new entrant in medical tourism, word of mouth is a late stage strategy that won’t work for you. You really appreciate it when it happens but it is inadequate to sustain a startup. You may not be a startup as a surgeon or dentist in your community, but at a global scale? Get real! You are starting from scratch! Nobody knows – or cares – that you exist. Only deliberate and consistent effort coupled with brand equity will change that. It’s doable. But it isn’t easy by any stretch of the imagination.

In medical tourism, you need brand equity in order to pull in referrals and patients from “across the road” even when there’s a supplier of an equivalent service, treatment, surgery or consultation on their side of the road.

Most people know about 250-300 people who are important enough to invite to a family wedding or funeral. That’s their sphere of influence.  For each patient you’ve treated in the past, that patient represents about 250-300 potential referrals. Change your perspective about your existing patients and follow up with them. Did they do well after their encounter with you? Ask for a referral. Say this: [Name], it has been a pleasure working with you. If you know of anyone with a similar medical problem or concern,  I would be honored to consult with them to determine if I can be of assistance.  One way that I keep my prices affordable is that I rely on patient referrals to grow my practice. And if I can be of further assistance to you or your family,  or refer you to trusted colleagues, I am at your service and only a phone call or an email away.”

By using this approach,  you are acknowledging their value to your business and appealing to their ego. You aren’t asking a favor. You are offering value that they can share with their “tribe”. And you are appealing to their sense of logic and value – they benefited from someone’s referral and now they are being asked to do likewise to keep prices affordable for all concerned. 

Now, let’s take stock for a moment. Since you aren’t a startup, how many patients did you treat in the past three years? Can you use the tactical approach called “reactivation” to leverage these connections to get to their 250-300 tribe members? In marketing and advertising this is called “reach”. 

If you had 300 patients last year who each had a successful outcome or consultation and problem solved, that’s a reach of 90,000 tribe members.  Over the past 3 years, if you had 900 patients who each had a successful outcome or consultation and problem solved, that’s a reach of 270,000 tribe members where you already have an advantage over your competitors. 

Now let’s make a few other calculations. What’s your average transaction value for a surgery?  If only one half of one percent of those 270,000 tribe members, you may have a chance to reach 13,500 new patients who might buy from you multiplied by that average transaction value. Now that’s a medical tourism service to be proud of.  So why don’t doctors and dentists do this simple act of appreciation and reactivation? Perspective! They’ve heard at medical tourism industry association events that facilitators are the way to get referrals. That’s nonsense. How will those new inexperienced facilitators get traction.  Does that suddenly just happen?  

You could offer then a 50% kickback and it still wouldn’t amount to much.  Will you be the ridiculous fool who stands up in a medical tourism industry association event and says “If anybody knows someone who needs orthopedic surgery, then please refer them to  me for a X% cut of what I make.” So then why do it by email or by phone?

How referrals “happen”

All referrals happen through a discussion between two or more people. There are three things that must happen to generate a referral to your service:  The conversation must center on something you do; you must be positioned top of mind and in a favorable light; and the person who knows and trusts you must be willing to introduce you to the people or person with whom they are speaking to solve that person’s problem.  Nobody needs an orthopedic surgeon or cardiologist. They need a solution to their medical dilemma.  

Your ideal customer has a need for what you do and knows the person that knows about you and for whom you’ve already solved a similar problem. When you tap into this influential circle, you aren’t asking your patient to make cold referrals to their whole tribe or asking for connections or contact details of persons with whom you have no relationship or trust established. That’s just not done in medicine and dentistry. 

Sourcing referrals from professional colleagues

Before a patient arrives at your doorstep, which other medical service professionals did they encounter? Whom did these patients trust to guide them? 

Primary care and other physicians and surgeons are a source of untapped profits and growth for your business. Finding the ones who aren’t in direct competition with you and complement your service is an inexpensive source of leads. I didn’t say “free” because you must invest in the relationship with them (time – which is not free; entertainment – which also has a cost) so that you are positioned at the top of their mind and they know enough to be comfortable to make the referral.  This is important because there is a risk of negligent referral that nobody wants to take. In fact, in some countries, there’s a risk of liability for negligent referral. In the USA, this risk is dealt with in lawsuits and settlements or court verdicts. I would sooner say “I don’t know anyone” than risk an accusation and legal consequences associated with negligent referral.  And all those facilitators who contract via email, sight unseen, sans inspections and credentials and privileges verification and reputation research? Risk-taking fools! All of them! And those who are “certified” and still do it? That’s like painting a bullseye on one’s behind and waiting for the arrows! Not to mention what credibility it gives to the  “write a check and attend a seminar” “certification(s)” they hold.

So how might you reward a professional colleague that makes referrals to you so that they look good? First invest time in growing the relationship.  Second, ask for the referrals. Third, give them a gift card or voucher for your products or services that they can share with the person with whom they make the referral. That way, you help them look great in the eyes of their patient. There’s no sales pressure, no conflict of interest, no ethical violation, and everybody wins. It only costs you the amount of the discount “if and when” redeemed.

To do this, you must know your costs and your margins for each service you offer. Price each service, treatment, surgery, or consultation so that you take this percentage only from margins you can afford to sacrifice. If you need to learn how to price your services to use this tactic, I developed the software application to help you. Contact me and I will set you up with a trial account to price 25 services at no charge.

Create Your Professional Brand on a Global Scale

A professional brand is simply the personality of your medical or dental practice, clinic, hospital or ASC. How you describe or express it in messaging, storytelling, imagery, location, positioning, logo, tag line, and staff behavior are all elements of branding. If you need help with branding, call me. Let’s chat and determine the gap from where you are to where you need to be. Then I can either fit you into my schedule to advise you or “refer” you to vetted colleagues I trust to help you who may have more time or quicker availability.

But I am going to let you in on a little secret: Branding is what you do “after” someone has transacted business with you. You don’t induce people to transact with you through branding. Branding attracts attention and grows awareness. Brand equity is the value you build that drives people to choose you over your competitor. It does not “sell” on your behalf. 

In medical tourism, you need brand equity in order to pull in referrals and patients from “across the road” even when there’s a supplier of an equivalent service, treatment, surgery or consultation on their side of the road.

Brand equity grows out of amazing patient experiences that convert your existing patients into raving fans who sing your praises and refer others to your service organically, naturally, and without paying sales commissions.


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Maria is a bestselling author and a top healthcare industry influencer and thought leader. She has excellent references and a huge project portfolio spanning 40+ years in healthcare business development and management.

She holds 25 copyrights, several trademark registrations, and shares several patent applications for software inventions.

She’s been recognized with numerous industry lifetime achievement awards for her work in contracted reimbursement, managed care, physician integration and alignment, and health tourism in the USA and 116 countries. 

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This article was originally published in 2009 and has been reformatted for consistency with the current website design.

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