Secret shoppers in the waiting room

The New York Times Health blog posted a story about an American Medical Association proposal, now tabled, to put secret shoppers in hospital and doctors' office waiting rooms to monitor how patients are treated by office staff. Though secret shoppers are already used in some individual clinics and health systems, the AMA has tabled the idea because they are afraid it will distract from the medical care of actual patients.

You can find the article here: http://well.blogs.nytimes.com/2008/06/18/should-undercover-patients-check-up-on-doctors/

This whole concepts set off a heated discussions about the ethics of using "secret shoppers" when they may distract from the needs of real patients. But the real point is this: You wouldn't need secret shoppers to tell you what it is like to be a patient in a waiting room if patients thought they could communicate honestly with their physicians. There is a substantial power differential between physicians and patients. Patients are often afraid to complain for fear of offending their physician, or even fear of getting fired from their physician's practice. So many patients don't speak up. I don't believe the answers is to put secret observers in waiting rooms to observe and report on conditions. I believe the answer is to continue to pursue open, honest and substantial communication between patients and physicians, built on a relationship of trust. This will solve more problems than any mystery shopper can.