DR. ACE GOERIG
OWNER & CO-FOUNDER
For every endodontic case that you complete in your practice right now, there are at least two other potential cases in your patient community that could be referred to your practice. That’s a significant opportunity for growth if you can tap into it.
However, even though that opportunity is available to you, it is also available to every other endodontist in your area too. Why? Because over two-thirds of endodontic cases are completed in GP practices without being referred. Truly, the competition in endo is not with other endodontists.
Factors that drive referral relationships
The question we are really facing is what moves a GP to prefer to refer endodontic cases rather than completing those cases themselves? If you think about your best referrers and analyze why they are great referrers, then you generally find they have one or more of the following mindsets:
- They like you and see you as a trusted interdisciplinary partner.
Everything begins with the doctor-to-doctor relationship, which is established both socially and clinically. If you look at the top GPs in your community who have busy and successful practices focused on high-value comprehensive care, none of them reach that level without embracing an interdisciplinary philosophy. That means they have optimized comprehensive treatment around a team of trusted specialists with whom they feel aligned clinically and that they enjoy working with. - Treatment in your practice is more convenient for patients and less stressful for the GP practice.
While most endodontic practices typically have a schedule that plans for a certain number of emergency same-day treatments, that is not the case in the GP practice. The typical productive GP is usually scheduled 2 to 6 weeks in advance. They often have two hygienists seeing patients every day, which require hygiene checks in addition to the patients scheduled in the doctor’s chairs. It’s very difficult to carve an hour or more out of those tightly scheduled days for an emergency endo, and it’s easier to refer. - Treatment in your practice results in better clinical outcomes.
You see the limited results of GP-performed endo all the time: missed MB2 canals that blow up, retreatments, separated instruments, and cases where the doctor simply realizes they are in over their head. Every time they refer a case where they get in trouble, it’s an opportunity to help them realize endodontists provide a faster and more predictable clinical outcome with a significantly reduced risk of a failed case or need for retreatment. It’s generally not possible for them to rise to your level: They lack the clinical techniques plus all the specialized technology and tools we have in our practices, such as CBCT, microscopes, etc. - Endodontic procedures dilute the GP’s productivity.
GP practices grow differently than endodontic practices. In endo, we grow by focusing on efficiency because most of the core procedures that we perform have relatively the same economic value. In a GP practice, at a certain point adding more patients does not result in any more growth. There is an upper limit to how many patients can be retained in hygiene, after which GPs need to focus on case acceptance for less frequent but larger cases, such as quadrant dentistry, esthetics and discretionary care, and full mouth cases. These cases feed into the interdisciplinary mindset mentioned above, but it also results in the understanding that any GP time spent on endodontic treatment would be more productively utilized on comprehensive restorative care. So, for economic reasons, it is better to refer out endo.
It is all about the relationship
While we think about GP referrers every day, GPs rarely think about us in the same way. We’re part of a treatment plan generally, but they don’t usually view the success of their practice as dependent on referring to us.
The most important things you can do is provide excellent, responsive and timely patient care (especially for emergencies), build up your doctor-to-doctor relationships through personal interaction, and back that up with a great marketing system to stay top-of-mind with referrers.
When we can nudge GPs over time by understanding what leads them to prefer to refer endodontic care, we become the specialist for all their endodontic treatment needs, which potentially triples the number of referred cases they send now.