Doctors help foil government's 'mystery shopper' plan

July 25, 2011

According to a New York Times article, individuals, arranged by the federal government, were to pose as new patients, calling physicians' practices up to three times to ask for expedited appointments.

According to the article (see "U.S. plans stealth survey on access to doctors," June 26, 2011, http://www.nytimes.com/2011/06/27/health/policy/27docs.html), the individuals were to pose as new patients, calling on the phone up to three times. They were to ask doctors' offices for expedited appointments. Government officials said they wanted to know whether the "patients" received different answers depending on whether they had public or private insurance, or were self-paying. The purported goal was for the federal government to identify whether doctors' practices can accommodate the purported millions of people gaining health coverage under the Patient Protection and Affordable Care Act.

ONLY OPEN TO SELF-PAYING PATIENTS?

This doctor shoppers plan was just another straw that was breaking the medical camel's back. Compliance with government policies, risk of audits, electronic health record system mandates, the threat of Medicare and Medicaid reimbursement cuts, and private health insurance company precertifications, prior authorizations, and payment denials apparently aren't enough to chase physicians away from participation in risky programs. I thought perhaps the idea of fake patients calling physicians' offices would wake doctors into dropping all government and private reimbursement programs.

Then I received great news. In the face of blistering criticism from doctors and politicians, the plan was called off (see "Administration halts survey of making doctor visits," The New York Times, June 28, 2011, http://www.nytimes.com/2011/06/29/health/policy/29docs.html). However small, this victory is sweet because it lends credence to anthropologist Margaret Mead's notion to "Never doubt that a small group of concerned citizens can change the world. Indeed it's the only thing that ever has."

Now if only physicians can get together to tackle other key issues, we could return to patient care. We all need to work solely for patients, privately, securely, and effectively. Any takers? Anyone? How about everyone?

The author is a family physician in Mullica Hill, New Jersey. From the Board columns reflect the opinions of the authors and are independent of Medical Economics. Send your feedback to medec@advanstar.com
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