NPS – The Most Important Number In Cash-based Physical Therapy Private Practice

Dave O’Sullivan | 17th May 2021

All business is a rocky road and running a cash-based physical therapy practice is no exception. But there are a few methods that may make that road a little smoother.

I’m a physical therapist, I didn’t study business at university so building a clinic has been a long journey. I have made some mistakes along the way but it’s the lessons I took from those errors which have made the difference.

Owning a clinic can be a recipe for sleepless nights. You worry about the next month and where the next patient will come from. Well, today I want to share with you one simple metric that will help you understand your customers and more importantly predict growth.

It won’t run your clinic for you but it will, with a few simple steps, change your business for the better.

Key takeaways;

  • What the net promoter score is.
  • What it means to your cash-based practice.
  • Implementing the net promoter score in your own practice.
  • The systems you need to do so.
  • The biggest mistake in cash-based practices.

Read on to find out how you can use the Net Promoter Score to grow a successful cash-based physical therapy practice.

Growing A Physical Therapy Practice Without Referrals From Insurance Companies

When we talk about a cash-based physical therapy business I don’t mean only having patients bringing in brown envelopes to pay cash. I just mean that we don’t have the luxury of referrals from insurance companies, third-party payers, and outpatient physical therapy, or if you live in the US, medicare patients.

If you’re anything like me your private practice and physical therapy services have never been able to rely on being a participating provider. But this means your success depends on having a foolproof way of understanding your customers and ensuring the growth of your cash-based practice.

Dave O'Sullivan lecturing on cash based physical therapy business

How The Net Promoter Score Helped My Cash-Based Practice

In 2015 I left professional sports and opened my own private practice above an old running shop. Just one room and me. Fast forward six years, we have a new clinic location and 11 staff and physical therapists making real changes with complex cases every day.

In 2017 and 2019 I took 12 weeks at a time away from the clinic to fly halfway across the world to act as a consultant physiotherapist at the Rugby Union and Rugby League World Cups. So many other therapists I know would have lost sleep over that but I knew I could leave my staff to run the business and continue its growth.

So how do I this? Well, I knew my staff had a system but I also knew they were tracking our net promoter score…

ProSport Physical Therapy Practice

Net Promoter Score

The net promoter score is a key metric in all business. You can use NPS to understand patient and customer perception of your cash-based physical therapy practice. It is a lagging indicator to understand how current patients and customers view your brand and their experience, as well as a leading indicator of your practice growth.

So many physical therapists rely on word of mouth to build their business, and we can’t forget just how valuable a network like this is but the days of passing on business cards are over. It just isn’t going to drive your practice to success.

Calculating The Net Promoter Score For Your Cash-Based Practice

Most people who own cash-based practices might think this is hard but just as we teach effective explanation and communication in the Mentorship it is only ever about asking the right question to elicit the answer you need.

In fact, you’re going to have answered this particular question yourself. So here goes….

Using a scale of 1-10: How likely is it that you would recommend ProSport Physiotherapy Practice to a friend?

Of course, you’re not going to be asking your patients how well we’ve done, that will be your clinic name in there, but you get the idea.

So now you have that number what do you do with it?

Effective explanation and communication in cash based physical therapy

Making Sense Of Your Net Promoter Score

You have answers from your patients, now you have to catagorise this data. Group the patient responses as follows…

  • Promoters (score 9-10) are loyal enthusiasts who will keep buying and refer to others, fuelling growth.
  • Passives (score 7-8) are satisfied but unenthusiastic customers who are vulnerable to competitive offerings and other services.
  • Detractors (score 0-6) are unhappy customers who can damage your brand and impede practice growth through negative word-of-mouth.

This may sound simple but it isn’t always black and white. Your patient may have come with back pain and you got rid of it, but did you give value to their life and make a meaningful impact? Or did you just do what they expected you to do?

This is the difference between achieving the results that people expect versus building confidence and resilience and getting those scores of 9 and 10.

Anatomy of the shoulder physiotherapy

Taking Action With Your Net Promoter Score

In all honesty, I couldn’t sit here and tell you that we never get 0-6. It happens in every practice. But if this does happen then we have the net promoter score. We can take action, contact the patient or customer, solve their problem, and put systems in place to make sure whatever may have happened doesn’t happen again.

The rule I live by is….

‘Make a mistake once it’s a mistake, make a mistake twice and it’s a choice.’

Some of these scores might hurt to look at but it is so important to the growth mindset that you and your physical therapy practice learn.

The NPS score will allow you to bridge the gap between momentum and growth. If you have an issue in your cash-based physical therapy practice with consistently low NPS scores then how can you take action? Is spending money on marketing and sales really going to solve your problem?

In all honesty, I couldn't sit here and tell you that we never get 0-6. It happens in every practice. But if this does happen then we have the net promoter score. We can take action, contact the patient or customer, solve their problem, and put systems in place to make sure whatever may have happened doesn't happen again.  The rule I live by is....  'Make a mistake once it's a mistake, make a mistake twice and it's a choice.' Some of these scores might hurt to look at but it is so important to the growth mindset that you and your physical therapy practice learn.  The NPS score will allow you to bridge the gap between momentum and growth. If you have an issue in your cash-based physical therapy practice with consistently low NPS scores then how can you take action? Is spending money on marketing and sales really going to solve your problem?

How The Net Promoter Score Sits In Your Value Chain

Your value chain is all of the resources it has taken to get your patient through the clinic door through to treatment and fulfillment, their journey’s end, and their NPS score.

But there is a costly error most cash-based PT practice owners make. They read that value chain from left to right. They focus on their Facebook ads and their marketing rather than addressing how the patients feel about the service they have provided.

In short, use your value chain but always read it from right to left.

Cash Based Physical Therapy Value Chain

The Biggest Mistake Every Physical Therapist Makes

Now you understand what the net promoter score is and how it can work for your cash pay physical therapy business it’s time to address the biggest pitfall therapists always make.

The one big mistake I see in most cash-based practices is that they treat patients but they don’t fulfill their promise. Their manual therapy or treatment programme is not helping people achieve their goals and they don’t prepare them for the real world.

Every patient needs the best one on one care but to create raving fans you need to build up their confidence. More importantly, you must be giving more value to their lives than they have paid in cash payment.

How do you do this? Well, the short answer is by building resilience and helping them get back to things that they want and need to do in real life.

Do they want to climb the stairs without pain? Get back to their Sunday league match? Or just pick up their kids?

The biggest mistake in cash based physical therapy

Building In Your Physical Therapy Systems

Yes, you may want more growth, you want to make more money, or maybe you want the clinic to run itself so you can spend more time with your family, but increasing marketing isn’t the answer. You must have the systems in place to facilitate this growth.

You need to have a team of go-to therapists, who excel in each of the 8 pillars below, use the 80/20 rule, use a system to get consistently great results, and produce happy patients.

If you have therapists turning out unhappy patients then you’ll have to take on more work, solve others’ problems, and put out these fires. It just defeats the point of you having a team in the first place.

Once you have that system that produces repeatable results and happy patients you can focus on the business systems. With all of this in place, your cash-based PT business can run without you having to put out fires and fix problems at every turn.

All successful cash-based practices have these systems in place.

8 pillars of the go-to therapist in cash based practices

Final Thoughts On Implementing the NPS In Your Cash-Based Practice

So, to recap….

  • Low NPS means that your patients and customers do not have a great overall perception of your brand/practice and will likely not promote your services.
  • High NPS means that your patients have a great perception of your brand/practice, and will most likely promote your services.

You need to be keeping track of this metric. You’re not always going to get 9s and 10s but if you get those lower scores then you can react.

The real key here is having the systems in place to allow the growth of your business. Every therapist on your team must be able to achieve repeatable results in order to create consistently happy patients

If you want more information on implementing a structured system to achieve consistent results and consistent clinic growth, click the link below and book your free strategy call today.

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