“Secret shoppers” in the doctor’s office

Members of the American Medical Association would like to keep “secret shoppers” — or people pretending to be patients so that they can assess something about a physician’s visit — out of the doctor’s office. The physicians have a point. Physicians are strapped for time and put considerable cognitive and emotional energy into each patient visit. Each “secret shopper” visit (or, let’s call it what it is — an unnecessary, pretend visit) takes up resources and time, and may not even be reimbursed.

I wouldn’t believe for a second an insurance plan “rating” of a physician or physician’s office. Most of the ratings that do exist are based on primarily economic criteria, such as saving money through fewer referrals to specialists. The argument that secret shopper patients might be able to assess the quality of a physician’s practice is a thin one. The receptionist’s telephone manner and time spent in the waiting room are absolutely not proxy measures for quality. Even the claim that secret shoppers will assess how physicians manage relationships with patients is utterly ridiculous. Relationships with patients are something that become established over time, as a physician continually sees the same patients and works with them to address health care concerns. A secret shopper who calls a few times and pops in once or twice can’t begin to assess a practice’s overall performance in this area.