NRC Health Consumer Expert Ryan Donohue has a vivid analogy about managing expectations that applies to healthcare leaders and parenting.

“You know that children can be ruthless in their expectations, and if you don’t fulfill them, you can have a real confrontation brewing on your hands,” he says. “But it’s interesting to think about this perspective, not just in healthcare but in other industries. And one of my favorites to examine is the Magic Kingdom.”

During a recent webinar, “Pandemic Parents: A Portrait of Shifting Priorities in Raising Kids,” Donohue shared that he had not visited Disney World as a child. Still, as a parent, he was excited to take his kids. While gathered around the Christmas tree, he and his wife announced that the trip would be in June. “To see their eyes light up, they were so excited!” he recalled.

Donohue said that as they started to plan the trip, they learned more about the heat of central Florida, the humidity, and how many people would be in the park. They learned that even in the planning, they had already missed some crucial deadlines by which they needed to book. They also learned quickly just how expensive the trip would be.

“But to our kids, none of those things mattered; they were just so excited,” Donohue said. “They were almost like our patients, saying, ‘You know what? We better have a blast!’ That’s what’s been built up in their mind’s eye.”

Living Up to Expectations

Donohue explained that on the first morning of their trip to the Magic Kingdom, his family didn’t know anything about the rides, but rolled in and tried Space Mountain first. His son, who was seven at the time, had never ridden a roller coaster, but the family agreed to try it together. They even waited in line for the first row of the first car.

“You may know where I’m going with this…Space Mountain is not a good first roller coaster,” Donohue said. “Our expectations of having fun and excitement went away as soon as those lights disappeared, because it was a dark ride. After twists and turns, it drops you in the dark. My son is in front of me, just screaming and yelling. Halfway through that ride, I felt a whoosh as his favorite Kansas City Royals cap flew off into the darkness.

“Outside that ride, he had a very different perspective of that experience, and I was to blame,” he continued. “I could feel the heat as I asked someone working there if there was any way someone could look for the lost hat. The cast member explained that the ride runs all day long and getting inside was not easy. Off we went, and as I was buying him a new, horribly overpriced hat, he told me he never wanted to go on that ride again. I think that’s true of many healthcare consumers when they have similarly high expectations. And then the real experience hits with a thud; I think that’s an issue for many people.”

Parental Trends Affecting Healthcare

Donohue explained that data from the NRC Health’s 2022 Pediatric Consumer Trends Report shows that people are deciding not to return to healthcare—it’s what he calls the “I don’t want to go on that ride again!” effect. People deferring care hit absolute record highs during the COVID-19 pandemic.

Donohue clarified that overwhelming pandemic stress has greatly affected parenting and, subsequently, healthy choices for children. Consider these trends. Among the return to pediatric care experiences, 13% of parents are unsure when to resume healthcare activities—and 5.5% say they will not return to healthcare, period. The number of parents deferring care for children has also dropped in recent months, from 11.6% in Q4 2021 to 12.3% in Q4 2020. Donohue said that 43% cite COVID-19 as a major impact on their decision to delay care.

“Financial reasons are big,” Donohue explained, “but their number-one concern was still COVID having a major impact on their decision. This feeling of COVID gives people a reason, maybe an excuse, not to go in, or take their kids in, because they are worried about cost. And remember, consumers before COVID were not champing at the bit to go in for care. They were looking for reasons to put it off. And if they were, the idea of being in financial ruin was reason enough.”

Donohue added that as parents, many people are very nervous about the reintroduction to healthcare.

“One of the things that we see a lot coming through in our [patient] comments is the worry about procedurally managing it with insurance and paying for care,” he said. “Half of the consumers feel a significant burden—a real yoke around their neck in paying for healthcare. Almost nine in 10 incur some level of difficulty in just understanding their healthcare bill. Two-thirds feel it’s important to fully understand it because of the money at stake. And 51% would love to see just a single bill.”

Making Every Touchpoint Count

Donohue said that it’s interesting even to think about this as a touchstone of experience. When we’ve completed pediatric care or the parents take their child home, hopefully that child is well and able to return to normal, healthy life again. It’s what we all hope for. But we realize that there is another touchpoint after they’re discharged. It doesn’t happen when that child’s on the exam table or the operating-room table; it often happens when mom and dad are at the kitchen table going through the paperwork that has come in following all those procedures. As Donohue explained, it’s not over for the parents at that point.

“That experience continues,” he said. “You are connected when they see your logo on that bill, even though it’s got a lot to do with insurance and their financial situation. I don’t have to say that many times—the chance for that to be a very negative touchstone is high. It can be so negative, it wipes out positive elements of the experience. It wipes out that fantastic nurse, helpful security guard, or great doctor, because the bill leaves the last taste for parents—and then it’s all over.”

In the Magic Kingdom story, Donohue joked that even though it took a couple of hours and a little bit more sugar, his son eventually forgave him. They had an excellent trip during the rest of their time at the Magic Kingdom, visited the other parks, and went home happy.

“A few days later, I noticed there was an odd-size package in the mail, and that package was his favorite hat,” he recalled. “So that Disney cast member that I fruitlessly asked, ‘Hey, we lost his favorite hat in this ride—I don’t know if there’s anything you could do,’ he listened and took down my information. They eventually went in for a maintenance break and found the hat; it had a little bit of grease on it, but they mailed it to us. And in the end, that final piece of our experience was magical. The fact that he got his hat back made his forgiveness of me more certain. So I appreciated that as a parent.”

These magical experiences can happen every day, Donohue insisted. “You don’t have to be Disney to do it; you just must pay attention, care, and know that everyone should be treated as a unique person,” he said. “And that includes parents and their children. We have no shortage of issues; it feels like we’re riding Space Mountain right now. It’s part of why I use the analogy.”

2022 Pediatric Consumer Trends Report.

“As healthcare leaders, we have an opportunity to take a long view and say, ‘What type of relationship do we want to build with parents?’” Donohue said. “I think that sort of deep thinking will do us well as we continue to provide the best possible care for everyone who needs it.”

Request your copy of NRC Health’s 2022 Pediatric Consumer Trends Report now.