Inside physician engagement: What a negative NPS really signals

In CHG Healthcare’s 2025 Physician Sentiment Survey, health care organizations received a Net Promoter Score (NPS) of -8. Bill Heller, the company’s chief operating officer, breaks down what that score means.

A negative score means physicians are more likely to discourage colleagues from joining their organization than recommend it. Heller notes that internal NPS often trail external scores in high-stress industries like health care, partly because physicians are weighing not just their organization but the broader strain of practicing medicine today.

Still, a negative eight is hard to dismiss. NPS has become a widely used proxy for loyalty, retention risk and long-term stability. And buried within that number is an opportunity: roughly one-third of physicians surveyed fell into the “passive” category — neither promoters nor detractors.

Heller argues that moving those passives matters more than trying to win over entrenched critics. Clearer communication, stronger trust, better listening and tangible reductions in administrative burden can push physicians from a hesitant “maybe” to a confident endorsement.

The takeaway for leaders is straightforward: loyalty isn’t built through compensation alone. It’s earned through trust, support and daily work conditions that make physicians want to stay — and recommend their workplace to others.