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January 18, 2017

Physicians' Referral Expectations – a Q&A with Dr. Javier Sevilla

Physicians’ Referral Expectations—a Q&A with Dr. Javier Sevilla-Martir


As part of Advancement Resources’ ongoing research into all aspects of philanthropy and development, we conduct numerous interviews with donors, development professionals, deans, and leading healthcare professionals. We recently conducted a particularly illuminating interview with Dr. Javier Sevilla-Martir, Professor of Clinical Family Medicine at Indiana University School of Medicine.


The following Q&A, excerpted from that interview, paints a picture of how physicians think and feel about the process of making medical referrals of patients to other physicians. These insights can be used to forge closer ties with physicians by meeting their expectations and helping them feel more comfortable making patient referrals to development professionals.


Q: To begin, can you tell us how often do you make medical referrals of patients to other physicians?


A: I refer about 5% of my active patient population for referrals over the course of a year.


Q: What are your expectations when you make a referral?


A: The ideal situation is that the patient gets a visit as soon as possible. I expect the patient to be contacted within a week and then for them to be seen in a timely manner. I also expect that the specialist I refer to will communicate back to me about their plans; ongoing communication is critical.


Q: What shouldn’t happen when you refer a patient to another physician or specialist? What are some things that would break down that relationship so you wouldn’t refer anyone to them again?


A: We expect all patients to be treated with dignity and respect—I expect that of all my colleagues at all times. What shouldn’t happen is a patient comes back and tells me that the experience didn’t go well, their needs were not met, or no attempt was made to meet them.


There are situations where you perceive that your concerns or the concerns of the patient were not attended properly or a specific request was not honored. If that happens, then I would not refer anyone to that particular specialist again.


Q: What if a further referral is recommended by the physician you’ve sent your patient to? How does that work?


A: As a primary care provider, I appreciate when the specialist writes back and says, “The patient has this problem; we recommend that you also consult with rheumatology,” for example. The key is that they are asking me or recommending me to do so, instead of them writing the referral themselves. It’s important because it allows me to bring my own input into the decision and I can discuss it with the patient to get their input.


Q: Do you have a conversation with the patient when you’re making a referral? Do you seek his or her consent?


A: Oh yes, we tell them what we recommend and I say, “I know a really good colleague that I’m sure will be a good resource for you.” So we always discuss it and we always plan with the patient.


Q: Have you ever had a patient say no to a referral?


A: Yes, patients often say no. They say they want to wait or they don’t feel like it at that time.


Q: When they say no, does that harm the relationship between you and the patient?


A: Oh, no, because we are a team and we are working together. If they say no, I simply document that I recommended a referral but that we are continuing with the current treatment and will wait and see and revisit in the future.


Ask & Act

  • How does Dr. Sevilla-Martir’s perspective of medical referrals apply to you?
  • How can you help your assigned physicians see that you will meet with patients and family members they refer in a timely manner and treat them with great dignity?
  • How can you ensure that you continue to communicate with physicians who make philanthropic referrals to the same level that they expect from medical referrals?
  • How will you ensure that your assigned physicians are included in key parts of the donor relationship after they make the initial referral?

Later in the interview, we asked Dr. Sevilla-Martir about his perspective of making philanthropic referrals.


Q: When you refer patients to development, do you have the same expectations of them as from making medical referrals?


A: I did not know what to expect when I first started working with development. But now I know that when we are talking about potential donors, we will have a meeting and I will get to talk to all the development people who are engaging my patients. That helps me trust that they will treat the patient with respect, and that they will continue to keep me fully informed.


I think a lot of the time the information about development is out there, but we physicians are not actively looking for it. When the development staff reach out to us, explain the possibilities, and truly engage us as colleagues, we see a light and we start to understand how we could engage more people, collaborate more, and ultimately help even more patients in our communities.


What can you do to help physicians at your organization “see a light,” understand the development process, and see you as a trusted philanthropy specialist?


Dr. Javier Sevilla-Martir has been in practice for over 20 years. He is Professor of Clinical Family Medicine at the Indiana University School of Medicine. Dr. Sevilla-Martir has developed several service-learning opportunities for engagement in the community and serving the underserved. His work has been recognized with multiple teaching and service awards, including the Joseph Taylor Excellence in Diversity Award for his work with the IUSM Student Outreach Clinic.



Other posts you might be interested in:


  Physician Objections to Engagement: Myths and Truths  

Physician Objections to Engagement: Myths and Truths

3 Attributes of Medical Development Stars

3 Attributes of Medical Development Stars

5 Insights from Patient and Family Perspectives

5 Insights from Patient and Family Perspectives



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