What Makes a “Best Doctor” Best?

The selection process begins when thousands of board-certified physicians across the United States are solicited to anonymously nominate physicians who they feel are clinically outstanding and academically relevant. Castle Connolly’s physician-led research team then interviews the candidates and investigates their professional records to validate nominations, verify credentials, determine essentially which are the “best of the best,” and ultimately refine the candidate pool. After a preliminary list is composed, each physician is asked to complete a professional biography form, which becomes an integral part of a selected physician’s listing in Castle Connolly’s Top Doctors guides, including America’s Top Doctors; America’s Top Doctors for Cancer; and Top Doctors: New York Metro Area. Selected physicians may also appear in certain magazines, including Redbook, Good Housekeeping, Men’s Health, Women’s Health, and Forbes, who partner with Castle Connolly to create a “Top Doctors” feature.

This type of publicity, however, is a double-edged sword. Ranked as a “Most Influential Doctor” in rheumatoid arthritis, a physician who preferred to remain anonymous says, “My primary expertise is lupus and has never been rheumatoid arthritis. I may be an influential figure in my area, but no one who understands what I do would call me one the best doctors for patients with rheumatoid arthritis. That is one of the many things wrong with [these] lists. They are, as USA Today admits, created for the purpose of a having a list to sell to ‘corporate clients.’ ” With other ranking organizations noting the options to buy a “lovely plaque and hang it your waiting room” and the “commercial rather than professional interest,” the business aspect of these lists detracts from their credibility, at least for physicians.

Cross-referencing with other databases to ensure accuracy is the final step in the making of a Castle Connolly “Top Doctor.” William Liss-Levinson, PhD, vice president, chief strategy and operations officer of Castle Connolly, states, “If you were to look at the few other bona fide companies out there [that] have been in this business and you were to compare certain lists, you would see a great deal of overlap. The reason is because we are all getting at, from different perspectives, the same kind of thing, which is that we’re all asking questions that get to the heart of who is a quality provider.”

Consumer Reports: Performance Data Rankings

John Santa, MD, MPH, director of the Health Ratings Center for Consumer Reports, contends that although Consumer Reports Health hopes for improved information for the benefit of the consumer, they offer a slightly different approach to physician ratings. In October 2010, Consumer Reports Health, in conjunction with the Society of Thoracic Surgeons (STS), released its first set of physician rankings based on clinical performance data such as mortality, complication, and the degree to which medicinal and procedural guidelines were followed. Seeing this ranking as the first step in a long line, Dr. Santa says, “We did not pursue a strategy the [other] best-doctors lists pursue. My impression is that, in most cases, those lists rely on reputation. At Consumer Reports, we prefer to use more objective information than what other people think about a doctor’s reputation.”