Do we really need mystery shoppers in health care?

I was a little bit shocked by this AP item in the San Franscisco Chronicle (AMA to consider endorsing undercover patients)

Lori Erickson-Trump has faked headaches and back pain. She's had physicals and MRIs she didn't need and she gets paid for it,” all to evaluate the performance of doctors and their staffs.Hospitals and health clinics are increasingly turning to these undercover patients to grade the health care experience being offered.Now the ethics council of the American Medical Association is pressing the doctors group to endorse such practices. AMA delegates are expected to vote on the proposal, along with dozens of others, during their five-day meeting beginning Saturday.

I admit to being somewhat ignorant of the mystery shopping/undercover patient concept but my initial reactions are negative:

• Unnecessary tests and treatment can be dangerous and should be avoided
• Regular patients should be just as good as mystery shoppers as evaluating health care providers, especially if they are given a bit of coaching beforehand
• I don't mind if my doctors thinks I might evaluate them, but I sure don't want them to think I might be a mystery shopper faking my symptoms!
• By definition a mystery shopper lacks a relationship with the provider being evaluated. Therefore s/he can't assess important aspects of the provider's performance, such as continuity of care, communications with other providers and family, and so on. Just evaluating the initial encounter doesn't sound so great to me

We already have good patient experience surveys (especially in Massachusetts, through Massachusetts Health Quality Partners) and there are survey firms that can interview patients in more depth.Maybe I'm missing something but I think the AMA should say no to this idea and send the mystery shoppers back to the hotels, department stores and burger joints where they belong.