Wednesday, July 25, 2012

"Best Doctors In New York" - Are They Really "The Best?"

New York Magazine, Castle-Connolly, U.S. News and World Report - all, and I'm sure many more, increase readership by creating lists of "The Best Hospitals" and "The Best Doctors."

As a physician let me caution you about relying solely on such information.  Though U.S. News and World Report gathers rather good statistical data on which to base its hospital rankings, this is not at all true for lists of "Best Doctors."  No real evaluations go into these lists - these "Doctor" lists rely almost exclusively on surveying physicians themselves and asking the respondents to recommend physicians they personally would favor.  So, "I'll be happy to recommend you, if you recommend me" is one way to claw your way onto these directories - directories which lead to increased referrals and plaques for the office (if you purchase them!)

As I read these lists I see many physicians with whom I am rather familiar - and I also note others who are missing!  There are quite a few "missing," very highly regarded practitioners of their specialty, whose absence astounds me!  And, of course, quite a few of the "best" hardly qualify for such acclamation.  I have had personal acquaintance with some of these "featured" physicians who, in my opinion, are mediocre at best.

If you are searching for "the best"physician,  rest assured there is no "one best."  But there are many who are excellent, many who are just OK, and those who are adequate, if not worse - and everything in between.  Lists include them and exclude them - no matter what the level.

So what to do?  A problem, for sure.  Your best chance to find "one of the best doctors" is by researching the highly-regarded academic medical centers in your area or in an area within reasonable geographic proximity.  In searching for the "right" physician, check to see how active and successful the center is in his/her specialty and if the facility has an approved training program within the specialty.  Find a physician on that faculty and review his/her training.  Physicians' (including surgeons) most critical education is acquired during the residency and post-residency (fellowship) years.  A residency in a highly-regarded university teaching program is usually the most competitive, graduating well qualified practitioners.  Ideally, the physician or surgeon should have completed his training at least five years prior to your consultation.

When consulting a physician in a non-surgical specialty, it often helps to see if he is affiliated with a well regarded institution whose faculty includes skilled surgeons in his specialty.  Patients may require surgical consultations and/or surgical procedures.  If this is the case, finding a major medical center where both referring physician and surgeon have privileges can be very advantageous.

What you have here is my opinion - I have no statistical data to support these recommendations.  But there is data that show that morbidity (complications) rates and mortality rates are lowest at centers with high volume in a particular specialty - and these centers are almost universally those described above.

Full disclosure - I have been on lists of "Best Doctors" and have also been excluded from some.

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