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Thirteen Scenes: Mapping the Patient Journey
Your team thinks in tasks. Your patients think in scenes: the drive, the parking lot, the door, the desk, the wait, the exam room, the bill, the walk back to the car. Every scene is a chance to be an ally or an obstacle.
Start here: the questions this brief answers
Tap a question for the short answer, then jump to the evidence.
Staff see a visit as a list of functions: intake, rooming, billing. Patients experience it as a story with about thirteen scenes, from the drive to the pharmacy afterward. Every scene holds a small question in the patient's mind, and every person they meet is either an ally or an obstacle. Health services researchers increasingly use patient journey mapping to find gaps that internal reports miss; a 2023 scoping review found 81 studies using it. The Disney Institute teaches that great service comes from process, place and people working together. The fastest way to start is old-fashioned: go and see. Walk your own patient journey, scene by scene, and fix the first thing that would annoy you as a patient.
“Your patient is the hero of this story, not you and not your practice. Your team decides, scene by scene, whether they meet an ally or an obstacle on the way to getting well.”
What is a patient journey map?
A scene-by-scene picture of how patients enter, experience and leave your care. A 2023 scoping review of 81 studies describes it as a fast-growing way to understand those experiences.
Go to the full answer ↓What are the thirteen scenes?
From the drive and parking to the desk, wait, exam room, handoffs, billing, the walk to the car and the stop at the pharmacy. Part 2 lists them with what patients are wondering in each.
Go to the full answer ↓Why do practices miss problems?
Because staff think in functions and patients think in scenes. Problems hide in the handoffs between functions.
Go to the full answer ↓What can we borrow from Disney?
The Disney Institute teaches that exceptional service comes from the intersection of process, place and people, and that "everything speaks."
Go to the full answer ↓How do we start?
Walk the journey yourself, then ask two patients to walk it with you. Part 5 has the checklist.
Go to the full answer ↓Your team thinks in tasks. Patients think in scenes.
Ask your team how a visit works and you’ll hear a list of jobs. Who opens. Who checks in. Who rooms. Who bills. That’s how a practice has to run.
It’s not how a patient lives it.
Patients don’t know or care which task belongs to whom. They experience a story: the drive, the parking lot, the door, the desk, the wait, the conversation, the bill, the walk back to the car. Remark-ology calls these scenes, and it counts thirteen of them.1
The problems almost always hide in the transitions, the moments when one person’s job ends and the next one hasn’t started.
Health services researchers have a name for studying this: patient journey mapping. A 2023 scoping review of 81 studies described it as “a rapidly growing approach for better understanding how people enter, experience and exit health services,” with “significant potential to inform new, patient centred models of care.”2 Practice Insight
Thirteen scenes, and the question in each one
| Scene | What the patient may be wondering | An ally move |
|---|---|---|
| 1. The drive | Am I going to be late? Is this the right address? | Send clear directions and a "here's what to expect" note before the first visit |
| 2. Parking | Where do I park? Will it cost me? | Reserved or validated parking; tell them in advance |
| 3. The front door | Is this the right entrance? | Clear signage; a door that looks like a welcome |
| 4. The lobby | Does anyone know I'm here? | Look up, stand, greet by name (Brief No. 59) |
| 5. The wait | How long will this take? Did they forget me? | Update before they have to ask (Brief No. 62) |
| 6. Intake and escort | Will they ask me something embarrassing out here? | Private questions in private; walk with them, don't point |
| 7. The exam room | Is the clinician even here today? | Tell them who is coming and when |
| 8. The conversation | Will I get to ask everything? | Ask what matters most to them today |
| 9. The handoff | Do I have to repeat my story? | Warm handoff: introduce them and their need |
| 10. Billing and next steps | What am I paying for? What happens next? | Plain-language explanation; no surprises |
| 11. Back to the car | Did I forget to ask something? | A written summary; a farewell by name |
| 12. Leaving the lot | Will I make it back to work on time? | Respect their time the whole way through |
| 13. The next stop | Is my prescription ready? Who picks up the kids? | Confirm the prescription is sent; follow up if anything is pending |
Scenes from Remark-ology (2025); questions adapted from the book; ally moves are CMT original guidance.1 Evidence type: Practice Insight.
Remark-ology frames every patient as the hero of their own story, overcoming obstacles to reach you. Inside your practice, they meet two kinds of characters: allies and obstacles. Your team decides which one shows up in each scene.1
What a jungle cruise teaches about a medical office
The Disney Institute teaches that “exceptional service derives from the intersection of process, place and people.” Its example is the Jungle Cruise: a queue and boarding process that runs smoothly, a place designed so that “everything speaks,” and people, the skippers, whose humor makes the ride memorable.3 Industry Research
Process
Scheduling, intake, handoffs, billing. Does each step move the patient forward, or make them wait for the practice?
Place
Parking, signage, chairs, restrooms, noise. Everything speaks, including the one-ply toilet paper.
People
Every person a patient meets is part of the story. The physician is one scene of thirteen.
One reviewer of a Texas concierge practice captured what it feels like when all three line up: “OMG, I love it there, I almost fell asleep it was so peaceful!”1
When a scene breaks, the story changes
An office manager told CMT about her own visit: “I drove across town, took the morning off of work and found childcare for our two kids for a 5-minute visit with the Doctor. On top of that I was held in contempt by the staff for just showing up and giving them my business?” She noticed later that the visit was billed as 30 minutes.
From Remark-ology (2025). Account as told to the author; CMT did not review the bill.1
Michael Tetreault’s wife completed 20 minutes of paperwork before an optometry visit. At check-in, staff pushed a $39 cash add-on. She said no. At checkout they charged it anyway: “Well, you signed the form.” After she pushed back, they removed it, then mentioned that her insurance would have covered it.
Every scene before and after the exam was an obstacle. Guess which part of the visit she still talks about.
From No More Waiting Rooms (2024).4
Go and see for yourself
Toyota calls it genchi genbutsu: understanding a situation by confirming the facts yourself, where the work happens.5 You can’t map a patient journey from your desk.
Walk it cold
Arrive as a patient would. Park, find the door, wait in the lobby, sit in the exam room for ten minutes alone. Write down every question that pops into your head.
Walk it with two patients
Invite two members to walk the journey with you and narrate what they notice. Their words are your map.
Mark the handoffs
Circle every point where responsibility passes from one person to another. That's where most broken scenes live.
Fix one scene a month
Pick the scene with the most friction. Fix it for every patient. Then move to the next.
- Print the 13-scene table and give one scene to each team member to own.
- Sit in your own exam room for ten minutes with the door closed. What do you see, hear and wonder?
- Ask your next three new members which scene surprised them most, good or bad.
Once your journey is ready, plan how new patients will find their way to scene one.
Free. No sign-up. Your answers stay in your browser. Step 3 of CMT's Learn, Build, Lead tools. It helps you pick the patient segments that fit your practice, find where they are, plan conversations with local physicians, check that your message sounds like care rather than a pitch, and leave with a 90-day plan.
This brief is educational. Changes to intake, privacy practices, billing or physical space may carry legal, accessibility or compliance requirements; check with qualified advisers.
Scenes, not tasks
See the visit the way the patient lives it.
Fix the handoffs
Problems hide between jobs.
Go and see
Walk the journey yourself, then with patients.
How this brief was built
The thirteen scenes come from CMT's Remark-ology (2025). This brief also draws on a 2023 scoping review of patient journey mapping (Journal of Advanced Nursing), a Disney Institute article on service design, a Lean Enterprise Institute definition, and stories from CMT's books. The "ally move" column in Part 2 is CMT original guidance, not tested interventions.
How to read the evidence types
Every key finding is labeled by evidence type. Labels describe the type of evidence, not its value. Each type answers different questions. Funding is disclosed on every source.
Randomized trials and systematic reviews.Best for cause and effect.
Large observational studies and government data.Best for trends at scale.
Surveys, smaller studies and expert consensus.Best for real-world experience.
Company-sponsored or company-reported data that is not peer-reviewed.Best for early signals and operating data.
Statutes, regulation and official guidance.Best for what is required.
What we don't know
- Which scenes matter most to concierge patients specifically; no published concierge journey-mapping study was found.
- Whether journey mapping improves retention or referrals in small practices; most published studies describe hospital or specialty services.
How to cite this brief
External review: this brief has not yet been reviewed by an outside expert. When review is complete, the reviewer is credited by name above with any conflicts of interest, and the version number is updated. Reviewers check accuracy and fairness; CMT is responsible for the final content.
Corrections policy: when an error is identified, CMT corrects it in the open and updates the version number above. Send corrections to the editor through conciergemedicinetoday.net.
Related CMT Research Briefs
References
- Tetreault M. Remark-ology: Creating a Remarkable Patient Experience Worth Remarking About to Others. Concierge Medicine Today, LLC; 2025.Funding: Concierge Medicine Today (self-published; no outside funder) CMT original
- Davies EL, Bulto LN, Walsh A, et al. Reporting and conducting patient journey mapping research in healthcare: a scoping review. Journal of Advanced Nursing. 2023;79(1):83-100. 81 articles reviewed. digital.library.adelaide.edu.auFunding: not stated
- Jones B (Disney Institute). What your business can learn from Disney's Jungle Cruise. Inc. January 31, 2017. www.inc.comFunding: industry (Disney Institute, a Disney training business)
- Tetreault M. No More Waiting Rooms: A Customer Service Road Map to Help Remarkable Medical Offices Navigate Their Way Towards an Irresistible Practice Where Gratitude Is on Repeat. Concierge Medicine Today, LLC; 2024. Stories are the author's own experiences and accounts told to the author.Funding: Concierge Medicine Today (self-published; no outside funder) CMT original
- Lean Enterprise Institute. Lean lexicon: genchi genbutsu. Accessed October 2026. www.lean.orgFunding: not stated (Lean Enterprise Institute, a nonprofit)
Educational and informational only. This CMT Research Brief does not constitute medical, legal, tax, financial, accounting or other professional advice, and it does not create a professional relationship of any kind. Statements about laws, regulations, tax rules and payer policies are general, may not reflect the rules in your state, and can change after publication. Consult a qualified attorney, accountant, tax adviser, compliance professional or licensed clinician before acting on anything here.
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