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Known FOR Something: The Two Questions Behind Every Referral
Most membership practices say they grow by word of mouth. Fewer can say what patients are actually telling their friends. Two simple questions close that gap, and the research on referred customers shows why it is worth the effort.
Start here: the questions this brief answers
Tap a question for the short answer, then jump to the evidence.
Every practice has a reputation. The only question is whether you chose it. Ask two questions: what do we want to be known for, and what are we actually known for? The first is what you say. The second is what patients say when you're not in the room. In a 2019 CMT poll, 42% of responding membership physicians said referrals and word of mouth drove 76% to 100% of their new enrollments. Research from a large bank found referred customers were worth at least 16% more and were about 18% less likely to leave. Word of mouth isn't luck. It is the predictable result of an experience worth repeating, described in words patients can repeat.
“Your brand isn't your logo, your website or your tagline. It's the sentence your patient says about you at the bus stop. Decide what you want that sentence to be, then earn it every visit.”
How much of membership-practice growth comes from word of mouth?
In a 2019 CMT physician poll, 42% said referrals and word of mouth drove 76% to 100% of new enrollments, and another 25% said 51% to 75%. The poll is self-selected and directional.
Go to the full answer ↓Are referred patients really more valuable?
In a study of about 10,000 bank customers, referred customers were worth at least 16% more and were about 18% less likely to leave. That is a banking study; CMT has not seen an equivalent for medical practices.
Go to the full answer ↓What are the two questions?
What do we want to be known for? What are we known for? When the answers match, patients do your marketing for you.
Go to the full answer ↓What happens when a practice isn't known for anything?
In CMT's 2020 to 2023 poll of prospective patients, only 23% said they would fight to save their current doctor's practice if it closed.
Go to the full answer ↓How do I find out what we're known for?
Ask. Part 5 gives a simple script, and the Community Marketing Planner includes a message check.
Go to the full answer ↓Two questions every practice should answer
Ask a membership physician how they grow and you’ll usually hear two words: word of mouth. Ask what patients are saying, and things get quiet.
Leadership author Jeff Henderson built a book around two questions: What do you want to be known FOR? and What are you known FOR?1 Practice Insight
Here’s why they matter. The first answer is what you say. The second answer is what your patients say. Marketing is the work of closing the gap between them.
When the two answers match, something remarkable happens. Your patients start describing you the same way you describe yourself, at dinner, at the gym, at the bus stop. That’s a sales force you didn’t have to hire.2
Old-school marketing: a brand is what it tells people it is. New-school marketing: a brand is what people tell each other it is.
Line quoted in Remark-ology, where CMT credits it to S. Cook.3
What the numbers say about word of mouth
CMT asked membership medicine physicians in 2019 how often referrals and word of mouth accounted for a new patient enrolling. The answers lean heavily one way.4
One physician in that poll said word of mouth is “almost all I rely on,” with less than $10,000 a year spent on other marketing: “patient experience and customer service is where I spend my sweat equity.”2
Outside medicine, the strongest evidence on referred customers comes from a Journal of Marketing study of about 10,000 customers of a German bank. Referred customers were worth at least 16% more over time and were about 18% less likely to leave, and the difference more than paid for the referral reward.5 Population Data
And trust follows people, not ads. In Nielsen’s 2021 Trust in Advertising study, recommendations from people consumers know were the most trusted channel, at 89%.6 Industry Research
That last number is the uncomfortable one. Many practices can’t say what a new patient costs them, which makes it hard to know whether the experience or the advertising is doing the work.7
Small, personal and repeatable
A dentist and his wife, a concierge physician, called Michael Tetreault one rainy day in Atlanta, thrilled to say they were moving their traditional practice to a concierge model. A few weeks later the dentist called back. “Michael, we send a short, handwritten thank-you note to our patients after each visit now.” Then he added: “It is so easy to impress patients, Michael. I don’t know why other Doctors don’t do this!”
From No More Waiting Rooms (2024).8
An operations supervisor at a managed care network, dealing with low reimbursements and a few weak service moments, took a suggestion from Michael: tuck a handwritten note to the doctor into each payment envelope. Within a week, physicians themselves, not their billing staff, started calling to say thank you. She reported about a dozen callbacks for every fifty notes, and doctors began recommending the network to colleagues because the relationship felt personal.
From No More Waiting Rooms (2024). Figures are as reported to the author; CMT did not audit them.8
Neither story involves a campaign. Both involve something small, personal and done consistently, which is exactly the kind of thing people repeat to friends.
One of Michael’s marketing mentors put it this way: “You don’t have to be seen everywhere. You simply need to be seen everywhere in your niche.” Another: “When you have a heart for your community, you don’t have to compete on price.”2
Would anyone fight to save your practice?
CMT asked prospective patients visiting its websites a blunt question: if your doctor went out of business tomorrow, how much or how little would you care?
These were people already shopping for a new doctor, so the sample leans unhappy. Still, the pattern is worth sitting with. A practice nobody would miss isn’t known for anything.
National data point the same way. In a 2023 Ipsos survey for MDVIP, a concierge company, 53% of U.S. adults 26 and older said the health system treats patients more like a number than a person.10 Population Data
When a patient decides whether to recommend you, the real question is simple: did they make me feel like a person? Everything in Part 5 is designed to make the answer yes, and easy to repeat.
Close the gap between what you say and what they say
Write your sentence
Finish this in one line: “We are the practice known for ___.” Make it something a patient would actually say, not a slogan.
Ask ten patients
“If a friend asked you about us, what would you tell them?” Write down their exact words. That is what you are known for today.
Find the gap
Where their words and yours differ, decide whether to change the experience or change the sentence. Usually it is the experience.
Make it repeatable
Pick one small, personal habit that proves your sentence, such as a handwritten note or a call after a hard diagnosis, and do it every time.
- Put the two questions on the agenda of your next team huddle.
- Ask three patients this week what they would tell a friend about you.
- Track where every new member heard about you for the next 90 days.
Use the planner's message check to see whether your words sound like care or like a pitch, then build your 90-day plan.
Free. No sign-up. Your answers stay in your browser. Step 3 of CMT's Learn, Build, Lead tools. It helps you pick the patient segments that fit your practice, find where they are, plan conversations with local physicians, check that your message sounds like care rather than a pitch, and leave with a 90-day plan.
Before offering any reward for referrals, read Brief No. 51 and talk to a healthcare attorney. Federal and state kickback and patient brokering laws can apply, including to rewards for patients. This brief is educational and is not legal advice.
Two questions
What we want to be known for. What we are known for.
One sentence
Something a patient could repeat word for word.
Every visit
Reputation is built in small, personal, repeated moments.
How this brief was built
This brief draws on CMT's books (No More Waiting Rooms, 2024; Remark-ology and Branded, 2025), CMT physician and patient polls reported in them, a peer-reviewed study of referral programs (Journal of Marketing, 2011), Nielsen's 2021 Trust in Advertising study, and an account of Jeff Henderson's Know What You're FOR. Stories from CMT's books are the author's own experiences or accounts told to him; names are withheld as in the books.
CMT proprietary data
CMT polls are open online polls of self-selected visitors to CMT web properties. CMT has not published sample sizes for these polls, and respondents were not verified. The cost-per-new-patient poll combined concierge and DPC respondents and is labeled as membership medicine combined. All are labeled Industry Research and should be read as directional.
How to read the evidence types
Every key finding is labeled by evidence type. Labels describe the type of evidence, not its value. Each type answers different questions. Funding is disclosed on every source.
Randomized trials and systematic reviews.Best for cause and effect.
Large observational studies and government data.Best for trends at scale.
Surveys, smaller studies and expert consensus.Best for real-world experience.
Company-sponsored or company-reported data that is not peer-reviewed.Best for early signals and operating data.
Statutes, regulation and official guidance.Best for what is required.
What we don't know
- The actual value of a referred patient in a membership practice. The best evidence on referred-customer value comes from banking, not medicine.
- How many new members each satisfied member refers, and how that varies by fee, specialty and community.
- Representative data on how concierge patients first hear about a practice.
How to cite this brief
External review: this brief has not yet been reviewed by an outside expert. When review is complete, the reviewer is credited by name above with any conflicts of interest, and the version number is updated. Reviewers check accuracy and fairness; CMT is responsible for the final content.
Corrections policy: when an error is identified, CMT corrects it in the open and updates the version number above. Send corrections to the editor through conciergemedicinetoday.net.
Related CMT Research Briefs
References
- Eastern Florida State College Foundation. Simpkins speaker Jeff Henderson says know what you're FOR (on Henderson J. Know What You're FOR, Zondervan, 2019). March 5, 2025. foundation.easternflorida.eduFunding: not stated (college foundation news item)
- Tetreault M. Branded: The Concierge Medicine Doctor. Softcover edition. Concierge Medicine Today, LLC; 2025. Includes CMT online polls the publisher describes as not scientific.Funding: Concierge Medicine Today (self-published; no outside funder) CMT original
- Tetreault M. Remark-ology: Creating a Remarkable Patient Experience Worth Remarking About to Others. Concierge Medicine Today, LLC; 2025.Funding: Concierge Medicine Today (self-published; no outside funder) CMT original
- Concierge Medicine Today, LLC. Physician poll, 2019: how often do referrals and word of mouth account for a new patient enrolling in your practice? Open online poll; self-selected; not scientific; sample size not published. Reported in Branded (2025).Funding: Concierge Medicine Today (self-conducted; no outside funder) CMT original
- Schmitt P, Skiera B, Van den Bulte C. Referral programs and customer value. Journal of Marketing. 2011;75(1):46-59. Author-hosted copy, The Wharton School. faculty.wharton.upenn.eduFunding: not stated
- Nielsen. 2021 Trust in Advertising study, U.S. highlights sell sheet (n=2,000). 2021. develop.nielsen.comFunding: industry (conducted and published by Nielsen)
- Concierge Medicine Today, LLC. Physician poll: average cost to acquire one new patient (concierge and DPC respondents combined). Open online poll; self-selected; not scientific; dates and sample size not published. Reported in Branded (2025).Funding: Concierge Medicine Today (self-conducted; no outside funder) CMT original
- Tetreault M. No More Waiting Rooms: A Customer Service Road Map to Help Remarkable Medical Offices Navigate Their Way Towards an Irresistible Practice Where Gratitude Is on Repeat. Concierge Medicine Today, LLC; 2024. Stories are the author's own experiences and accounts told to the author.Funding: Concierge Medicine Today (self-published; no outside funder) CMT original
- Concierge Medicine Today, LLC. Patient poll: if your doctor went out of business tomorrow, how much or how little would you care? Prospective patients visiting CMT web properties. Reported as 2020 to 2023 results in Remark-ology (2025) and as an earlier multi-year result in No More Waiting Rooms (2024). Open online poll; self-selected; not scientific; sample sizes not published.Funding: Concierge Medicine Today (self-conducted; no outside funder) CMT original
- MDVIP. Patient frustration surges: Americans struggle with broken healthcare system (Ipsos KnowledgePanel survey of 1,010 U.S. adults 26 and older, December 1 to 10, 2023; margin of error plus or minus 3.2 points). Press release. February 27, 2024. www.mdvip.comFunding: industry (MDVIP press release; survey conducted by Ipsos)
Educational and informational only. This CMT Research Brief does not constitute medical, legal, tax, financial, accounting or other professional advice, and it does not create a professional relationship of any kind. Statements about laws, regulations, tax rules and payer policies are general, may not reflect the rules in your state, and can change after publication. Consult a qualified attorney, accountant, tax adviser, compliance professional or licensed clinician before acting on anything here.
Independence. Concierge Medicine Today is an independent publication. It does not accept payment for favorable coverage, and it does not favor one practice model over another. Company names and products are mentioned for context only and are not endorsements. Funding is disclosed for every source in the reference list.
Accuracy. CMT verifies figures against their original or best available sources at the time of publication. Where a figure is an estimate, an inference or a company-reported number, the brief says so. This content is not without possible error or omission.
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