How would Disney run a medical tourism business?


Disney takes a very wide view of its competition.  It’s not Universal Studios who bother them, but "any competition that the customer compares us to". This could be anywhere where customers witness a high level of service and an over-the-top experience. 

Competing on a basis of achieving a positive guest experience at all points of contact is equally applicable to the healthcare sector.  Fred Lee, in his popular book If Disney Ran Your Hospital, sums this up well: “In the battle for the supremacy of perceptions in the patient’s mind, our competition is anyone the patient compares us to.  Unfortunately, they do not compare us to other hospitals”.

Perception counts

A 2003 Press Gainey Associates Patient Satisfaction Report identified the top drivers for patient satisfaction, which included how well the staff worked together to care for patient; overall cheerfulness of the hospital; responses to concerns or complaints made during the patient stay; amount of attention paid to your personal and special needs; nurses kept patient informed; nurses attitudes towards patient requests; and skill and friendliness of the nurses.

Hospitals and clinics however still spend much of their time on their assessment of clinical outcomes, rather than on how the patient judges the outcomes.  As the above survey shows, this judgement involves evaluating the total experience of the healthcare facility not solely the clinical medical experience.

Focus on outcomes and perceptions

From a patient services perspective, for higher guest satisfaction and loyalty levels, the focus should be on both improving outcomes and perceptions. Improving outcomes include building team responsibility, eliminating carelessness, stressing what the medical team should be doing and process mapping.  Building positive perceptions involves prioritising personal responsibility, being tuned into patient perceptions, improvement of staff behaviors and attitudes, stress what staff should be saying, seeking to impact impressions, and best possible thinking.

At Disney, employees are referred to as ‘cast members’ and all customers are ‘guests’.  Cast members are taught to be ‘assertively friendly’ and to know what to say, via practicing scripts and storyboarding, to make the best positive impression.  Managing the moments of truth between guest and cast member interactions creates a powerful positive impression.

If Disney ran your hospital or clinic, nurses for example would begin to believe that they are judged not so much against the standard of other nurses, but against the standards set by the nicest people providing customer services, anywhere.  The same goes for the food service staff, housekeepers, receptionists and doctors.

Courtesy is more important than service efficiency

The four most important areas that Disney stresses to newly hired cast members are, in this order: Safety, Courtesy, Show (sensory impressions) and Efficiency (Process).  Safety as number one aligns well with hospitals, but the other areas particularly related to patient satisfaction (e.g. courtesy) are often not clearly defined in healthcare sectors and thus not always carried out in service delivery.  This is why Disney places courtesy higher than efficiency.

4 out of 5 for Guest Satisfaction is not enough

Many hospitality and healthcare facilities use a 1-5 Likert scale to assess patient satisfaction with their hospital visit.  If a ‘1’ means not satisfied, then providers generally see everything above a 4 as a satisfied patient. 

But Disney doesn’t show the full range of guest satisfaction scores to its cast members, only the percentage of guests giving ‘5’s to satisfaction (i.e. excellent). This is because Disney sees only scores of 5 are linked to loyalty and thus the likelihood to return as a guest.  In fact, a guest who gives a 4 is about six times more likely to defect than a customer who gives a score of 5.  Disney sees loyalty, not purely satisfaction, as the most important factor needed to protect the organisation against future competition in a complex market.

An example of this is a hotel staff member cleaning all guests’ windshields in the parking lot and placing a note on the windshield saying, ‘Clean windshields on us - have a great day!’.  By doing something memorable, guests remember this, which in turn generates a buzz or story for others to re-tell, thus building loyalty.  A patient who is merely ‘satisfied’ has no story to tell, as everything went as expected.

For hospitals and clinics, to get patients to become loyal and sing the praises of the healthcare facility to others, true compassion must be shown by the staff. According to F.Lee (of the above noted book) there is nothing quite as powerful in patient satisfaction scores as a phone call placed to the home of a discharged patient.  If it comes from the nurse or doctors, this is a powerful message of compassion and concern.


These are just a few of the service elements that Disney would focus on if it did indeed run your hospital or clinic (who’s to say it won’t happen in the future?).  Every healthcare manager should be reinforcing the principles of service excellence learnt by hard graft in the hospitality sector, and start using some of these suggestions to build loyalty.

About the author

Frederick J. DeMicco, Ph.D., RD, CGSP spent a part of his career at Disney World, Orlando at the Contemporary Hotel and Wilderness Lodge Resort Resort and in healthcare at the Massachusetts General Hospital in Boston.  He completed his Ductorate degree at Disney University.  He is editor of Medical Tourism: Hospitality Bridging Healthcare (H2H) and Wellness, published by Apple Academic Press. [email protected]

“You can design, create and build the most wonderful place in the world –but it requires people to make the dream a reality” - Walt Disney


If Disney ran a medical travel business

Resources, 30 April, 2018

Fred deMicco, The University of Delaware, IMTJ Medical Travel Summit USA 2018



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