The one number you need to know ... to grow!

May 1, 2008
Tiger Woods is arguably the best golfer of all time. His game seems flawless, and from an operational standpoint .

For more on this topic, go to and search using the following key words: focus on strengths, minimize weakness, improve skill, work harder on strengths.

Tiger Woods is arguably the best golfer of all time. His game seems flawless, and from an operational standpoint ... it is. He leads in just about every category kept except one. His greenside saves are his personal worst ranked statistic. He does not get up and down from sand traps with anywhere near the prowess that he demonstrates in his other golf skills. So one would think (incorrectly, unfortunately) that one would find Tiger at the range working diligently and endlessly to improve his weakest skill. Correct a deficiency. Smooth a chink in the armor. Not so. Instead, he works even harder on his strengths to minimize his chance of ever finding himself in a greenside bunker. He focuses on his strengths to minimize exposure of his weakness and thus improve his overall scores. By the way, he just happens to lead the PGA Tour in greens in regulation. He drives the ball so far he is close enough to reach the "dance floor" as planned and hardly ever faces the dreaded sand save for par. Focusing on his strengths has minimized his weakness.

What are the strengths of your game as a dentist? What about your team? How do you know if you are focusing your time and talents on doing that which makes your practice thrive and grow? You could measure all kinds of statistics in your practices from "new patients per month" to "percentage of cases accepted" or even "production per hour." All of this is good data to measure your effectiveness. But what measures do dentists have for patient satisfaction, loyalty, or engagement? How do we know what our clients are really thinking about us?

And would it matter if we did know? It turns out that measuring the strength of the engagement patients have with us is the best predictor of long-term sustainable growth and profitability. I'm not saying the other data on your dashboard is not important; it is. But this one metric may be the most important number you need to grow. The Gallup poll folks partnered with the Pankey Institute years ago to develop a patient satisfaction survey (there was also an employee satisfaction corollary). This evolved into the term Loyalty Measures, and eventually the language changed to Customer, Client, or Patient Engagement. Gallup has long quit surveying dental patients and employees, but has continued to serve larger populations, industries, and professions. They have developed CE12 (Customer Engagement 12 questions) and EE11 (Employee Engagement 11 questions) surveys that gauge the relative level of engagement and loyalty of clients and team. These queries are copyright-protected as question sets and cannot be used without Gallup's involvement. But one of the questions was studied extensively by Fred Reicheld as a single question that served as a predictor of the entire survey. In his groundbreaking article in Harvard Business Review in 2004, and two books since (Loyalty Rules and The Ultimate Question), he has simplified the data gathering to one question that can tell us how we are doing at customer relations, client loyalty, and patient satisfaction. He calls this measure the Net Promoter Score.

Simply asking a patient, "How likely are you to refer a friend or colleague to this dental practice?" and scoring the response from 0 to 10 will give you the one number you need to grow. "Nines and 10s" are so loyal and engaged that they are called Promoters of your practice. They are willing to risk the trust they have in another relationship by recommending your team. That advocacy is as strong a statement of support as you can get. "Zeros through Sixes" have indicated by their response that something is amiss here. They cannot even score you close enough to Seven through 10 to demonstrate strong levels of engagement. They are called Detractors. In Reicheld's work, his statistical and metanalysis of the data from thousands of businesses suggested dropping the "Sevens and Eights" altogether. They had not stepped far enough into either category to claim ownership. They are Neutrals.

By subtracting the percentage of Detractors from the percentage of Promoters, you get the Net Promoter Score or NPS. This metric is used across many businesses including every division of GE as its behavioral bellwether of how the company is doing. When tracked side by side with financial health measures, the NPS is the best predictor of long-term sustainable growth and profitability. For a more detailed discussion, Reicheld's article in HBR and his Ultimate Question book will serve you well. What gets measured gets done. Want to grow? Want to have better patient relationships? Measure, initiate some process or product improvements, and monitor. You'll know how you are doing. It's like money in the bank.

Mark Murphy is a featured presenter for the National Dental Network and the National Lab Network. He lectures internationally on a variety of dental clinical and behavioral subjects. Dr. Murphy practices part time in Rochester Hills, Mich., and is the director of professional relations at The Pankey Institute. You may contact him by e-mail at [email protected] or visit

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