Taking the Mystery Out of the Patient Experience

It wasn’t long ago that I frequented the movies courtesy of a national theater chain, complete with admission passes and discounts on popcorn and soft drinks. I was a mystery shopper, and completed forms after every theater visit that provided the national chain with valuable information on the service provided by the hired help. In short, the powers-that-be wanted to know about my movie-going experience, and what they could do to make it better.

Mystery shoppers are common in today’s marketplaces. They’re less common in the world of healthcare, but they’re a growing trend.

“We are definitely seeing an increase in acceptance,” says Kristin Baird, RN, president of Baird Consulting, which uses mystery shopping extensively to help healthcare organizations and physician practices improve their services. “And often it’s physician-owned practices that are calling us, because they’ve got a vested interest in the success of the organization.”

Obtaining valuable information

Drew Stevens, PhD, head of Stevens Consulting Group, says that whereas patient surveys provide one-dimensional statistical feedback, mystery shoppers provide qualitative commentary on how they were treated from the moment they walked through the practice’s front door until they left the facility.

“There’s data that supports the fact that if people are given the opportunity to fill out a survey, they’re usually rushing through it,” Stevens explains. “And they’re rushing through it either to get an inducement, if an inducement is offered, or simply because they’ve submitted to completing the survey but typically feel it’s a waste of time.” In contrast, mystery shoppers provide a broader, more complete view of the patient experience.

And that experience starts even before patients walk in the front door. According to Baird, it’s important to understand the patient experience from the moment they make the initial phone call to schedule an appointment. In addition to a regular itinerary of questions, Baird asks mystery shoppers two key questions following their appointment-scheduling phone call: Based on the phone encounter, how likely would you be to pursue your personal care with this practice? And, how likely are you to recommend this practice to others?

“We have found that in some situations, as much as 45 percent of our mystery shoppers say they wouldn’t pursue care at that practice based on their phone encounter,” Baird explains. “That’s significant for these doctors who are trying to build a practice.”

Beyond the negatives

There’s a tendency on the part of skeptics to think that mystery shoppers are only employed to uncover the negative aspects of a patient experience. But according to Stevens, that’s not the case at all.

“You don’t want to just fix errors,” he says. “The whole notion of patient shopper is not to fix the flaws as much as it is to heighten the experience for the patient.”

Baird explains that she is often contacted by practices that want another method of being able to coach some of their physicians who are having trouble with patient satisfaction. But in some cases, the mystery shopper has quite a different experience. One shopper said she wished she lived closer to the physician because she would transfer her care to him without hesitation. She noted, “He would sit and talk with me in a manner I could understand. He made me feel like he respected my opinion.”

Says Baird, “Yes, [the physician] performed low in some areas, but he sat down. He made eye contact. All those things made for a positive provider encounter. So, we said he’s doing a good job; let’s capitalize on his strengths.”

The human experience

Baird says that because patient satisfaction surveys have become the norm in healthcare, many practices think they understand their problems; understand why patient satisfaction scores are low in certain areas. But, she adds, that’s not always the case. It gets back to understanding the entire patient experience.

“Just because we silo departments in healthcare doesn’t mean that the patient silos the experience,” she explains. “The patient doesn’t silo it out and say, 'You met my needs on the telephone but not with registration.' It’s bundled, because it’s bundled to them. You do or you don’t meet their needs, and not every one of those touch points is created equal.”

And, says Stevens, merely obtaining information from a mystery shopper program is not sufficient. The next question is, what are you going to do from an accountability perspective?

“Forget about reading x-rays,” he suggests to physicians. “Now you need to read your people. How are you going to hold them accountable for the observed behavior? It’s up to the physician to create a sense of accountability for everyone. If you want change, you’re going to have to institute it.”