Tuesday, June 17, 2008

Calling all Shoppers

Recently, a panel of AMA delegates vehemently opposed the idea of using secret shoppers to evaluate customer service of medical practices. For those of you unaware of what a "secret shopper" is (via Wikipedia):

Mystery shopping is a tool used by market research companies to measure quality of retail service or gather specific information about products and services. Mystery shoppers posing as normal customers perform specific tasks -- such as purchasing a product, asking questions, registering complaints or behaving in a certain way -- and then provide detailed reports or feedback about their experiences.

According to the article, "the secret shopper concept is not being proposed to evaluate clinical skills but the way medical professionals manage relationships with patients, from the process of making appointments to such things as explaining billing practices." Of course, this shouldn't interfere with real patients and take up valuable resources. I'm sure there is a way to address this.

I do understand the slippery slope that this can create (this could be linked with those controversial physician ratings that have gained recent press). However, it is disturbing that a tactic designed to create a better patient experience is so opposed. We've all been there: dealing with a rude receptionist, not having a procedure fully explained, not knowing if insurance will cover it or not, inconvenient hours, not getting a follow-up phone call when promised, unknown lab results (even if they are normal) and this list can go on and on.

Interestingly enough, the University of Vermont's medical school is among schools utilizing a "Mania Day." "One part drama, two parts science as doctors-in-training test their diagnostic skills and bedside manner by assessing the ailments of patients played by real people..." This teaching and evaluation tool has been around since the 1960's and continues to gain in popularity and use. In fact, my NP education included performing pelvic and rectal exams on real live models (aka people willing to experience these extremely uncomfortable procedures in the name of education and training - I don't think I realized how much I appreciated with they did until now! A big thanks to them!). This was an invaluable exercise that helped me to prepare for the real thing. Fans of Seinfeld will remember the episode (The Burning) where Kramer & Mickey act out patient scenarios to medical students:

Our eyes met across the crowded hat store. I, a customer, and she a coquettish haberdasher. Oh, I pursued and she withdrew, then she pursued and I withdrew, and so we danced. I burned for her, much like the burning during urination that I would experience soon afterwards.

That, of course would be gonorrhea.

Ultimately, I believe this will all make for better patient encounters and possibly outcomes. I would ask those resisting this to just pick up the phone, try making an appointment for a routine illness and tell them that you are a new patient without health insurance. Let me know how far you get.

1 comment:

Jodi Manfredi said...


I appreciate your support of Medical Mystery Shopping and the bit of levity you've added to the topic.

As an owner of a Medical mystery shopping company I would like to point out the practice is also used quite frequently by specialty or “fee for service” practitioners such as plastic surgeons, ophthalmologists offering Lasik surgery, cosmetic dentists and dermatologists. They offer elective procedures and recognize the need and value in mystery shopping their facilities. This practice should not offend anyone as the shopper is there for a noninvasive consultation and cannot be viewed as endangering anyone or compromising the real patients' care. I’m fairly certain a face lift is not an emergency. These professionals have done their research and know for decades mystery shopping has proven to increase referrals, client/patient retention and reduce employee turnover.

Nursing homes and assisted living communities also employee healthcare mystery shoppers to tour the facilities and make observations. They recognize areas in need of improvement and record not only those items but are also looking for that exceptional employee and facility. Personally, in the event I would need a nursing facility for a loved one, I would take comfort in knowing they care enough to measure their level of resident and family satisfaction.

I agree with the recommendations of AMA Council on Ethical and Judicial Affairs. Experience healthcare mystery shopping companies understand their concerns and know mystery shopping in healthcare should be handled with care as it is very different than retail.