Harley Street Secrets

I didn’t expect the violent reaction that followed my last post about companies posting fake messages on web forums, because I thought that was a quite an obvious and known practice (even if I now understand that the topic was never discussed before anywhere on the web). I like the idea of companies spending their time playing around with innocent pastimes (“In the advanced state of society, therefore, they are all very poor people who follow as a trade what other people pursue as a pastime” – Adam Smith, The Wealth of Nations, 1776), trying to improve the image of improbable cosmetic surgeons or writing nasty comments about each other.
This time, I should talk about mystery shopping, a legitimate business practice that commercial cosmetic surgery companies obviously conduct in their very own rough way. In practice, mystery shopping is about testing the competition with a secret shopper, that will have instructions to investigate the service, the efficiency, the friendliness and the ability to deal with atypical scenarios of a specific business (you can read more about mystery shopping on Wikipedia). There are registered companies providing mystery shopping services, but in general cosmetic surgery companies would avoid them, convinced as they are that they can do better by themselves. As a consequence of this, nurses or ‘friendly’ coordinators would be moved from Watford to Leeds or from Birmingham to London to have a consultation for a breast enlargement that will never happen with another nurse or coordinator they must have never seen before. In the average busy day of any company, the secret shopper will mix with the normal patients, and will get the normal, useless free consultation whose only reason to exist is to find out if a specific patient has really got the money to pay for the operation. It is not unusual for a secret shopper to end up in front of a surgeon, showing her breasts and trying to enter the unusual scenario that was planned in advance, asking, for example, what that surgeon would think of a particular brand/shape of implants that the poor guy could never have available at that specific company he is working with.
I suppose that mystery shopping in cosmetic surgery may account for about 2% of all the free consultations provided (this is based on an article about mystery shopping in healthcare published by the Wall Street Journal), so your chances of being in the same waiting room with a ‘fake’ patient are quite high. In this case, you must remember that, according to the quoted article on the Wall Street Journal “shoppers resort to hiding tape recorders in their bags, jotting details down in appointment books or crosswords, and going to bathrooms to take notes“.
Is this ethical? Probably not. The American Medical Association states in this report that: “Physicians and staff should be informed before a secret shopper program is instituted, and a time frame for when a secret shopper may visit their practice should be given, and physicians should have the opportunity to review the feedback that is generated from an evaluation“, and I’ve never seen any of these measures being taken. Also in the same document: “The confidentiality of the other (bona fide) patients may also be a concern when secret shopper “patients” are employed as these individuals are trained to observe listen to the conversations of medical staff and are thus more likely to overhear confidential information“: is the Healthcare Commission aware of this and of mystery shopping in general?
Mystery shopping is an innocent pastime, but do you really want to have your consultation next to a shopper, or with somebody trained to sell in such a way?