Medical Spies Check In to Check Out Care

WASHINGTON —  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 patients are treated.

“It was a frightening experience,” he recalls of the shock he felt that day. “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 everyone is willing to be prodded, poked with needles and X-rayed for the sake of research.

“It’s not like sending someone to Burger King or McDonald’s or Nordstrom,” 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 that 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, recalls being forced to stand for nearly half an hour in a leg cast while she checked in at one medical 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.

“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 tiny microphone taped to her chest.

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.

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