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'Mystery shoppers' will help government make healthcare diagnoses

June 27, 2011|By Marissa Cevallos, HealthKey / For the Booster Shots blog
  • A federal plan will have mystery shoppers call doctors' offices to try to schedule appointments; primary care is beleaguered by dwindling numbers of doctors and the increase of chronic illness.
A federal plan will have mystery shoppers call doctors' offices to… (Christine Cotter / Los Angeles…)

Spy, snoop, survey, assess, analyze, quantify — pick your favorite verb to describe the Obama administration's plan to send out fictitious patients, or "mystery shoppers," to try to get an appointment with a primary care doctor.

Under the plan, mystery shoppers will call doctors in nine states to try to schedule an appointment first posing as someone with private insurance and another time as someone with public insurance, according to the New York Times. The administration says it’s important to know how difficult obtaining access to care is, especially as the healthcare system braces for millions more Medicaid patients in 2014. But some doctors quoted in the New York Times article used words like “snooping” and “Big Brother” to describe the federal tactics.

The L.A. Times offers a look at what beleaguered primary docs are up against in an article Monday, “What happened to the family doctor?

It describes the demands on a doctors’ time this way:   

“It would take 10.6 hours a day for a physician to follow all the treatment recommendations for patients with 10 common chronic diseases, including diabetes, heart disease, high blood pressure, depression, asthma and arthritis, according to a 2005 study in the Annals of Family Medicine. That doesn't leave much time for a 6-year-old's school physical or his mother's brush with the flu.”

Patient-centered “medical homes” are one solution, the story notes, and some have already been funded by the new healthcare law. The article explains:

“It's an idea that germinated in the late 1990s as a way to provide patients more access to primary care — with longer office visits and office hours, more convenient electronic scheduling, a team approach to managing patients' health and more email and telephone contact with physicians.”

But such “homes” have implementation drawbacks — other ideas to lessen the burden on primary care doctors include more group visits and online consultations, and more support staff to take care of routine care. 

Whatever innovation comes out of the necessity to address the primary care shortage will be welcome, though hotly debated. 

And so will the tactics used to determine the extent of the crisis, such as “mystery shoppers.”

But it’s worth pointing out the survey method isn’t a new way of gathering information. Most recently, researchers from the University of Pennsylania posed as mothers and called clinics in Cook County, Ill., to make an appointment for a child, identifying themselves as having either public (Medicaid/Children's Health Insurance Program) or private insurance. They found that two-thirds of the public insurance callers were denied an appointment, compared with only 11% of those with private insurance.

healthkey@tribune.com

RELATED: More news from HealthKey

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