Govt. Wants 'Mystery Shoppers' to Probe Docs About the Ease in Getting an Appointment
Proposed program would survey more than 4,000 docs about ease in getting appt.
June 28, 2011— -- In an effort to understand why some research has found that as many as 60 million Americans can't get primary care physicians, the federal government is considering using "mystery shoppers" to investigate whether primary care physicians are accepting or rejecting new patients depending on the type of insurance they have.
According to Christian Stenrud, a spokesman with the Department of Health and Human Services, "understanding access to primary care is a priority of the administration." One of the biggest obstacles is a shortage of primary care physicians.
"Primary care providers are critical to help us meet our goal of ensuring everyone has access to affordable, high-quality health care," Stenrud said.
A government document describing the program says if it's instituted, staff from the Office of the Assistant Secretary for Planning and Evaluation will call 4,185 primary care physicians in nine states. Each office will get two calls -- the person on the phone will act as a prospective new patient with private insurance and at a separate time, as new patient with public insurance. Callers will say they either have an urgent medical need, or request a routine examination.
Later, physicians will get a third call that asks doctors directly whether they are accepting new patients, and how long it takes to get an appointment. That call will also tell doctors about the "mystery shopper" program. While Stenrud didn't address the program's cost, The New York Times, who first reported the mystery shopper proposal, said the first surveys would cost around $350,000.
Before the program gets under way, the government is inviting feedback from doctors and patients.
ABC News asked a number of primary care physicians and health policy experts for their thoughts on the government's "mystery shopper" initiative. The responses varied, with some experts saying the program is deceptive and others saying the findings could be useful.
The American Medical Association is 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.
"No deception is necessary. Just ask: 'Do you accept Medicaid patients?' said Dr. Daniel Blumenthal, associate dean for community health at Morehouse School of Medicine in Atlanta.
Patients with Medicare can generally get appointments, experts say, because Medicare pays physicians more than Medicaid does.
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