Actors play patients. Using surrogate patients to look into private practice

The authors describe a prospective research design in which actors serve as surrogate patients; this approach can be used to study health care delivery in providers' private offices. A previously published study -- in which an actor with actual dental pathology played the roles of a heterosexual, a homosexual, and an intravenous drug user to learn how dentists would respond to a new patient who appeared to belong to a group at hgh risk for AIDS -- offers an example of the design methodology. The authors discuss the benefits and limitations of the design and note that the behavior of other health care practitioners can be examined using simulated patients. Using carefully selected and trained professional actors rather than untrained patients or students can increase the reliability of findings and protect the rigor of the research.