Physical therapy can be a long, hard, difficult—and yes, sometimes unenjoyable—experience. So what, then, keeps patients coming back for more? Well, it’s probably safe to assume that it’s not the sweat-inducing gym sessions or the wince-eliciting manual therapy. Rather, I would argue it’s the feeling your patients have when they leave your clinic at the end of their visits. How are they feeling as they walk to the parking lot? Satisfied? Happy?

You might not realize it, but the answer to this one small question has a huge impact on the success and growth of your physical therapy business. Happy patients are much more likely to refer their friends and family to your clinic for their physical therapy needs. And once you have a steady stream of satisfied patients, you can watch word-of-mouth marketing go to work for you within your community. Before you know it, those appointment slots fill up—and you get your own dose of happiness.

It might sound simple, but the biggest question is: where do I start? That question leads to a slew of others like: what should be my goal? What exactly makes patients happy with their experience anyway? How can I ensure happiness across the patient experience? That last question is certainly a pickle. When you really examine all the consumer touchpoints in your clinic, it can get overwhelming—and fast. But in any business, the best way to manage outcomes is through metrics. Let’s look at five crucial metrics to architecting a positive patient experience—your key to word-of-mouth marketing.

1) Inbound phone call answer rate

A phone call is usually the first interaction any patient has with your clinic. It’s your first impression, and you’ve only got one shot to get it right. Mess it up and your potential patient might be on his or her way to the therapist down the street. On the other hand, impressing a patient during his or her initial phone call will likely seal the deal. So how do you make sure your clinic handles inbound calls with poise, expertise, and promptness?

There are tons of metrics to look at here. You should have a quality assurance program in place to monitor and constantly improve service, and you should be tracking your conversion rate to see how successful your front office is at converting prospects into patients. But the most important metric in this category is perhaps the simplest: how many calls are your staff actually answering? It seems rudimentary, but in a recent study we conducted on inbound phone calls, we found that, on average, more than 25% of calls go unanswered. No one wants to leave 25% of their business off the table—that’s missed opportunities to book appointments, reassure patients you appreciate them, show people your business is open, and save your front office time on the phone tag runaround—so obviously, everyone should shoot for 0% calls unanswered. Things happen, though, which can make that goal unrealistic. So, your practice should be gunning for under 10% unanswered—while continually striving for that oh-so-elusive rate of less than 1%.

Check your current phone system. It should have the capability to track how many calls came in and how many your clinic answered. If it lacks that functionality, it’s time for a new phone system.

2) Wait times

In this age of instant gratification, nobody likes to wait. People hate waiting in line so much, in fact, that they overestimate how long they’ve waited in line by about 36%. A patient’s wait time begins the second he or she walks in the door of your clinic and continues until he or she is face-to-face with the therapist. Everything in between is wait—and in the patient’s mind, waste. And that’s how you should think of it, too. After all, studies show that wait time impacts customer satisfaction more than anything else that occurs during a patient’s visit.

To achieve optimal patient wait times, you’ll need to establish a benchmark. Unfortunately, there isn’t some new fangled, high-tech way to do this, so I suggest you go ol’ fashioned. Have your front office staff start a stopwatch when a patient walks in and keep it running until the therapist is ready for him or her. Repeat this process for every fifth patient who visits your clinic over the course of a week. At the end of the week, you should have a pretty good idea of the average time it takes your clinic to get someone from the front door to the treatment room.

Once you have your baseline, take a look at all of the touchpoints during a patient’s wait period. Does the patient intake process take a long time? Are you constantly running 15 minutes behind schedule? There are a lot of factors in this part of the puzzle, but just know that every minute you shave off is one more reason for your patients to leave therapy more satisfied.

3) Patient outcomes

This one is pretty obvious: people seek out physical therapy because they’re trying to solve a musculoskeletal problem, and—no surprise here—they want to get better as quickly as possible. Outcomes as they relate to the patient experience are actually two-fold: 1.) You need to make sure that you have a system in place to track patient progress using evidence-based practice (EBP), and 2.) you need to be sure that your patients understand how you’re defining progress and how you’re gauging theirs. The second point warrants its own blog post, but here’s the nutshell:

  • Explain the purpose behind everything you’re doing.
  • Avoid explanations that are too clinical for patients to understand.
  • Point out patient gains. (Wins are wins, and everyone loves a win.)
  • Leverage current patients for referrals, which I’ll cover under “5. Net promoter score.”

4) Days Sales Outstanding (DSO)

There is no quicker way to undo all the hard work you’ve put into providing amazing customer service and exemplary patient care than to allow your patients to experience issues with collections. We’ve all seen it on Yelp and other review sites—or maybe even heard it straight from the mouth of an irate patient: When people feel like your clinic has hit their wallet in an unfair way, they have no problem telling anyone who will listen. And in a world driven by peer recommendations and reviews—especially of the online variety—you can’t afford to have harsh remarks about your billing practices floating around the interwebs. Luckily, there are metrics that can help you prevent patient billing slip-ups.

According to Investopedia, DSO is a “measure of the average number of days that a company takes to collect revenue after a sale has been made. A low DSO number means that it takes a company fewer days to collect its accounts receivable. A high DSO number shows that a company is selling its product to customers on credit and taking longer to collect money.”

This metric is huge—not only for your clinic’s bottom line, but also for your patients. The longer it takes you to submit a claim, the longer it will be before the insurance company processes the claim, and the longer your patient must wait before he or she gets hit with a bill from the insurance provider. And as many a Yelp review will confirm: The longer the period of time between the actual visit and the patient’s receipt of the bill for that visit, the more likely it is that the patient will be upset with the amount due. That’s why it’s essential not only to file claims promptly—and boy, do I mean promptly—but also to explain upfront what patients should expect regarding your business’s billing timeline. In general, if your DSO is more than 45 days, you should re-examine your billing system and your collections process.

5) Net Promoter Score

The Net Promoter Score (NPS) is the holy grail of satisfaction metrics. This satisfaction tool is delivered through one simple, straightforward question:

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

  • People who answer with a number between one and six are considered detractors;
  • those who give a number between seven and eight are passives;
  • patients who supply a nine or ten are promoters.

When you subtract the percentage of detractors from the percentage of promoters, you get your Net Promoter Score. For simplicity’s sake, let’s say you surveyed 100 patients upon discharge, and 23 rated you between one and six; 50 rated you between seven and eight; and 27 rated you at nine or ten. To calculate your NPS, you would throw out the 50 passives and subtract the percentage of detractors (23) from the percentage of promoters (27). This means your NPS is a positive four.

There are many methods to collect your NPS data. You can use free tools like SurveyMonkey or SurveyGizmo to email the survey to your patients upon discharge. Or, if you don’t have access to software, you can ask patients to complete an exit survey following their appointment and then manually enter their response into a spreadsheet.

Now, there are some valid complaints out there about NPS, two of which are 1.) NPS doesn’t offer you any advice on what to do next, and 2.) it doesn’t explain why you have the results that you do. Essentially, you will know that you have a positive, negative, or neutral NPS score, but why? And now what?

Here’s what I recommend to gain better insight into your NPS: Conduct the NPS survey with a patient at different touchpoints throughout his or her episode of care. Perform the survey after the initial evaluation, and then again following a daily note visit, a progress note visit, another daily note visit, and finally, at discharge. By tracking the patient’s NPS throughout the episode, you can see where the score changes and analyze what happened between the two measurement events. Leveraging the NPS data in that way will allow you to pinpoint different pieces of the patient experience that might need some work. A consistently high NPS score indicates that all touchpoints and abovementioned metrics are in great working order.

Another NPS pointer: add a comment box underneath the NPS question, and make that field optional. Not everyone will add their two cents, but many times, those on the far left or far right of the spectrum will have an opinion to share.

So there you have it: five metrics to measure at five different touchpoints during the patient experience. Focus some time on managing these metrics, ensure that you and your team are dedicated to understanding the data, and most importantly, do something about it all. As you improve your results, you should witness happier patients, better reviews, and more word-of-mouth referrals. And once you hit your goals for these metrics, know that the work isn’t done. There’s always room for improvement, so establish new goals and strive to hit those. After all, devoting time and effort to patient satisfaction is certainly a smart investment when it comes to your practice’s growth and success.

Do you track metrics in your practice? How satisfied are your patients? How do you know? Share your thoughts in the comments below.

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