----------------------------------------------------------------------------
'Mystery patients' go undercover to check out medical care
----------------------------------------------------------------------------

WASHINGTON (October 3, 1997 3:15 p.m. EDT http://www.nando.net) -- Dave
Gorden was just another guy with uncooperative veins to a hospital worker
who had trouble drawing blood at his bedside. She had no idea he was a spy.

After she finally obtained a vial of his blood, the worker accidentally
tossed it into a can of used needles and other medical waste and then
dumped the can into a sink to retrieve the blood sample. She left the mess
behind for Gorden to clean up.

It could not have happened to a worse -- or better -- patient.

Gorden was a "mystery patient," hired by the hospital to feign illness and
assess the way its patients are treated.

"It was a frightening experience," he recalls of the shock he felt at the
experience. "I sat there for a half-hour before I could even move."

With hospitals, doctors and others in the health-care industry vying for
patients in an increasingly competitive medical marketplace, small but
growing numbers are spying on themselves to see how they can improve.

Some faux patients go right to the brink of surgery as they test the
strengths and weaknesses of a hospital or doctor's office.

Sending in "mystery shoppers" is a common research technique for stores,
banks, restaurants, even amusement parks, but the ruse is more difficult to
pull off in a hospital.

Not just anyone can check in.

And not just anyone is willing to be prodded, poked with needles and
X-rayed all for the sake of research.

"It's not like sending someone to Burger King or McDonald's or
Nordstrom's," said Barbara Gerber, a consultant who runs a national network
of mystery patients and goes undercover herself. "It's very, very complex
to do it in a hospital."

Patients must be able to fake the right symptoms; phony lab results may
need to be prepared; a doctor is usually in on the scheme to ensure the
incognito investigator will be admitted.

In one case, Gerber went all the way up to the point of outpatient surgery
before the doctor (who was part of the plot) made up an excuse to cancel
the procedure, saying Gerber had drunk orange juice that morning.

Other experiences are more mundane.

Gerber, president of Devon Hill Associates in La Jolla, Calif., recalls
being forced to stand for nearly half an hour in a leg cast while she
checked in at one group practice.

"They really had no way to register me sitting down," she said. "Those
little things, they're the things that make people angry."

Mystery patient Suzanne Boswell's specialty is scoping out dental offices.
Her promotional brochure shows her wearing a Lone Ranger-type mask to avoid
blowing her cover when she arrives for a check-up or other dental care.

"I've got REALLY clean teeth," says the Dallas-based consultant. "I've had
'em straightened. I've had 'em whitened. I've had 'em bonded."

Still, she goes back for more, a secret microphone taped to her chest. (She
brings her own X-rays to avoid overexposure to radiation.)

Hospitals and doctors say that having mystery patients test their service
helps administrators understand how patients feel as they work their way
through the often bewildering health care system.

For example, Gorden's visit at Bradley Memorial Hospital in Cleveland,
Tenn., brought new attention to little things -- like making sure aides
turn patients' wheelchairs around in the elevators so they are not stuck
facing the wall.

"The small things mean so much," said Bradley's marketing director, Dewayne
Belew. He called Gorden's visit "the sentinel event" in a successful effort
to improve the hospital's service.

Consumer advocates say they do not know much about mystery patients, but
they welcome the idea of medical professionals trying to find out more
about how patients feel.

"It's a good check for the health-care system," said Geri Dallek of
Families USA, a consumer group.

Rick Wade, a spokesman for the American Hospital Association, said mystery
patients can provide useful -- but limited -- information.

"You can never truly have the point of view of the patient," he said.
"You're missing the most important factors: pain, discomfort and fear."

Still, Wade said, the undercover investigators can offer insights on
"hotel-type" issues such as courtesy, food and responses to special requests.

The experience does not come cheap. Gorden, who's been a mystery patient 50
times over the past 15 years, charges $12,000 to $15,000 for what is
usually a three-day hospital stay.

Mystery patients report they have little trouble maintaining their cover,
but Gorden did find himself on the receiving end of the deception once when
a doctor tipped off the radiologist that he was a fake patient.

The radiologist decided to play a trick on Gorden and told him there was a
suspicious spot on one of his X-rays.

"Yes, I was a mystery patient," Gorden said, "but that's not funny."

By NANCY BENAC, The Associated Press
Copyright 1997 Nando.net
Copyright 1997 The Associated Press
<http://www.nando.net/newsroom/ntn/health/100397/health23_20049_noframes.html>
----------------------------------------------------------------------------

[log in to unmask]