Clinician's have this wonderful way of being competitive. They have worked hard to obtain their degree, their registration, and open their practice. Why shouldn't they be competitive? When in private practice, you have fought hard for every single referral you get in the door. In the practice I worked for before, the mentality from the board was to just "get bums on seats." It doesn't have to be this way and as you build your private practice a few good reasons why you shouldn't just see every client that comes into your office.
Word of Mouth Referrals
When a clinician is humble enough to say, "this client isn't for me" or "even with supervision, I'm outside of my scope," then the client receives a better clinical outcome. With a short follow up letter to the GP, "Thank you for this referral. The client presented with drug and alcohol dependancy, of which I feel "So and So" would be a better fit. Therefore, I have referred the client on to them. If you would like, I'd be happy to come in and discuss the clinical presentations that I feel I work best with. These clinical presentations would include some of the symptoms that So and So presented with; however, when I conducted my Diagnostic Interview, I realised they missed informing you of some bigger issues. I would like to continue to provide good clinical outcomes to your patients and thus would be happy for a chat." The GP will be pleased that you handled the client appropriately and may be happy to meet with you.
When making the referral out, the other allied health professional will see that you are collaborative and while they may not send you referrals right away, over the due course of time, the relationship will grow and so will cross referrals.
Clinical Outcomes
We all know that when rapport isn't there, clinical outcomes are harder to achieve. When working with a client a few of the key things to remember is if you continue working with a client that you do not have sufficient knowledge about their presentations or you simply don't enjoy the client they will assume this is how therapy should be. In return, they may attend a few sessions and never go back to therapy. Any therapist who has a high turnover of new client referrals should be ashamed of themselves and should really evaluate what is happening in the the clinical room. Majority of your clients are not "Fixed" in a few sessions. For those of you reading this and scoffing at this statement, please be alarmed as I hear this from clinicians. Your colleagues. AHPRA registered clinicians. There is a very strong difference between over-servicing and under-servicing your clients, but "fixing them" should never slip between your lips. The worst outcome you can have, unbeknownst to you, is a client who never returns to seek therapy because of a poor experience on your behalf.
Shortage
Let's face it. At no point in time will people stop seeking assistance. If your referrals have dried up, you should look at yourself as a clinician. The best clinicians I work with are ones who, regularly, indicate that their diaries are full. They are not able to take any new clients as they need their availability to service their current clients. If we work to normalise therapy then you will start to see a whole world open up. Practitioners should not be competitive to one another. Even if there are 60 Bulk Billing practitioners on your street, you should be receiving word of mouth referrals for your speciality and clinical areas. The practitioners who "see everyone" and seek for any "bum on a seat" are the ones we need to watch out for. However, if we all had each others backs and made referrals to one another, we wouldn't have to worry about how we're going to get "bums on a seat." Our bigger focus will be how to get the best client outcome, regardless of the number of sessions, albeit 2 or 22 or 222.
