Is the right doctor for you on a list of 'best' doctors?

By Virginia Linn, Health Editor, Post-Gazette

The cover of Pittsburgh Magazine's April edition is an attention-grabber: "The Best Doctors in America."

And it lists more than 300 "medical superstars" practicing in the Pittsburgh area.

I looked for the names of my doctors. Let's see ... family practice/internal medicine, nope, not listed. Ob-gyn, nada. Dermatology, another miss. Surely my kids' doctor in a very busy and innovative pediatric practice must be listed. Nope.

Well. Four strikes in four specialties. You'd think in my position I'd be able to pick them better.

Or, perhaps this list doesn't give you the whole picture -- which is the main reason why you won't find the same review in the Post-Gazette.

The list is published annually by Best Doctors Inc., a company based in Aiken, S.C., and Boston that develops a database of about 30,000 doctors in more than 40 specialties. It compiles the list based on recommendations from other doctors. They were asked: "If a loved one needed a doctor in your specialty, to whom would you refer them?"

UPMC Health System quickly trumpeted the results in full-page newspaper ads, noting that 75 percent of the doctors selected in the region were from UPMC. Even so, UPMC wasn't included in the "Best Doctors Premier Hospital Network" of 28 hospitals compiled by the company because of its high concentration of top doctors, services to international patients and dedication to excellence. Curiously, neither was Johns Hopkins Hospital in Baltimore, which is rated "best of the best" in the annual U.S. News and World Report magazine hospital review.

The Best Doctors list is more baffling for who's not on the list, than for who is. Dr. Marion Block, chairwoman of the Department of Family Medicine at The Western Pennsylvania Hospital, was selected as the 2001 Family Physician of the Year by the 4,800-member Pennsylvania Academy of Family Physicians. But she's not listed.

Dr. Paul Lebovitz, who's built a respectable gastroenterology and digestive health practice at Allegheny General Hospital -- and even traveled around the world looking for a remedy for irritable bowel syndrome -- isn't included. The local chapter of the Crohn's and Colitis Foundation named him the Healthcare Professional of the Year in 2000. Dr. Miguel D. Regueiro of UPMC, who was honored earlier this month as the foundation's 2002 Physician of the Year, also isn't on the list.

Neither is Dr. Carol Rose, a UPMC anesthesiologist and immediate past president of the Pennsylvania Medical Society.

And some of the well-known names in plastic surgery are missing: Drs. Leo McCafferty and Dennis Hurwitz (former president of the Allegheny County Medical Society), to name a couple. Yet Hurwitz is the only local plastic surgeon listed in another compilation: America's Top Doctors by Castle Connolly Medical Ltd.

Obviously, who's picked for any given list depends on who's doing the picking and what criteria they're using.

What Pittsburgh Magazine doesn't tell you is that the objective of Best Doctors is to help people who have very serious illnesses find a doctor with the most experience in treating their condition. "We've got about 5 percent of the medical profession in our database," said Suzy Tichenor, Best Doctors' vice president of business development.

"That doesn't mean that the doctor you're seeing is not the right doctor for your condition."

That's a critical point. Such a list is only one tool consumers should use in selecting a doctor. It won't tell you about the doctor's bedside manner, how efficiently he operates his office, how friendly his staff is, how accessible he is to patients and whether he listens to or considers a patient's input.

Even in this era of managed care, many of us still pick our doctors based on recommendations from our friends or neighbors. That's how I came to all three of my doctors and my childrens' pediatrician. And for the most part, those word-of-mouth referrals have held up.

I was amazed when my primary care physician spent nearly two hours with me during my first visit. She wanted to know what vitamins I took, whether I was taking calcium supplements, got regular mammograms, etc. Never did I feel rushed, and she kept encouraging me to ask questions. Based on what I read every day in health news, she seemed to be on top of the latest research and preventative health strategies.

The pediatric practice is busy, but I like that my kids' doctor has children about the same age as mine and he's going through the same development stages -- and challenges -- with them. He talks to my children, not down to them, about their school, hobbies and other interests. The office also has a half-hour, call-in consultation every morning with a doctor, which is helpful, especially to first-time parents who worry about everything.

These are qualities that often aren't recognized by peers, but are so important to consumers.

Even though Best Doctors Inc. includes family practitioners and general pediatricians, it's really designed as a guide for very ill patients and those seeking a second opinion.

"The more serious the illness, the more vigilant the consumer has to be in researching and pushing for an expert," Tichenor said. "Just as in any profession, the people that are the peak of their profession perform the job the most efficiently and cost-effectively. If you're going to the doctor who has seen the illness the most, you're assured of getting the right diagnosis up front and right treatment faster."

The Best Doctors list and various referral services are available on the Web, but for a fee. Its Web site, http://www.bestdoctors.com/, however, also includes at no charge a very helpful list of questions under each disease category that consumers should ask their doctor. "If he can't answer them, perhaps you should look for another doctor," Tichenor said.

The bottom line is you've got to find the doctor who's right for you -- someone you're comfortable with and who you can trust.