My dermatologist is a very smart guy. So at my annual check up, I asked him what lessons he has learned about applying the NPS framework in healthcare.  He told me that the big insight for his practice was that he had been spending way too much time focusing on detractors. Most of them, he concluded, were simply not going to be happy doing business with him no matter how much extra attention he provided.  These inherently grumpy patients were ruining the office atmosphere for other patients, they destroyed the motivation and enthusiasm of his nursing and administrative staff, and they were eating up a lot of his personal time and energy. So, he decided to help them find other physicians.  The result, he told me, was that his practice started to grow and flourish like never before. The cost of detractors was far greater than the accountants could measure, but investing to fix detractor problems was not necessarily the best way to reduce this cost.

I feared I had used up my allotted time on this conversation—but the doctor seemed interested to talk further about NPS. So, I asked him why NPS adoption had progressed so slowly in health care. It is so clearly relevant; the notion of treating a patient in a way that makes them want to recommend friends and family seems perfectly suited for doctors, hospitals, clinics...just about any health care provider. Not only that, major suppliers to the healthcare industry such as GE, Philips, and Siemens have all adopted Net Promoter. Awareness among healthcare executives must be growing.

My doctor agreed, but then opined that perhaps the reason for slow adoption had to do with fear. In his view, the senior executives of hospitals and the like were more concerned with staying out of trouble and keeping their lucrative jobs than they were with building a truly great culture that could provide extraordinary quality care and reasonable prices. I was skeptical. Sure, measuring NPS in any business requires courage. It is one thing to talk about moving from good to great at your Board retreat, but to actually report how many customers are promoters, passives and detractors turns this high-minded concept into a sobering (maybe threatening?) challenge.  But it doesn’t make sense that healthcare execs would have less courage than leaders in other industries.

Hopefully, we can get some answers to this question at the upcoming Net Promoter Conference (February 1-2 in New York). I plan to ask keynote speaker Steve Bonner, CEO of Cancer Treatment Centers of America, what he thinks about NPS in healthcare. Bonner’s organization has demonstrated impressive results using Net Promoter. So I want to ask Steve: Why haven’t more of his peers adopted NPS? Are they too focused on fixing detractors (like my dermatologist early on)? Do they think the current customer satisfaction surveys are sufficient for creating promoters—or has the government tied their hands with a measurement process that stifles innovation? Do they fear what NPS might show about the state of their current operations? Or do they simply feel overwhelmed with the amount of turbulent change and complexity?

I can’t wait to learn more from a seasoned industry executive like Steve Bonner about what Net Promoter advances we can expect to see in the healthcare arena.