Time to put a little bit of Disney into medicine

Why is a trip to the doctor’s office more like going to the DMV than going to Disney World? Both the DMV and Disney World involve waiting in long lines, but Disney has made the entire experience fun and exciting, while the DMV has made it cold and frustrating.

“But medicine is different,” you may say. Seeing the doctor was never meant to be a fun or exciting experience, after all. When you’re sick, you go to the doctor to get well—no more, no less.

This type of thinking, though, is what clearly separates businesses that thrive during rocky economic times (such as Disney and Starbucks and Apple) and those that do not.  The “user” experience, you say, should not matter in medicine where the idea of getting well is based upon the medicine and not the connection or interaction between doctor and patient.

The industrial economy of the 20th century could care less about consumer experience — the factory made the product and the consumer purchased it. In medicine this idea was paralleled by the the doctor prescribing the medicine and the patient taking it.  But now, in our digital economy, following the rules has been replaced by the user experience. We want to connect before we purchase. The same goes for medicine and healthcare where patients (and doctors) are longing for interaction.

Businesses that embrace this concept and provide remarkable experiences for their customers do well, while those businesses that simply want to believe the “if we build it, they will come,” mentality are struggling. Where would you place medicine on this spectrum?

As consumers, we long for interaction and connectivity with products, services, and people in our world—but where is that connectivity in medicine? Where is that transformative experience? In my opinion, the patient experience is at best an after-thought forgotten beneath the mantra of the paternalistic model of medicine.

Remember, the industrial era of our economy was based upon similar principles as the paternalistic model of medicine. It is the “do as I say” approach that seemed to work well when our economy was based upon the factory/ worker paradigm. Medicine also worked well with the focus being the pill. This made sense at a time when antibiotics led the way for the modern pharmaceutical panacea that now serves as the pillars of modern medicine.

But as a society, much has changed since we embraced this industrial type of thinking. For one, we are no longer dying of infectious disease like we did at the turn of the 20th century. Our chronic conditions are now much more multi-faceted and the result of genetic, nutritional, environmental and hormonal imbalances to say the least. Next, as a society, we have embraced the digital internet and no longer seek out the brick and mortar businesses that we did even 20 years ago. We now readily shop on Amazon and Netflix and individually purchase songs on iTunes. And lastly, we now embrace mobile technology using our smart phones to help us interact and manage our connections and daily lives in ways we could not have conceived of at the turn of even the 21st century.

In short, the technology of today is rapidly changing the way we interact with each other and businesses around us. Unfortunately, though, modern medicine has not advanced along these same paths.

Sure, we can now email with our patients and make use of e-prescribing, but how many of you truly feel that today’s medical “experience” is much different from 25 years ago or even 60 years ago? Why is this? Why do we settle for mediocre experiences for our customers (patients)? Why are we okay with advancing the use of pharmaceuticals while not using our insight to advance our communication capabilities?

Modern medicine is in need of an overhaul–we feel this and our patients tell us. Now is the perfect time to help shape the future of medicine–one defined by remarkable patient experiences. Here are a few ways in which all of us can help in that effort:

  1. Redefine the physician office. Take down the glass partition that separates the patients from the staff. Throw out the customary waiting room chairs and magazines and add pinball machines, WiFi and espresso machines. Since we make patients wait, why not allow them to wait in a more relaxed and modern environment?
  2. Make use of social media to broaden our communication capabilities. We are so far behind when it comes to other industries when it comes to social media. Why isn’t every doctor making You Tube videos and leading their patients on Facebook? As consumers we demand this of other businesses, so why not medicine?
  3. Modernize the current hospital room. Patients feel scared and nervous entering the hospital, so why not help put their minds at ease by changing the rooms to feel more like hotel rooms? I know many hospitals attempt this, but to truly change the look of the hospital room, the hospital staff needs to be on board to create a different “feel” in the hospital room.
  4. Create a healing and meaningful experience for our patients. This does not mean we get dressed up in costumes, but it does mean we need to reinvent what our roles are. Patients generally become ill because they have lost meaning in some aspect of their life. We can help them get back to that meaning, by becoming their health ally and gently guiding them along the healing path. This may mean we make house calls or provide group visits or even virtual visits through Skype and texting. By consistently showing each patient that we have time to listen to them and validate the context of their suffering, we will be creating experiences for them that are personal and healing.

This is a short list as I am sure you can think of countless other ways to bring about positive patient experiences in medicine.

The sooner we embrace the notion that the “experience” of medicine truly matters, the more readily we will be able to connect more deeply with our patients. And that is something everyone in medicine absolutely longs for. The next time you, as a customer, have a great user experience outside of medicine, start thinking about how you can bring that same experience to medicine. Because modern medicine needs some Disney more than ever.

Craig Koniver practices integrative medicine and consults with physicians at The New Rules of Medicine.

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  • Anonymous

    Disney is already one step ahead of you, Dr. Craig. There are actually courses out there for health care professionals and hospital administrators based on Fred Lee’s landmark book “If Disney Ran Your Hospital: 9 1/2 Things You Would Do Differently”.   http://myheartsisters.org/?s=If+disney+ran+your+hospital

    Lee maintains that hospitals could learn a lot from Disney. “Unlike traditional service organizations, Disney does not provide a service. Neither does your hospital.
    What both do provide is an ‘experience’. Hospitals
    would do well to emulate the most vital experiences that earn Disney the
    love of both guests and employees.”

    As a heart attack survivor, my perception of what’s going on around me in hospital and
    how I’m treated IS reality, regardless of others’ good intentions or good care.
    Lee says that doctors, nurses and hospital staff must learn to look at every interaction
    with us from the patient’s perspective, NOT from theirs.  A radical suggestion for many docs!

    • http://www.facebook.com/people/Craig-Koniver/100001463176810 Craig Koniver

      Thanks for pointing this info out! I look forward to learning more about Lee’s ideas…

  • Anonymous

    In the modern medical third party payer system the patient is not the customer, the insurance co. or the gov. is the customer. The patient is the product. None of your suggestions will come to pass until and unless that relationship changes.

    • http://www.facebook.com/people/Craig-Koniver/100001463176810 Craig Koniver

      Completely agree with you….it is time we, as physicians, started thinking outside the box and make changes to our individual practices. We cannot rely on the government or the health insurance infastructure to push for the changes that we desperately need.

  • http://twitter.com/chasedave Dave Chase

    Bladedoc is right…historically (and still the norm). As long as the customer is the 3rd party payer. There’s a saying in tech that if you aren’t paying, you are the product. Fortunately, there’s many disruptive innovators out there – albeit, it’s still relatively isolated and scattered. They are returning to the model of a direct relationship between an individual and a provider.  In a piece about disruptive innovators http://www.huffingtonpost.com/dave-chase/health-20-innovators-oppo_b_997467.html, read the comment from a Qliance patient below the article. I’ve been to their office. It’s wholly different than the typical DMV-like healthcare provider (though with a unique odor prevalent in most MD offices). Similarly, I’ve been to MedLion, One Medical, and others who are delivering great medical care in an environment that is actually pleasant and thanks to the use of technology, it’s often at a lower cost (it helps when you disintermediate insurance or at the very least streamline it).

    I haven’t had the opportunity to visit Dr. Koniver’s practice but I’d imagine it’s more Disney than DMV. No doubt, the disruptive innovators will go through what Arthur Schopenhauer called the 3 stages of truth – first it is ridiculed, then it is violently opposed and then it is accepted as self-evident. The results from studies done on practices such as Qliance’s are impressive – lower costs and higher satisfaction. The big “problem” these new models have is they sound too good to be true.

    • http://www.facebook.com/people/Craig-Koniver/100001463176810 Craig Koniver

      Thanks for making such a great point about the 3 stages of truth. The more we, as physicians, accept the status quo as the only way of doing business, the more we will contribute to increased health care cost, worse patient outcomes and dissatisfaction within our own practices. Thanks for spelling that out so well…

  • http://www.facebook.com/knasky Kevin Nasky

    “Patients generally become ill because they have lost meaning in some aspect of their life.”

    I’d challenge this assertion, but I’m not ever sure what this means, exactly. What evidence is there that illness stems from a loss of meaning in one’s life? What illnesses? How do you quantify (heck, qualify?) a loss of meaning?

    • http://www.facebook.com/people/Craig-Koniver/100001463176810 Craig Koniver

      Kevin, I practice holistic medicine where disease processes take on a different meaning than in the conventional medical world defined by diagnoses, medicine and procedures. So, for example, a patient with heart disease clearly has physiologic atherosclerosis, but to me, this represents much more than just high cholesterol, bad genes and smoking….this represents poor nutrition, lack of consistent exercise, as well as some type of disconnect from how they are feeling….that is certainly a simplified example. I don’t rely on the standard evidence based approach–I rely on getting to know each of my patient’s context where everything in their life matters–from their nutritional choices to what types of thoughts they think about to the quality of sleep they get to how they creatively express themselves. 

      I don’t strive to quantify loss of meaning–I leave that for patient history and lab reports. I qualify loss of meaning through my perspective of truly believing that everything matters in a patient life. I hope this helps explain my statement better….I am happy to write more if not….

  • Doug Capra

    This is a kind of update on Pine and Gilmore’s book, The Experience Economy. We’re probably way beyond the “experience” aspect now, as Pine and Gilmore suggest. We may be into what they call the Transformation Economy. The book is well worth reading.

    • http://www.facebook.com/people/Craig-Koniver/100001463176810 Craig Koniver

      I agree, it is a great book indeed as is their newest one about the digital/ virtual worlds. 

  • http://twitter.com/susangiurleo susangiurleo

    Craig, great piece…wouldn’t it be great to have an interactive waiting room?  Maybe people walk into a  pre-waiting area with a quick video with health care info offered (like Disney does before a long line or wait), and then they head into another room where there could be a wall with healthy recipes to take home, or stations where folks could use a smart phone and QR codes to download information on their condition. And as people walk out ,they go through a health care “gift shop” stocked with things people generally need when they leave the doctor’s office. Or, crazy idea here, have a pharmacy in the physician’s building!!

    • http://www.facebook.com/people/Craig-Koniver/100001463176810 Craig Koniver

      Great ideas! Thanks for commenting. Yes, there are tons and tons of ways to redefine the boring and banal waiting rooms and doctors’ offices. Hopefully the more we discuss these ideas, the sooner they will come to fruition!

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