5 Things Every PT Needs to Know About the Net Promoter® Score

The Strive Labs Team is excited to have Heidi Jannenga, PT, DPT, ATC/L, co-founder and president of WebPT writing this week's guest blog. She brings with her more than 15 years of experience as a physical therapist and multi-clinic site director as well as a passion for healthcare innovation, entrepreneurship, and leadership. You can find Heidi on Twitter, here. Thanks, Heidi!


At last year’s Ascend Business Summit, Strive Labs founders Scott Hebert and Ryan Klepps detailed several metrics frequently used by Subscription as a Service (SaaS) businesses (like Netflix) that physical therapy practices could adopt and implement themselves. More importantly, they explained why PTs would want to monitor and track such metrics.

If you know me, have heard me speak, or read any of my blog posts, then you’re probably aware that I’m a huge proponent of data collection. Most folks say you can’t manage what you don’t measure; I say you can’t enhance patient care, boost business performance, or prove your value to payers, referrers, patients, and the healthcare community at large if you don’t collect, track, and act upon data.

One metric that helps you do all of that: Net Promoter® Score (NPS®). As the president and co-founder of a SaaS (and PT-centric) business, I have quite a bit of experience in the NPS® department. And now, I want to share what I’ve learned with all of you. On that note, here’s what PTs need to know about NPS®.

1. NPS® is a standardized loyalty metric.

Developed by business strategist Fred Reichheld (along with Bain & Company and Satmetrix) in the early 2000s, NPS® rates how likely a customer (i.e., a patient) is to recommend your brand, product, and/or service to a colleague or friend. It’s a solid indicator of customer engagement and retention, because typically, people only recommend companies, products, or services that they feel are truly deserving of their love and loyalty.

2. You calculate NPS® by asking one simple question.

To calculate your business' NPS®, you must first ask your patients one question:

On a scale of one to ten, how likely are you to recommend [your business name here] to a friend or colleague?

What do the responses mean?
  • Those who answer with a number between one and six are considered Detractors.
  • Those who give a seven or eight are deemed Passives.
  • Those who provide a nine or ten are labeled Promoters.

As the names would imply, the more Promoters you have, the better your score.

How do I calculate my score?

% of Promoters - % of Detractors = NPS®

As this blog post explains, you determine your practice’s Net Promoter® Score by:

  1. Calculating your percentage of Detractors (portion of patients surveyed who rated your practice with a number between one and six).
  2. Determining your percentage of Promoters (portion of patients surveyed who rated your practice with a nine or ten).
  3. Tossing out the results of those patients who rated with a seven or eight. (They’re Passives, meaning they’re not inclined to say anything—positive or negative—about your practice to anyone. So, they don’t factor into your score.)
  4. Subtracting the percentage of Detractors from the percentage of Promoters. That’s your NPS®.
How do I collect NPS® responses?

There are two main methods:

  1. Use a free tool to create a survey, and then email it to each patient upon discharge.
  2. Have patients complete an exit survey upon discharge and then enter those responses into your patient/practice management system, outcomes software, or spreadsheet.

3. NPS® is less about what everyone else is doing, and more about what you’re doing.

Obviously, the higher the NPS®, the better, because that means you have more patients who would recommend your practice than not. Unfortunately, there isn’t a golden number you should be targeting. Scour the web, and every resource you find will define a different number or range as “good.” While NPS® is a standardized patient satisfaction metric, it doesn’t have a standardized interpretation of results. But this is a good thing. After all, improving your practice should be about your practice.

So, survey your patients and calculate your NPS® regularly. Then, use that score to consistently benchmark your business. As content marketer Charlotte Bohnett explains in this article, “The only way to go is up, and if that’s what you do, then it’s a reminder to keep up the great work and continually optimize processes and behaviors to further improve your ratings. If you tumble in ratings, you know you’ve got to right the ship before you lose (potentially more) patients.”

4. You should collect other engagement/satisfaction metrics, too.

While NPS® is widely used in business, it does have its drawbacks:

  1. You toss out passive customers, which means you’re not taking into account all patient satisfaction ratings.
  2. NPS® is simply a score. It doesn’t explain why your business has this score. So, unless you leave a comment field on the survey (which I recommend), your patients have no opportunity to explain their reasoning for the ratings they provide.
  3. Again, NPS® is just a score. It doesn’t give you advice on what to do with that score—or even an explanation of what that score means. As authors Stout, Wang, and Roper state in this Advance article, “A simple numerical score is not actionable.”

For these reasons, NPS® shouldn’t be the sole patient satisfaction metric you collect. Instead, it should be one of several survey questions you ask patients throughout their episodes of care.

5. NPS® isn’t just for patients.

Here at WebPT, we regularly survey our Members, and we collect NPS® data, specifically, once per quarter. But we also regularly conduct an employee NPS® Survey. That’s right; we ask our employees if they’d recommend WebPT as an employer. Our company culture means everything to us, and to ensure that we’re not only preserving our core values, but also doing right by our employees, we must regularly survey them and act upon the data we collect. After all, there’s always room for improvement. And the happier your employees are, the better the quality of their work, service, and commitment to your customers. Whether you have five or 500 employees, I recommend surveying them just as you do your patients. The more data points you have, the better. It’s the key to improvement on all fronts.

There you have it: five things you, as PTs, need to know about NPS®. Now that you’re in the know, it’s time to take action. After all, collecting data is meaningless if you don’t do anything with it.

About the Author

Heidi Jannenga, PT, DPT, ATC/L, is the co-founder and president of WebPT, the leading EMR software for PTs, OTs, and SLPs. She co-founded WebPT after recognizing the need for a more sophisticated industry-specific EMR platform and has guided the company through exponential growth, while garnering national recognition. Heidi brings with her more than 15 years of experience as a physical therapist and multi-clinic site director as well as a passion for healthcare innovation, entrepreneurship, and leadership.

An active member of the sports and private practice sections of the APTA, Heidi advocates for independent small businesses, speaks as a subject matter expert at industry conferences and events, and participates in local and national technology, entrepreneurship, and women-in-leadership seminars. Heidi is a mentor to physical therapy students and local entrepreneurs and leverages her platform to promote the importance of diversity, company culture, and overall business acumen for private practice physical therapy clinics.

Heidi was a collegiate basketball player at the University of California, Davis, and remains a lifelong fan of the Aggies. She graduated with a BS in Biological Sciences and Exercise Physiology, went on to earn her MPT at the Institute of Physical Therapy in St. Augustine, Florida, and obtained her DPT through EIM in 2014. When she’s not enjoying time with her daughter Ava, Heidi is perfecting her Spanish, practicing yoga, or hiking one of her favorite Phoenix trails.


Interested in learning more about the NPS® and how this powerful tool provides truly actionable data that drives business growth? Contact us at hello@strivelabs.com, check out StriveHub Reach, or click below to download our FREE NPS® Calculator and start tracking and measuring customer loyalty at your clinic today!

Download DIY NPS® Calculator Here!

Heidi Jannenga, PT, DPT, ATC/L



WebPT Co-Founder & President

Phoenix, AZ http://www.webpt.com