Jun 26, 2011
As we continue in what can only be characterized as a tumultuous time in healthcare the NY Times reports that the Obama administration is scheduled to role out a "secret shopping" program to investigate physician availability and whether there is any biased treatment against those with Medicare or Medicaid.
U.S. Plans Stealth Survey on Access to DoctorsBy ROBERT PEAR
Published: June 26, 2011
WASHINGTON — Alarmed by a shortage of primary care doctors, Obama administration officials are recruiting a team of “mystery shoppers” to pose as patients, call doctors’ offices and request appointments to see how difficult it is for people to get care when they need it.
The administration says the survey will address a “critical public policy problem”: the increasing shortage of primary care doctors, including specialists in internal medicine and family practice. It will also try to discover whether doctors are accepting patients with private insurance while turning away those in government health programs that pay lower reimbursement rates.
Federal officials predict that more than 30 million Americans will gain coverage under the health care law passed last year. “These newly insured Americans will need to seek out new primary care physicians, further exacerbating the already growing problem of P.C.P. shortages in the United States,” the Department of Health and Human Services said in a description of the project that it submitted to the White House.
Plans for the survey have riled many doctors because the secret shoppers will not identify themselves as working for the government.
“I don’t like the idea of the government snooping,” said Dr. Raymond Scalettar, an internist in Washington. “It’s a pernicious practice — Big Brother tactics, which should be opposed.”
According to government documents obtained from Obama administration officials, the mystery shoppers will call medical practices and ask if doctors are accepting new patients and, if so, how long the wait would be. The government is eager to know whether doctors give different answers to callers depending on whether they have public insurance, like Medicaid, or private insurance, like Blue Cross and Blue Shield.
Dr. George J. Petruncio, a family doctor in Turnersville, N.J., said: “This is not a way to build trust in government. Why should I trust someone who does not correctly identify himself?”
Dr. Stephen C. Albrecht, a family doctor in Olympia, Wash., said: “If federal officials are worried about access to care, they could help us. They don’t have to spy on us.”
Dr. Robert L. Hogue, a family physician in Brownwood, Tex., asked: “Is this a good use of tax money? Probably not. Everybody with a brain knows we do not have enough doctors.”
In response to the drumbeat of criticism, a federal health official said doctors did not need to worry because the data would be kept confidential. “Reports will present aggregate data, and individuals will not be identified,” said the official, who requested anonymity to discuss the plan before its final approval by the White House.
Administration officials said the survey would yield an enormous benefit to the government while imposing an extremely limited burden on doctors.
The new health care law includes several provisions intended to increase the supply of primary care doctors, and officials want to be able to evaluate the effectiveness of those policies.
Federal officials said the initial survey would cost $347,370. Dr. Hogue said the money could be better spent on the training or reimbursement of primary care doctors.
Most doctors accept Medicare patients, who are 65 and older or disabled. But many say they do not regard the government as a reliable business partner because it has repeatedly threatened to cut the fees paid to doctors treating such patients. Congress usually steps in at the last minute to avert such cuts.
In many parts of the country, Medicaid, the program for low-income people, pays so little that many doctors refuse to accept Medicaid patients. This could become a more serious problem in 2014, when the new health law will greatly expand eligibility for Medicaid.
Access to care has been a concern in Massachusetts, which provides coverage under a state program cited by many in Congress as a model for President Obama’s health care overhaul.
In a recent study, the Massachusetts Medical Society found that 53 percent of family physicians and 51 percent of internal medicine physicians were not accepting new patients. When new patients could get appointments, they faced long waits, averaging 36 days to see family doctors and 48 days for internists.
Source NY Times