Primary Care and Walt Disney World

What do Primary Care & Walt Disney World have in common?

.... Not much, as it turns out.

I recently had a chance to enjoy the Magic Kingdom with my family, including my very excited four year old daughter. For those of you who haven’t had a chance to visit Walt Disney World, it really is an amazing place. Every last detail of your visit has been designed by a team of designers, architects and engineers called “Imagineers”. Removing  all cynicism, apprehension, and the last semblance of adult restraint you were desperately trying to hang on to.

It begins with the military efficiency of the parking lot- a beautiful dance where 300 cars and two RVs can be parked perfectly seemingly instantly. As you approach the Kingdom either by ferry or monorail (I thought those things died in the 80s), the visual experience has been very clearly thought out to draw you into something special and leave your daily existence in the parking lot.

I discovered that there has been some new magic installed since I visited as a wee tot.
Apparently they now have an underground “experience command center” beneath the castle, where some kind of early warning system helps them know when people in the queues are getting frustrated. I witnessed this first hand when two cast members magically appeared with giant bubble wands and suddenly everyone in the line was happy.

The Walt Disney World Magic Kingdom Mini Guide app aids navigation,helpfully displays the wait time for rides, and allows you to instantly make reservations for restaurants (however, it does not fix the fact that you forgot to reserve breakfast with Cinderella four months before your trip).

 

The thing is, its not really magic. Its a team of people working like dogs to create an experience where you, yes you, are the most important person there.

From the spy cameras that must be everywhere, to the underground “utilidors”, there is an infrastructure that allows all that hard work to remain invisible so that all you see is the magic. Even the most sullen teenager can’t help coming out of their shell and engaging with the Disney experience because of all that went into designing the experience.

When was the last time a trip to your doctor was “magical” or even enjoyable, for that matter?

While I don’t really advocate doing exams while dressed as Captain Jack, I think its high time that we in primary care get serious about improving the patient experience.Its quite plausible that if a patient enjoys a visit and has a good experience, they may be more vested in their healthcare and thus follow through on our recommendations. We lament “non-compliance” and always couch it in terms of patient factors and choices, but rarely do we acknowledge that non-compliance has as much to with physicians and the medical environment as it does with the patient. Isn’t it possible that some patients just don’t care or didn’t absorb what we told them because they were so uncomfortable and wanted to bolt as soon as we freed them from our sadistic gowns?

We need to start looking at healthcare as a service and be more serious about satisfying the customer, or in this case making health care truly patient centric.

This means that we need to engage our patients and communities, listen to what health truly means to them and see healthcare through their eyes.Look at the waiting room as an example. First of all, think about what just that name does to your mood. As a patient, you are given a stack of forms that make no sense and told to sit in an uncomfortable room full of strangers. You have no idea why you are waiting or how long it might be. The furnishing makes it clear that you are just an afterthought and clearly not the most important person in the room. You might have a few old, safe magazines, maybe one dumbed down computer, a blaring TV, and, if you’re lucky, Wi-Fi that barely works. After a seemingly random amount of time, you’re taken to another cold and foreboding room, you answer some more random questions and then you…. wait some. You feel helpless, you’re probably naked, and you are clearly not in control of this situation. You’re frustrated. And you’re not all confident that this encounter is really all about you.

This totally colors your interaction with your provider. You can’t help it; you’re human and first impressions really matter. If you are made to feel helpless by the waiting room experience, you are really going to feel helpless when the very studious and harried doctor comes breezing in with nary an explanation for what he has been doing for the past 45 minutes.

Think about this from the Disney perspective:Every single detail is managed to make the most important person in the room feel that way.

You received an email reminder of the appointment and a visual depiction of what to expect during the course of the visit. Everybody says Hi and is pleasant on your way in. When you check in, you are told how long you can expect to wait (even if its completely wrong, it helps to have an idea).You’ve already had all your forms filled out ahead of time either on-line or the information was pulled automatically from an on-going electronic plan of care customized for you.You were given links ahead of time describing the rationale behind the preventive services you were due for and now in the patient lounge, you can explore this further with visually keyed information cards and kiosks, or you can use the free Wi-Fi on your complimentary tablet to explore further.

There are comfortable places to sit, catch up on emails, and private places to make that last minute call. Visually interesting displays indicate the schedule of wellness and cooking classes that are being offered that day. You whip out your smartphone and check the free app for your doctor’s office that tells you your doctor has one patient to see before you and your room is currently being cleaned. You stop by the café to grab a coffee and receive a text message telling you that room 175 is ready for you with a handy full color map that directs you there.

You feel good, you’re actually enjoying this and you can’t wait to meet with your doctor....how hard is this?

It is all existing technology and could be ready tomorrow. It just takes awareness that our patients really don’t like our offices and that impacts their entire healthcare experience. It takes willingness to see the experience from the patient’s perspective.

Being a patient can be challenging at times and sometimes you have to do things that really aren’t all that pleasant, but what if at the end of the day, you could look back and think “that was fun, I’m actually kind of looking forward to my next visit!"

 

Marc R. Matthews, M.D. of Kasson Mayo Clinic - Family Medicine. CFI works closely with Marc, in an effort to improve the Community Health platform, by developing a sustainable plan for the delivery and experience of health care for the Dodge County community.