I love ice cream—like, really love it. And if there’s one thing I can say about living in Phoenix, it’s that we’ve got a pretty killer ice cream scene—which makes sense when you consider that Phoenician summer days can climb all the way up to a balmy 120 degrees. So when I’m in the mood for something sweet, I know I’ve got options. However, more often than not, I find myself hitting up my favorite ice cream spot time and time again. It doesn’t have a ton of flavor options, and it’s not in my immediate vicinity. Plus, there are several other shops along the way that serve up a decent scoop. But it’s my absolute favorite, and I just keep going back.

So, why wouldn’t I settle for another shop’s satisfactory product? Simple: I’m loyal to my chosen haunt. I tell my friends about this place; I bring family members there when they visit. And just as I have a choice in where I satiate my sweet tooth, your patients have a choice in where they attend therapy. That means that now, more than ever, fostering patient loyalty—not merely patient satisfaction—is crucial to your practice’s success. However, if you’re only tracking patient satisfaction, you’re not getting the full story. And this is exactly where Net Promoter Score® (NPS®) tracking comes into play.

Patient satisfaction has a direct impact on a practice’s revenue.

But, let’s back up for a second: why do practices track patient satisfaction in the first place? For one thing, as patients shoulder more and more of the financial burden for the healthcare services they obtain, the competition for winning over those patients is steeper than ever. And providers who boast high patient satisfaction ratings can use those scores to attract new patients. (To learn how you can leverage patient satisfaction and outcomes data as part of your overall marketing strategy, be sure to download our free rehab therapy marketing guide.)

According to studies referenced in this whitepaper from the International Journal of Marketing Studies, “Patients’ quality perceptions have been shown to account for 17-27 percent of variation in a hospital’s financial measures such as earnings, net revenue and asset returns. Moreover; negative word of mouth can cost hospitals $6,000-$400,000 in lost revenues over one patient’s lifetime.” That’s a whole lot of green at stake.

Increased satisfaction means better therapy outcomes.

Additionally, patient happiness is strongly linked to therapy outcomes. That’s because patients who are more satisfied with their care and more engaged in therapy are also more likely to stick to their care plans and adhere to their prescribed home exercise programs—thus improving their therapy outcomes and increasing the likelihood that they’ll achieve their health goals. So obviously, tracking patient satisfaction is crucial to ensuring the success of your practice. But, you won’t achieve optimal results if you use the wrong tool.

Satisfaction surveys are biased.

Discharge surveys only tell you part of the story.

Many rehab therapy providers currently distribute satisfaction questionnaires to every patient upon discharge. This methodology may seem logical; after all, it makes sense that you would ask a patient about his or her satisfaction with care at the conclusion of care. Collectively, though, the data gleaned from discharge satisfaction surveys can be incredibly skewed. That’s because, as WebPT’s Erica McDermott reports here, about 70% of patients end up dropping out of therapy before their official discharge. That means the remaining 30% are the only ones who receive a satisfaction survey—and the patients who could provide feedback that actually speaks to the reasons patients drop out of therapy never have the opportunity to do so. It also means the results of those discharge surveys will primarily represent the attitudes of your practice’s most satisfied patients—thus making the end results seem more favorable than they actually are.

Some patients are more likely to respond than others.

A study conducted by BMC Health Services found that patient satisfaction surveys are inherently biased due to sampling issues and respondent demographics. According to the study, not only were the surveys completed by a mere 16% of survey recipients, but also there was a strong correlation between the likelihood of a patient responding to and completing a satisfaction survey and his or her age, sex, race, and insurance type. Specifically, the study revealed that the older a respondent was, the more likely he or she was to complete the survey—which means the resulting data would represent an incredibly narrow patient sample.

Satisfaction doesn’t equate loyalty.

Still, even if you solve for bias and use a solid tool to deliver your satisfaction surveys, the very nature of satisfaction reduces the power of the resulting data. After all, it’s getting harder and harder to attract new patients—which means it’s becoming more and more important to leverage existing patients for repeat business and word-of-mouth referrals. But, a satisfied patient won’t necessarily help you in either of those areas.

Loyal patients are the most valuable.

In the words of author, speaker, and business trainer Jeffrey Gitomer, “Customer satisfaction is worthless. Customer loyalty is priceless.” This may sound like semantics, but in truth, a satisfied patient isn’t necessarily a loyal patient, and this difference points to yet another reason to take patient satisfaction data with a grain of salt.

Customer satisfaction refers to a patient’s attitude toward goods or services. Customer loyalty also refers to attitudes about goods or services, but it specifically relates to how a patient’s opinion affects his or her decision to choose your services over your competitors’. In other words, satisfied patients stick around until they find something better or more convenient; loyal patients will choose you time and time again—and recommend that their friends and family do the same.

NPS is the new gold standard.

So, if patient satisfaction surveys aren’t 100% reliable, then what measurement tool should providers use instead? Well, here at WebPT, we’re partial to the Net Promoter Score® (NPS®). This score is derived from your patients’ responses to one simple, but highly telling question: on a scale of 0 to 10, how likely are you to recommend this service to a friend or family member?

The format is more conducive to generating responses.

The effectiveness of NPS—at least in part—stems from one simple rule of thumb: less is more. When you keep things short and sweet, patients are more likely to give you an accurate, honest response. Plus, patients are probably more willing to answer one simple question than they are to complete an entire questionnaire. (After all, patients often only partially complete satisfaction surveys.) As a result, you get a much more diverse sample of patient responses—and thus, more relevant and usable data.

The results are more actionable.

Additionally, the 0-to-10 scale will give you a better understanding of how many brand promoters you have. NPS puts respondents into three categories based on the responses they choose:

  • “Promoters” (those who score 9 or 10)
  • “Passives” (those who score 7 or 8)
  • “Detractors” (those who score 0 to 6)

The more promoters you have, the more loyal your patient base, which translates into decreased patient churn as well as increased retention and word-of-mouth referrals. On the other hand, if you find that a lot of your patients fall into the detractor group, it could explain why you’re seeing trends like a high percentage of no-shows, a drop in referrals, or negative online reviews. And if you track NPS regularly throughout the course of care, you can start taking action to:

  1. Capitalize on your promoters, and
  2. Address the issues that are creating detractors.

Plus, you can use benchmarks to assess how your clinic stacks up to others in your area and across the country (hint: the average NPS score for rehab therapy practices is 84).

For an in-depth explanation of how to calculate your practice’s NPS, check out this blog post. And to learn how you can automate the entire NPS process—from survey delivery and score analysis to follow-up outreach tailored to both promoters and detractors—take a look at WebPT Reach, the leading patient relationship management software for physical therapists.


When I indulge in a perfect scoop of ice cream, it’s a transcendent experience. And once an ice cream shop has earned my undying devotion, you better believe I’m telling everyone I know. That’s why it’s crucial for any business—whether it’s an ice cream shop or a rehab therapy practice—to track loyalty, not merely satisfaction. If you’re not capturing the right data, then you’re not getting an accurate picture of how happy—and more importantly, devoted—your patients really are. Does your practice track patient satisfaction and/or loyalty? Tell us about your experience in the comment section below.