The impact of neutral clients and patients on the NPS

Neutrals in NPS
8 min

I was recently asked by a manager of a large hospital about why the SPL calculation does not consider neutral, and what to do with them after all?

The doubt raised several questions and internal debates in our team, and I decided to go deep and search for content, articles, and interviewing professionals and clients about the ideal approach to patients or neutral clients.

I take this article to bring some insights, and also four tips that will help you convert neutrals into promoters.

Let's start at the beginning. What is NPS?

In a very didactic way, simple and objective. O NPS (Net Promoter Score) is a metric created to monitor the satisfaction and loyalty of customers and patients with a brand, product or service. We talked in more detail about what NPS is in this article.

Book cover, Fred Reichheld's Final Question published in 2006
Book cover, The Definitive Question 2.0 by Fred Reichheld and Rob Markey published on 2011

Created by Fred Reichheld and initially published in the year 2003 in the article The One Number You Need to Grow, edited in the book The Ultimate Question, and later deepened together with Rob Markey in the book The Ultimate Question 2.0.

Basically, NPS is obtained through Definitive Question or The Ultimate Question that gives name to the books:

NPS measuring ruler, From 0 to 1 10, how much would you recommend a company to a friend or relative?

Based on the grade indicated by the respondent, segmentation is done in three groups: Detractors (notes of 0 at 6), Neutral (notes 7 and 8) and Promoters (notes 9 and 10).

The main objective of doing this segmentation to obtain a satisfaction indicator, is to understand what is the “BALANCE” among the customers that promote the brand (Promoters), and customers who are dissatisfied and who naturally speak ill of the brand to other people (Detractors). 

This is important, because in the studies carried out by Fred, the only customers really likely to recommend the company naturally, and do the famous “word-of-mouth”, were those with notes 9 and 10, that is. The promoters!

However, the effort of promoting customers is partially or totally destroyed when there are dissatisfied customers and speaking badly of the brand, that is. The detractors!

Practical example:
Promoter clients = 1 (50%)
Neutral customers = 0 (0%)
Detractor customers = 1 (50%)
Promoters - Detractors = PROMOTERS BALANCE
1 - 1 = 0 (0%)
Formula do NPS, with its division in Promoters, Neutrals and Detractors and a simulation of how to do the calculation

But what about neutrals, why don't they go into the calculation?

This is a group, who buys only what he needs and nothing more. They are passively satisfied customers, not loyal, with a very different set of attitudes and behaviors. Make almost no recommendations, and when they do, are with reservations and without enthusiasm, that is, who are not enchanted by the service or the experience they have.

In this way, it didn’t make sense to include neutrals in the calculation to arrive at the “BALANCE” of customers who promote your brand. For neutrals do not promote or destroy.

Practical example including neutrals in the equation:
Promoter clients = 1 (33%)
Neutral customers = 1 (33%)
Detractor customers = 1 (33%)
Promoters - Detractors = BALANCE Promoters
1 - 1 = 0 (0%)

The weight of each group in the NPS and the importance of the treatment

First, if we analyze the scale of possibilities for the respondent of the definitive question, we see that detractors have the greatest weight among the three groups, with seven possibilities (0 at 6), followed by two possible notes for neutrals (7 and 8) and two for prosecutors (9 and 10). But why that?

At a certain point in the explanation, Fred considers NPS conservative. After all, detrimental customers often talk about the bad experience in greater volume than the promoters. Therefore, the weight of the detractors already reflects their importance in relation to the urgency in understanding and dealing with the problem that they experienced in the experience with your company.

If you want to go deeper into this topic, we did a webinar on Treating Patients, and we invite subject matter experts to give an insight into the importance of the deal. Content can be viewed on here

NPS thermometer

Bringing the theme to market reality

To better understand how the topic is treated by market professionals, and to help me enrich the content of this article, nothing better than real ‘cases’ applied in practice.

I talked to Debora Tineo, customer experience and service manager at holding Athena Health, that uses NPS to monitor their patients' experience.

“Obviously our main focus is the detractor, but as our volume of detractors has been decreasing, we are also managing to approach the neutrals to understand the reason for the note, and if there is any dissatisfaction. Our job with the neutrals is to get in touch to build loyalty and make promoters come in the next opportunity ”

And on the priority scale, reiterated:

  1. Detrator
  2. Neutral
  3. District Attorney

That is, the neutral client or patient is the one who needs to experience or experience something incredible to become a promoter in the next experience with your company. So the importance of knowing your feeling. To seek insights on how to definitely enchant him.

Remembering that Athena Health is already at a more advanced stage regarding the treatment of patients and the use of NPS as a metric for monitoring satisfaction and improving processes.

Therefore, as Débora herself reiterated, the priority will always be dealing with detractors, and that the second step is to move towards the enchantment of neutrals so that they become promoters.

Net Promoter System, Inner Loop and Outer Loop concepts

Now that we understand a little more about neutrals, and how they influence our NPS, I have separated some tips that you will like.

4 tips for converting neutrals into promoters

Tip 1: Include satisfaction surveys as part of your customer’s journey.

The satisfaction survey is an essential tool for the continuous monitoring of feelings, opinions, suggestions and criticisms from your customers. In terms of neutrals, it is essential to understand why they were not delighted to the point of giving notes 9 or 10.

Invest in a tool that in addition to segmenting the three groups of the NPS, bring insights from comments, and evaluations of all points of his journey in the experience with your brand or product. It’s this information that will indicate exactly where your company is going wrong or getting it right.

Tip 2: Reduce friction between your company and your customer

Who likes to answer long and tiring surveys? Nobody! Invest in quick searches and with the least possible friction, and that bring insights using artificial intelligence and dynamic data analysis to shorten research time and improve engagement.

There is no point in improving your customer experience, with research that generates a bad experience.

Tip 3: Loop Closure: Have the goal of dealing with 100% of your clients or patients

As Fred Reichheld taught himself in the book The Ultimate Question, invest in closing the cycle and in the proper treatment, prioritizing detractors, then the neutrals.

It is this direct contact with the customer, that will make you understand exactly what was the real problem or motivation of your bad experience. Tente love it, showing that you care about your opinion, and is willing to solve problems that may have occurred and receive suggestions for improvement.

Tip 4: Improve your processes based on your customer's voice

It is essential to put the customer's voice in the company's culture, starting with senior management and reaching the employee. Based on these opinions, you will be able to correct processes and products, to delight and provide the best experience possible.

The customer's voice is the best path to a culture of customer centric or patient centric.

Extra tip: We deal with several issues related to this topic in our Webinars with experts and invited market references, access here, and see all editions.

What did you think of this article? I would like to hear your opinion on this matter, and what is your view on dealing with neutral clients and patients. Use the field below to comment. Thanks, until the next article. : )

Alex Pereira is Content and Communication Coordinator at SoluCX

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