Monday, June 27, 2011

Anger, Outrage, and Concern Over Stealth Survey of Physicians

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 to request appointments to see how difficult it is for people to get care when they need it.

Robert Pear, “Stealth Survey To Test Access to Physicians,” New York Times, June 27, 2011

June 27, 2011
– The Obama administration is at it again- investigating doctors and questioning their motivations in treating patients.

In a "mystery shopper survey,", announced today, Obama officials have contracted to have the National Opinion Research Center in Chicago firm call offices of 4,185 doctors in nine states to see if the doctors will accept patients with Medicare, Medicaid, private insurance or “self-pay.”

Never have I seen the level of anger, outrage, and concerns among physicians over this proposal. Doctors say, among other things, that this study;

- is a prelude to forced participation in Medicare and Medicaid programs,

- smacks of a police state mentality,

- is anti-democratic,

- government itself created the primary care shortage through CMS coding practices of paying specialists more,

- shows a bias against private practice,

- is just plain silly.

I belong to the school that says the proposal is silly. Anybody with an ounce of sense knows the reasons why doctors turn away patients on government programs - Medicare and Medicaid pay significantly less than private plans, often so little that practices cannot meet expenses; the hassle involved in seeing patients gaining payment saps time, energy, and profits out of practices; and the proposal is simply further evidence of the government's altitude and attitude problems.

Because of their elevated status, government reformers are too far removed for the clinical trenches, and because of their attitude that government, not doctors and patients, knows best, reformers see a beautiful growing forest, not ugly fallen trees.

Besides, what would the stealth proposal data reveal? That doctors are engaged in some clandestine plot to undermine the health reform law, that doctors are acting in their own self-interest to survive as small business people, or that they are overloaded with current patients and have no more room for the proposed flood of low-paying government patients.

I do not know, but the proposal strikes me as another PR black eye for the Obama and Democratic health law. From the physicians’ point of view, the stealth program is ham-handed, insensitive, and inappropriate.

For President Obama and the Democrats, the stealth proposal may be prompted by recent polls. In Massachusetts, whose health plan is often cited as a paradigm for Obamacare, 53% of family physicians and 51% of internists do not accept new patients, and waiting times are 36 days to see family physicians and 48 days to see internists. Three national polls in June indicate 37.7% of Americans favor Obamacare and 52.3% oppose it, a 14.6% margin of opposition.

Surely, the reasoning in Washington may go:the fault for doctors not accepting new patients must lie with the doctors, not with the health reform plans. What's good from the government's point of view must be good for patients. Surely, low reimbursements,unwieldy bureaucracy barriers, and overwhelming practice loads could have nothing to do with it.


BobbyG said...

Have to agree on this one. Why not take it a step further and send in what would be in the lab called "QC blind matrix spike" patients to compare the docs' dx's with the mystery patients' known clinical problems?

contactos barcelona said...

It won't work in actual fact, that's exactly what I suppose.