Doctors Tested by Undercover Patients

June 16, 2008 11:25 AM
by Shannon Firth
The American Medical Association ponders the ethics of using “secret shopper” patients to evaluate doctors.

30-Second Summary

Many hospitals and clinics use undercover patients to evaluate physicians and staff, much as retailers use “secret shoppers” to assess salesclerks. At an upcoming meeting, the American Medical Association (AMA) House of Delegates will decide whether to endorse the controversial practice, with several preconditions

Dr. Richard Frederick of the University of Illinois College of Medicine challenged the American Medical Association to re-examine the issue of secret patients. In Virtual Mentor, the AMA Journal of Ethics, Fredericks describes “sham patients” visiting congested emergency rooms feigning chest pain. He asks, “How could the hospital administration defend this exercise to someone who suffers an adverse outcome while waiting his turn behind the person who is only pretending to be sick?”

However, evidence of improvements following undercover studies at Beth Israel Deaconess Medical Center in Boston can’t be ignored. In two years, the center shortened the wait for an appointment from 12 days to three, enhanced communication with patients, and improved attention to patient privacy; customer service ratings also “jumped from 2.6 (fair) to 4.8 (excellent).”

In a March 2008 report, Canadian researchers uncovered gender bias among physicians who were consulted by male and female secret-shopper patients with “moderate knee osteoarthritis as close to identical as could be found.” Each met with 38 family doctors and 33 surgeons near Ontario, but the male patient was far more likely to be referred for surgery.

In 1993, Dateline NBC was widely criticized for broadcasting a segment featuring an undercover patient seeking treatment for cataract surgery; the eye center’s attorneys characterized the approach as “entrapment.” 

Headline Link: Is using undercover patients ethical?

Opinion & Analysis: The viability of undercover patients

Related Topics: Undercover patients on TV; exposing gender bias


Most Recent Beyond The Headlines