Saturday, March 03, 2007

Paying To Be A Top Doctor

America’s Top Doctors®. Every doctor wants to be one. The prestige. The glory. The acclaim.

The narcissism.

On the surface this accolade sounds so wonderful, so comforting. Just to know your health care is being delivered by one of The Best®. (I thought I’d trademark that term).

You see, that little ® symbol means that certain corporate gnomes called Castle Connolly Medical Ltd. have paid to protect the term “America’s Top Doctors®.” I guess they're afraid someone might want to steal this term and change it into “My Hospital Paid For Me to be Listed as one of America’s Top Doctors®.”

To really search their database of presumed America’s Top Doctors®, you have to pay these corporate gnomes – that is unless you want to see the doctors from certain centers that have already paid to be sure you see their doctors. Then you can search their database to see those carefully chosen doctors are chosen not only by doctor peers, but by hospital administrators that want their doctors to look good to America.

I guess I can stand patients rating doctors – after all, they’re the consumers of health care. But when companies are paid as fronts for hospital systems to preferentially promote their physicians as “America’s Top Doctors®,” the ethical nature of this practice is suspect at best.

But their data stinks, too. I tried to find an America’s Top Doctor in Illinois who practiced as a Cardiac Electrophysiologist. Guess how many were there?

One.

Amazing. Only one Top American Cardiac Electrophysiologist Doctor® exists in Illinois (I didn’t pay to see if it was me).

But then I saw this press release about how their also providing searches about disciplinary actions against doctors in 46 states. You can click on their website and get the information.

I wonder if they’ve filtered the data the same way they’ve filtered the Top Doctor data as a means of skewing public opinion about a competing health care systems that have not paid to be included in their database.

You see, once they make differential displays of data that are dependent on receiving payments to view their database, the potential for manipulating what is displayed is unlimited and limits credibility of the data displayed.

But then, they don’t care about accuracy. They just care about the money.

-Wes

4 comments:

View from the Trekant said...

Agreed. Just like the "Who's Who" nonsense. Echo Doc

Moof said...

If there's a penny to be made somewhere ... it will be found, and exploited.

I once was sent to "one of the 10 best physicians in the country" of a particular specialty - I saw him 4 times total, never exchanged more than a dozen sentences with him, and resolved that next time, I will insist on staying with my local doctors and hospitals - or die.

When seeing someone so "important," you have to sacrifice a lot of what you would get when going to someone you know: the comfort of being familiar enough with the physician to trust him, and being able to communicate with him ... and the flip side of that - the realization that he knows you well enough to raise you above the prospect of being "interesting case #1,000,001" ...

William Liss-Levinson, Ph.D. said...

Our annual nationwide-nomination survey process has identified many outstanding phsycians - Castle Connolly Top Doctors - across the U.S., including 24 of Dr. Fisher's colleagues at Evanston Northwestern Healthcare (ENH). Some of those appear in our national guide, America's Top Doctors, while others appear online at our website as regional Castle Connolly Top Docotrs and also may have appeared in a print guide we did for several years, Top Doctors: Chicago Metro Area, and/or in Chicago Magazine, which has turned to us for the past 8 years to do their Top Doctors feature issue every two years. Dr. Fisher's reckless disregard for fact obviously motivates him to run a headline which is untrue. Nobody pays to be a Castle Connolly Top Doctor - they don't, they never have, they can't and they never will. That's the reality that Dr. Fisher seeks to deny, and in doing so not only does he besmirch our reputation but he equally insults his own colleagues at ENH.

As a healthcare professional with 22+ years experience in all sectors of the not-for-profit provider side of healthcare prior to working with Castle Connolly for the past 10 years, I am dismayed by Dr. Fisher's behavior. What he has patently confused - and seeks to draw others into his confusion - relates to the display of doctors' profiles online at our website for those people who wish to search for free, versus those who are willing to pay an annual membership fee [which costs them less than the price of our guides themselves]and thus have access to the entire online database. Dr. Fisher, we are not a non-profit entity, but then again neither are YOU. I would never suggest that you should offer ALL your services to your patients at no charge, even though I am sure that you are generous and compassionate to some of those in need. Castle Connolly offers anyone and everyone, at no charge, access to 20-25% of our overall database online - as is clearly explained on the website in several differnt places. I daresay that we are far more generous with our free services to the healhcare consumer in need than you are.

DrWes said...

Dr. Liss-Levinson,

While I respect your views, I would ask you to check how many pages of the Chicago Magazine you quote are "paid advertisements" of the practices around Chicago - nearly the entire issue. I am quite aware of the glossy photos our institution sends the magazine (rather than them independently acquiring these photos) for inclusion on the paid advertising pages.

Now, that being said, let's look at your 'nomination process.' How many hospital administrators versus practicing doctors decide who's nominated? What exactly are your criteria for "refining" the pool of applicants? Who decides? Are your criteria published online or protected under the shroud of trademark law? And could explain to me what a "featured hospital" is and how they are selected? How many of those "featured hospitals" were allowed to nominate doctors versus "non-featured hospitals?"

Let's be real: this is a marketing tool. And certainly the aire of credibility I'll leave for others to decide. My institution (as you point out) is certainly no different than others in wanting to promote their doctors, and certainly, the doctors you select are fine inviduals. But there IS a selection process that is NOT fully transparent, and an income stream from hospitals and some individuals who want to search your database that supports your work. Certainly doctors may not pay for inclusion on your list, but their employers? Hmmmm.
Finally, to prioritize your doctors as "top" based on surveys is demeaning to those of us who struggle for constant excellence in our fields based on the outcomes and satisfaction of our patients, not surveys and database reviews. Just look at the Chicago Metro area (the third-largest in the US) with over 4 million people and only EP doctor in this area on your database. Sorry, sir, I respectfully submit your data are skewed.