New Emphasis on Customer Service in Medicine

Scripts to follow

Barbara Gerber thinks there is not.

She is the founder and president of Devon Hill LLC, a La Jolla, Calif., firm that specializes in medical mystery shopping. Gerber, who sometimes sports disguises including a wig, has undergone lab tests and a mammogram. In her work for hospitals and medical practices from Montana to New Jersey, she gives detailed scripts to the two dozen people she regularly hires as sham patients and may send three people in to do a “shop” of the same place.

Gerber said she got the idea for medical mystery shopping after a bad experience as a hospitalized patient in the mid-1990s. She advises hospitals to alert their staffs in advance that mystery patients will be visiting “in the next weeks or months.”

“Once you tell the staff you’re doing it, it’s not really deceptive anymore,” she says.

While Gerber says that her shoppers do not routinely disclose who they are because it creates too much consternation, Jodi Manfredi, manager of health care client services with the San Diego-based firm TrendSource, said her contractors may reveal what they are doing if a patient comes in with an urgent problem.

Unlike Gerber, Manfredi said her contractors do not focus on care, but rather on experiences with the staff. “We focus on interpersonal skills, on doctors’ listening skills and whether they seem rushed,” she says. “Many patients will leave a practice because of the experience with the front office staff.”

Shoppers’ pay

Manfredi, who specializes in shopping dental and cosmetic medical practices, said mystery shoppers are paid anywhere from $25 to $200 per session, depending on the length or complexity of their assignment; hospitals and medical practices typically pay between $20,000 and $100,000 for a series of mystery shopping services, which include recommendations.

One hospital’s experience

At Beth Israel Deaconess Medical Center, a Harvard University teaching hospital in Boston that recorded nearly 700,000 outpatient visits last year, eight secret shoppers regularly assess staff performance by posing as patients on the telephone and in visits to its 51 waiting rooms.

The center employs its own shoppers, including those who telephone the hospital and have more than 100 scenarios they use—posing as a 55-year-old woman calling to make an appointment for a bone density test, a jogger experiencing heart palpitations who needs to see a cardiologist, and a woman newly diagnosed with invasive breast cancer who says, “I’m not sure what I’m looking for, can you help me?”

“We want to provide the kind of care each of us would want our own families to receive,” says Mark Zeidel, chief of medicine at the hospital and a champion of the program, which, he says, has “engaged our staff” and improved efficiency. “It is amazing how often calls get dropped and people can’t find the right person,” he says.

Shoppers get results

Hospital officials point to the tangible improvements they say are largely attributable to the use of mystery shoppers: Appointment waiting time has been cut from an average of 12 days to five, and telephone customer service ratings have improved. Waiting room ratings increased from 78 percent in 2007 to 90 percent in 2009; Zeidel says visits to outpatient clinics have increased 35 percent since the program was launched.

Sherry Calderon, manager of ambulatory services at Beth Israel, says: “I really feel like this kind of regular checking has driven change here that nothing else has.”

Sandra G. Boodman, a former staff writer for the Washington Post, writes regularly about health for the Post and Kaiser Health News.