Earlier this year, the American Medical Association took up the question of whether or not to endorse the use of medical mystery shoppers. Although they did not take a position on whether or not to endorse it, medical mystery shopping has been going on for a long time.
Jodi Manfredi, President of Examine Your Practice, recently shared information with other MSPA member companies about the ins and outs of medical mystery shopping. The information she presented about healthcare mystery shopping, and what secret shoppers need to know about it, is summarized here with her permission.
According to Jodi, the purpose of medical mystery shopping is not to judge clinical skills, such as whether the doctor made a good diagnosis or ordered appropriate tests, but to evaluate interpersonal skills. Mystery shoppers also report on the overall experience, from making an appointment, to the condition of the waiting room and office and the courtesy of the staff and health care professionals.
Although following the guidelines is important in every mystery shopping assignment, it is critical when doing a healthcare mystery shop. For example, the Health Insurance Portability and Accountability Act (HIPAA) includes strict legal requirements regarding privacy. Using a digital recorder or video recorder on a medical shop could be a violation of Federal law, if the shopper were to inadvertently capture information about another patient (e.g., get them on camera or overhear snippets of conversation).
Secret shoppers present with a condition that will not involve invasive testing. It is also important that the shopper not receive a prescription or sample medications.
In some cases, the mystery shop may simply be a doctor interview. Many real patients will make an appointment with a physician just to talk with them and decide if they want to select them as their doctor. Choosing a provider is hard enough without the added stress of illness when you are trying to do so.
One concern that has been voiced about doctors is that mystery patients crowd out patients who truly need care. Jodi stressed that if a mystery shopper is in a clinic, office or emergency room and a patient comes in needing emergency care, the shopper should leave.