Truth can be stranger than fiction, and for an investigative journalist covering the outrages of health care costs, ProPublica reporter Marshall Allen had a dream medical story call him on his phone: A well-known New York company reached out and told him he had been “honored” as one of the nation’s Top Doctors.
Not bad for a guy with an English degree from the University of Colorado and zero medical credentials, he reported in a recent, wry article.
He tried to explain to a saleswoman for the company how unqualified he was. But after a chat and after negotiating a “nominal fee” for his accolade — down to $99 from $289 — he bought a plaque and the right to promote himself as a specialist in “investigations” and a Top Doctor.
That’s a hoot, right? Allen wanted to know more. So he called John Connolly, founder of the company that puts out the Castle Connolly Top Doctor awards, who mocked him and said Allen shouldn’t be performing any surgeries. He reported:
Connolly said his company depends on nominations by physicians to identify ‘top doctors.’ The New York City-based company has a research team, he said, that checks the license, board certification, education and discipline history of each nominee. This is something that any member of the public could do on public websites maintained by regulators. But such checks would at least ensure someone like me wouldn’t enter the ‘top doctor’ ranks. Connolly believes it would be ‘very difficult’ to game the nominations but gave me a verbal disclaimer. ‘We don’t claim they are the best,’ Connolly said of his company’s honorees. ‘We say they are “among the best” and ones we have screened carefully.’
Allen provides a fun read about this marketing boo-boo but notes it underscores a real problem for patients: How do they find good doctors and how much credence should they give to designations of practitioners as super, top, and best. These terms, he notes, are part of promotional packages professionals employ to boost their business, including by advertising in airline magazines and special sections that pop up in local magazines and newspapers. They may need to be taken with more than a grain of salt, he finds.
In my practice, I see not only the harms that patients suffer while seeking medical services, but also their struggles to access and afford safe, efficient, and excellent medical care. I see lots of excellent doctors (and lawyers) — and some bad ones, too. It can feel like a life-and-death search for patients, however, to find good doctors to help them through the complexity and uncertainty of costly current medical care. (This is also true of patients’ quest to find excellence in hospitals — an issue that has become mired in medical politics and methodological arguments that don’t seem to keep patients’ needs as a top focus).
A solid primary care physician can provide the foundation for patients’ sound medical treatment. The hunt for this important member of your medical team can occur on a reasonable timeline, without the stress that might accompany, say, finding a cancer specialist immediately after diagnosis.
Resources exist now so patients can check their prospective doctors’ education and credentials, notably their specialty and sub-specialty certifications. Patients may wish to ask family members, trusted friends and work colleagues for recommendations, diving into questions like a doctor’s accessibility outside of scheduled appointments. A face-to-face visit will help establish other key attributes: Does the doctor listen well, provide empathy and compassion without condescension, and can she put into words your biggest dreads and concerns, even if you cannot? How up to date does your doctor and her facilities seem? It’s crucial for practitioners to stay atop a rapidly changing field and they must commit to doing so.
By the way, it can be helpful to navigate online to see if doctors who might treat you have licensing complaints or malpractice lawsuit verdicts against them. Doctors are human and they can blunder. But research also shows that the civil justice system can be a powerful, effective way to root out bad doctors and improve the health system, even when others may not have done so. Studies show that a small slice of doctors get hit with malpractice claims, which tend to repeat against them.
Patients deserve honest, fair, compassionate, careful treatment from all medical caregivers, no matter their education, fancy offices, titles, awards, and high-priced practices. Don’t hesitate to speak up and to keep letting hospitals and MDs know if you don’t find them in their care of you to be super, top, or best. As a reporting colleague pointed out to Allen on social media, though his article was tongue-in-cheek fun, it reminded her that a key way that Christopher Duntsch advanced himself in his new community of Dallas was to hype his receipt of a sketchy medical accolade. Don’t remember him? He’s the now convicted back surgeon dubbed Dr. Death for the swath of destruction he inflicted on patients.