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Is a "Mystery Shopper" Coming to Your Waiting Room?


Retailers and hotel chains have long employed "mystery shoppers" to gauge how well their customers are treated. Now regulators want to take the same approach to determine whether access is a problem for new patients seeking out primary care physicians.

Retailers, hotel chains and financial-services firms have long employed “mystery shoppers” to gauge how well, or poorly, their customers are treated. Now federal regulators are considering taking the same approach to determine whether access is a problem for new patients seeking out primary care physicians.

“The Office of the Assistant Secretary for Planning and Evaluation (ASPE) is requesting Office of Management and Budget (OMB) approval to use the mystery shopper approach to collect data from PCP offices to gain insight into the precise reasons that PCP availability is lacking,” according to a report in the Federal Register. The Department of Health and Human Services will take public comments on the issue for 60 days.

The agency plans to send out mystery shoppers to 465 primary care doctors in nine states, according to the Federal Register. Each office will be contacted twice: One mystery shopper will be privately insured, and one will be insured under Medicare or Medicaid. The scenarios will simulate patient requests for appointments with either an urgent medical concern or routine exam appointment. The study will implement a standard protocol to ensure that the key research questions are addressed and the necessary standardized information from the calls is collected, the report said.

Additionally, the same physician across all the nine states will be contacted a third time using a direct-questioning approach. They will be informed about the study and asked directly if they are accepting new patients and how long it would take to obtain an appointment. The purpose of this additional data collection component is to evaluate the validity of the mystery shopper approach in generating accurate estimates of physician availability and timeliness of services, the proposal states. The data are expected to be collected and compiled within four months of the proposal receiving clearance.

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