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Aug 14 2014

Top Doctors and Best Hospitals – for a Price

You mostly see them in airline magazines. But sometimes I see a banner or badge on a doctor’s website, or even a hospital’s billboard.

Big proclamations they are!  Dr. Horatio P. Speshultee is a TOP DOCTOR as ranked by some organization or another.  Or ST. HARELDA’S HOSPITAL has been ranked #1!

Oh really?  Says who?

And, fellow patients, THAT is the key.  WHO SAYS and HOW MUCH THEY PAID FOR THE RANKING is the most important part of all of this.  Because if you are choosing hospitals or doctors based on such labels, the label originator and its purpose will have a huge impact on your ability to get the care you need.  Making bad choices based on the wrong assumptions can only be trouble.

I raise this today after reading this piece in the New York Times, Top Doctors, Dead or Alive.

The author, Abigail Zuger, MD reviews an invitation to her 16-years-long-dead uncle to be considered a TOP DOCTOR ranking.  Maybe he was a good doctor when he will still alive, but… ?  A little suspect at the least.

I’ve seen these sorts of invitations before. I get them from some company called “Who’s Who” – I can be a Who’s Who in all kinds of great things – from business to marketing and maybe even patient empowerment (although I haven’t seen that one.)  It’s a company that produces directories for those with an ego.  If you fill out the paperwork, and pay a sum of money (not usually more than $79 or $89) then you TOO may be listed in that directory and get your very own copy of it!

Please note – no one is vetting this list. No one is looking to see if any real accomplishment is tied to it.  You pay your money, you show up in the book.  And you get to list all your accomplishments, dubious or not, true or not. These companies have been in business for decades, hawking their flattery and reeling in the profits. I can only think that it’s intent is solely to stroke egos.  But hey – if it pays the bills…  who am I to ask questions?

Well – maybe I’m exactly the one to ask… because when it comes to proclaiming these doctors are any good…. well then….

Therein lies the rub. With no actual vetting taking place, and without knowing who WE are and what WE need, how can anyone claim these doctors to be at the top? And, frankly, at the top of WHAT?  The top of the list of doctors who make the most money?  Or have the biggest egos?  Or do the most facelifts?  or?  TOP doesn’t tell me a darn thing.

And yet, there are patients who fall for the hype every day.

Now, we Who’s-Not-Whos don’t usually see those directories (they look impressive on the doctor’s bookshelf), but we actually do see the results of similar efforts in magazines. TOP DOCTORS, TOP PLASTIC SURGEONS, TOP STEAKHOUSES… we’re impressed, right?

Don’t be too impressed. At least not until you figure out how the rankings were done, and what the standard for “top” is, and maybe even most important, whether that “top” designation was simply based on whether or not a check was written. You’ll need to check out the fine print to see who sponsored the ranking, and what had to happen for that label to be publicized.  Then decide whether or not you want to believe it.  You might be surprised to know that some of the biggest names in websites and magazines that provide these TOP designations display their choices based on advertising dollars paid.

For me – I see egos all over those faces. I don’t see excellence, and I don’t see anyone who is focused on his/her patients or their outcomes. I just see someone who wrote a check to someone else who would promote the label on their behalf.

And I’m not buyin’ it.

Here is more information on researching the best doctors for you.  (And note, no TOP designation is required.)

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1 comment

  1. Dr. John Connolly

    A note from Dr. John Connolly, President and CEO of Castle Connolly Medical Ltd.
    __

    Doctor Zuger writes so well, it is difficult not to be seduced by what I believe is her failure of logic. She states “…that I do not have a clue what makes a top doctor, let alone how to find one.”

    If that is the case, to whom does she refer her patients? Does she just pick a name out of a plan directory or respond to an ad as many patients do? I doubt it. If she is like most physicians, she refers her patients to doctors whom she believes are among the very best – at least I hope so.

    During my ten years as president of a medical college, I learned that physicians generally know who are the best doctors, those who are well trained, have sharp, up-to-date clinical skills, care for patients well and do not have problematic malpractice or disciplinary histories.

    That is why Castle Connolly surveys physicians extensively, many tens of thousands in fact, asking them who are among the best in their communities and the nation. That is why our physician-led research team screens the education, training, hospital appointments and disciplinary history of every physician nominated by his or her peers to be included as a Castle Connolly Top Doctor.

    Is it a perfect system? No, and that is why we offer a descriptive narrative explaining to people how we believe they can identify excellent doctors. Do we “know what goes on when they are closeted with a patient who drives them nuts” or when they are “running late and have theatre tickets”? Interestingly, often their colleagues do know, but not always. Nevertheless, the kind of research we do and the kind of research patients can do on their own clearly will result in the ability to identify physicians who offer more than having a valid license or not being in jail.

    What I find most distressing about Dr. Zuger’s piece is her conclusion that “we are left with only a single unarguable definition of a top doctor: one who is not on the bottom.” Following that logic, one would believe that all of the residents Dr. Zuger mentions were of the same intelligence, skill and dedication with no distinguishing traits of future excellence; that it makes no difference who a patient selects to treat their cancer, operate on their back or perform a delicate surgery on their brain tumor; that it makes no difference in what hospital they practice, or whether or not they are board certified, or what their level of training or experience is, as long as they are not “at the bottom.”

    Does any physician or patient believe that? I doubt it. At Castle Connolly we believe, and are committed to, the principle that “top doctors make a difference”.

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