When people decide they're ready for therapy, more of them turn to their primary care provider than to anywhere else. In Thriveworks' 2025 survey of more than 2,000 U.S. adults who were in therapy, recently in care or planning to start, 39% said they'd look to their primary care doctor, ahead of friends and family (32%), insurance company resources (31%), search engines (28%) and online directories like Psychology Today (26%). Thriveworks' own read is that seamless referral tools "may outperform paid digital advertising alone," which is a hedge, not a finding, but it matches everything I've seen in my own work.
Most therapists I know have a Psychology Today profile and no relationship with a single physician. That's backwards, and it's fixable.
What I learned building referral relationships in health care
Before I trained as a counselor, my job was building referral relationships. At Patina, a primary care company for adults 65 and older, I worked with our Senior Director of Behavioral Health and a staff psychologist to build a two-way behavioral health referral pathway inside primary care, and helped secure more than 100 provider partnerships. At AccentCare, I was the liaison to more than 300 referral sources in home health and hospice. At KeystoneCare, I managed more than 150 referral relationships across the continuum of care, including physicians at Penn Medicine and Jefferson Health.
The setting changed, but three things stayed true everywhere:
- Referral sources refer to people they trust to make them look good. A physician who sends a patient to you is putting their own judgment on the line.
- Clarity beats charm. The providers who referred most were the ones who knew exactly who to send me, and who not to.
- The relationship is built after the first referral, not before it. What you do when a patient actually shows up decides whether a second one ever comes.
What's in it for the doctor
Primary care physicians are drowning. They screen for depression and anxiety, they hear about grief, insomnia, marriages and panic in 15-minute visits, and then they have to find somewhere to send people. Most of them keep a short, informal list of names they trust, and most of those lists are out of date.
You're useful to a PCP if you make their job easier. Specifically:
- You take a problem off their plate. A patient they can hand off with confidence is one less loose end.
- You're actually available. Tell them whether you have openings and how fast you'll reach out to someone they send.
- You're clear about cost. Say what insurance you take, or your fee and whether you provide superbills. The same Thriveworks survey found 95% of people say knowing their out-of-pocket cost before booking matters.
- You make them look good to their patient. Patients remember who sent them somewhere that helped.
The same logic applies to specialists. OB-GYNs and midwives see perinatal anxiety and depression. Pediatricians see anxious kids and overwhelmed parents. Psychiatric prescribers need therapists for the patients they're medicating. Physical therapists, pain specialists, oncologists and neurologists see the toll chronic illness takes. In Thriveworks' 2026 Pulse report, 79% of Americans said physical ailments affect their mental well-being at least somewhat. Every one of those offices is a possible partner.
Lead with your specialization
"I'm a therapist accepting new clients" gives a doctor nothing to hold onto. "I work with new and expecting parents dealing with anxiety and intrusive thoughts" does. Your specialty is what turns you from a name into a solution to a specific problem they see every week.
A few ways to match the pitch to the provider:
| If you work with… | Talk to… | Frame it as… |
|---|---|---|
| Perinatal anxiety and depression | OB-GYNs, midwives, lactation consultants | Somewhere to send a postpartum patient who screens positive |
| Kids, teens and families | Pediatricians, school-based health centers | Help for the anxious 12-year-old and the parents asking what to do |
| Chronic illness and pain | PCPs, pain medicine, rheumatology, physical therapy | Support for the emotional side of a long-term diagnosis |
| LGBTQ+ clients | LGBTQ+-focused clinics, gender-affirming care providers | An affirming clinician they can refer to without worrying |
| Trauma | PCPs, urgent care, occupational medicine | A trauma-trained clinician for patients they're not equipped to help |
| Couples and sexual health | Urology, OB-GYN, pelvic floor physical therapy | A therapist comfortable with the conversations their patients avoid |
Be honest about the edges, too. If you don't treat active substance use, eating disorders or high-risk suicidality, say so. Telling a doctor who not to send you builds more trust than claiming you can see everyone.
Your first email
Keep it short enough to read between patients. Send it to the practice manager or care coordinator if you can find one; they often keep the referral list. Here's a script you can adapt:
Subject: A referral option for [your specialty] patients near [neighborhood or town]
Hi Dr. [Last name],
I'm [Your name], a [credential] in [town], and I work with [specific population and concern], in person at [location] and by telehealth across [state].
I'm reaching out because I imagine you see patients who [specific situation, e.g., "screen positive for postpartum anxiety but aren't sure they need medication"], and I'd like to be a reliable place to send them.
A few things that might be useful to know:
- I currently have openings for new clients and reach out to referred patients within one business day.
- I [am in network with X and Y / charge $___ per session and provide superbills for out-of-network reimbursement].
- With your patient's written permission, I'll let your office know they've connected with me.
I've attached a one-page overview you're welcome to keep at the front desk. If it would be helpful, I'd be glad to stop by for 10 minutes or set up a short call with you or your care team.
Thanks for the work you do,
[Name, credential] [Phone] · [Secure contact for referrals]
Two things to avoid: don't mention any current or past client, even without names, and don't offer anything of value in exchange for referrals. Lunch for a whole office as part of an educational talk is a common practice, but anything that looks like payment for a referral crosses a line under the ACA Code of Ethics (A.10.b) and, depending on the payer, federal anti-kickback rules.
If you don't hear back in two weeks, send one short follow-up with something useful attached, like a handout their patients can take home. Then add them to your quarterly update list. Most of my best referral sources took three or four touches.
Closing the loop, with consent
This is the habit that keeps referrals coming, and the one most therapists skip. When a physician sends someone your way, they want to know it worked. Hearing nothing feels like the patient fell through the cracks.
Here's how to close the loop the right way:
- At the first session, ask. Explain that Dr. [Name] referred them, and ask whether they'd like you to let the doctor's office know they've started care. Some will say yes gladly; some won't, and that's their call.
- Get it in writing. Use a signed release of information that names the provider and limits what you'll share. HIPAA permits some sharing for treatment coordination without a signed authorization, but the ACA Code (B.6.g) asks for written permission before sharing records, some state laws are stricter than HIPAA, and a signed release protects everyone.
- Share the minimum. "Your patient has connected with me and we've begun working together" is usually enough. No diagnosis, no details, unless the client agrees and coordination truly calls for it.
- Use a secure channel. A HIPAA-compliant email or fax, not your personal Gmail or a text.
- If there's no consent, say thanks anyway. A general note like "Thanks for thinking of my practice" to the office, with no client information at all, keeps the relationship warm without disclosing anything.
When a client does consent, that short note does more than any brochure. It tells the doctor you're reliable, and reliable is what gets you the next referral.
Where to start this week
- Pick five practices within a few miles that see the people you specialize in.
- Find the practice manager or care coordinator for each.
- Send the email above, adapted to each one.
- Put a reminder on your calendar for two weeks from today.
If you'd like help building the list or the one-pager, that's exactly what Full Panel's Referral Partner Development service is for. Book a free consult.
Sources: Thriveworks, therapy-seeking decisions, Nov. 2025 · Thriveworks, 2026 Pulse on Mental Health · ACA Code of Ethics (2014)