Here are the specific strategies that I've employed to create a 100% referral-only, 100% cash practice. After reading through the list, commit to and take action upon at least one new idea. As well, blow the dust off of an idea you previously employed that has slipped through the cracks of your procedures.

1. Request family referrals at the end of your ROF. Make people an offer to bring in their family members for a complimentary/discounted first visit. Remember the old saying, "The apple doesn't fall far from the tree."

2. Make people an "offer they can't refuse." (I couldn't resist!) The first thing you're thinking is "free visit." That's not what I mean here. You've got to offer people a compelling reason to bring their family members into your office for a check-up.

3. Give people a deadline. You want to extend your invitations with a sense of urgency. "Listen Mrs. Jones, this offer for the family check up is for your first two weeks of care. I'm offering you quite a gift here so don't hesitate to take me up on the offer. However, when the two weeks are up, the fee will resort to our standard fee."

4. Let your staff in on it! If you're going to make a referral request at the end of your ROF, be sure that your staff members have a follow-up dialogue with the practice member at the end of the visit. "I'm sure Dr. Jones told you about her family referral policy. That's really a tremendous gift Mrs. Smith. I see that you have a husband and three kids -- which one do you want to schedule first?"

5. Create a club. Why not create an "Ambassador Members" club?" This is really simple and it's fun. Let your practice members in on the creation of your Ambassador club by telling them that you're thinking of creating one. You want their feedback. So ask them if they'd like to become members, offer them a gift as a member (coffee mug, water bottle, key chain, etc.) Then explain that as Ambassador Members they can request as many gift certificates as they want to give to their friends and family members. Start them off with at least five of them.

6. Create gift certificates. Please have gift certificates on hand at all times. I know, seems so obvious until you need one and you can't find them!

7. Have a referral board in your practice. NOT the kind where you breach doctor-patient confidentiality. When you put someone's name up on display as a referral source in your reception area you're violating a trust. Be sure to obtain permission to advertise that Mr. So-and-So referred Mary What's-Her- Name before you post it!

A doctor posted my name in his reception area as a referral source without my permission. It bugged me not because my name was being used as an endorsement, but because I wasn't asked first.

The kind of referral board to which I'm referring is one that offers information on a "Topic of the Month." You may offer information on testimonial results, research studies, conditions etc. Then you simply have to say, "Do you know someone suffering with...?" and offer the information, along with an office brochure and gift certificate.

8. Create an office brochure. Yes, just like I mentioned above regarding the gift certificates. This is an obvious one until you need it. By the way, you need it NOW! It doesn't have to be perfect but it has to be done. Do it now.

9. "By whom were you referred?" This is a great question to ask every new member who calls your office for the first time. Let people know from their very first encounter that yours is a referral-oriented practice. Remember that it starts with consciousness!

10. Variety is the spice of life! Be sure to invite referrals to your office in a variety of ways. Design strategies that open a plethora of doors into your service through your current membership.

11. "Always deliver more than your practice members expect." HINT: The title is the "Top 10 in-office referral strategies," and I'm offering you 12!

12. Okay, the last one is perhaps the simplest one in the world. If you begin quivering at the thought of asking for a referral... every shift I make ONE referral request. You don't have to go nuts and ask every person who walks through the door for a referral for the next month until you burn out from boredom or rejection!

Here's the language I use to request a referral. "Bill, is there one person you can think of who you wish was coming into my office for care like you are?" When they say "yes," then ask "who?" When they say "no," say "okay, I was just curious." That's it. No personal rejection and your ego remains in tact!

When practice members do tell you about a referral, ask them why they'd like that person to receive care. Let them give you the list of reasons. Conclude the conversation by asking the following question (please ask these questions the way that I've tested, tweaked and researched them!): "What can I do to help you to bring them into the office?"

You'll notice, I don't ask what I have to do to get them to my front door! It's their friend or family member. THEY are the ones who'll generate the referral. I've long given up my need to control, so I'm perfectly okay with granting my existing practice members the opportunity to do the work!