Program to Use Mystery Shoppers to Probe Doctors Scrapped

Proposal scrapped after public feedback.

ByABC News
June 28, 2011, 5:52 PM

June 28, 2011— -- The U.S. Department of Health and Human Services has decided against using "mystery shoppers" to investigate whether primary care physicians are accepting or rejecting new patients depending on the type of insurance they have.

"After reviewing feedback received during the public comment period, we have determined that now is not the time to move forward with this research project," an HHS official said in a statement.

Instead, according to the statement, the government would focus on improving access to primary care in other ways, including an emphasis on training new practitioners and encouraging providers to practice in underserved areas. The Obama administration is also working on a plan to offer better payments to providers.

The original government proposal describing the program said staff from the Office of the Assistant Secretary for Planning and Evaluation would call 4,185 primary care physicians in nine states and pose as prospectdive new patients, saying they had either private or public insurance. The purpose would be to determine if the doctors' willingness to accept new patients depended on the type of insurance.

ABC News asked a number of primary care physicians and health policy experts for their thoughts on the government's "mystery shopper" initiative. Many of the responses were negative and accused the government of spying and being deceptive.

The American Medical Association was strongly against the government's proposal.

"We know there is a physician shortage in this country that will only grow worse as more people enter Medicare and coverage is expanded to those currently uninsured," said Dr. Cecil Wilson, the AMA's immediate past president. "The government should be working to address this shortage so all patients can have access to the health care they need, rather than using mystery shoppers to tell us what we already know."

"Patients don't want the federal government sneaking around, trying to manipulate their doctors," said Richard Saltman, professor of health policy and management at Emory University's Rollins School of Public Health in Atlanta.

"It is almost laughable to think that our federal government would spend good money during these difficult times to see if we [primary care physicians] are putting up obstacles to deter Medicaid patients from making appointments in our practices," said Dr. J. Jacques Carter, assistant professor of medicine at Harvard Medical School in Boston. He said that repeated surveys indicated there is a growing shortage of primary care physicians for a number of reasons, including retirement and frustration over a seemingly endless amount of paperwork.

He acknowledged that some physicians do try to turn away Medicaid patients, which he called "deplorable," but said doctors get paid so little from Medicaid that it rarely covers the cost of providing medical services.

"All over the country, doctors are dropping out of poorly reimbursing plans," said Dr. Peter Lavine, an orthopedic surgeon and past president of the Medical Society of the District of Columbia.

Patients with Medicare can generally get appointments, experts say, because Medicare pays physicians more than Medicaid does.