The lists are usually compiled by a company commissioned by the magazines to create “Best” lists. The method usually used for choosing physicians is to ask prominent doctors to nominate other doctors for the honors. They ask the nominating physicians to identify doctors in their community to whom they would send their family. In other words, the listing begins with a sort of popularity contest. They usually choose specialists who are board certified and they like doctors who teach at medical schools. They look at credentials to see if the doctors are on the staff of a prestigious hospital and if the doctors belong to professional organizations. The surveys are geographically oriented and usually revolve around high socioeconomic areas where the “Best Hospitals” are located. So it is not unusual to see, for example, quite a few doctors listed from towns like Short Hills and Livingston, because those towns are near St. Barnabus Hospital. But try to find your old country doctor from Sussex County, and he will be missing in action. If Albert Schweitzer were practicing in the Pine Barrens, I doubt you would find him on the lists.

So let me identify a few issues right out of the gate. There are many criteria aside from the above that one can use to define a “Best Doctor”, but almost none of them are actually measured and almost none of them can be found with the best search engines. For example, most doctors spend most of their time seeing patients in their offices, but no one is assessing the quality of care done in medical offices. So how are we to identify a “Best Doctor” when there are is no objective way to evaluate office care? In addition, there is no agreement as to a precise definition of a “Best Doctor.”

For the data which is available, such as where a doctor trained, whether he has been sued and whether he has pursued continuing medical education credits, it is very difficult or impossible for a patient to find such information. Doctors, hospitals, state agencies and professional organizations have failed to provide the public with this type of data. So if one is inclined to search for a “Best Doctor,” you should know that you have a moving target and that whatever information you get will not be comprehensive. The “Best Doctor” magazine lists are undoubtedly replete with fine doctors despite the selection shortcomings, but many truly “Best Doctors” never make the list and, in fact, are never even given a shot at consideration.

So the best you can do is to be aware of the issues and try to seek information by recommendations, research, or seeing a doctor and judging for yourself. Of course a lay person may be incapable of assessing some of the criteria. Here is my list of characteristics that identify a “Best Doctor.” Try to find doctors who embody as many of these criteria as possible:

1) Credentials: Board certification is very desirable. Special recognition (e.g. FACP after an internist’s name tells you that he has passed certain examinations and is qualified in his field). A medical school appointment and recognition by other doctors suggests excellence (e.g. if someone is Chief of Medicine at their hospital). Another clue is when doctors publish papers or present lectures or teaching rounds to doctors and nurses.

2) Medical school: Graduation from a well regarded medical school suggests potential for excellence. It would be great if you can get his class rank, but lots of luck with that one.

3) Postgraduate training: Look for doctors who have been trained at University Hospitals (not every hospital with “university” in its name is a true university hospital). You probably would prefer someone trained at the Mayo Clinic to one who did his residency at Secaucus General. It means that the doctor learned his craft from a first-rate faculty.

4) Hospital affiliation: In general, one would like to live near a large tertiary care hospital with high end services such as heart surgery. Such hospitals are often “teaching hospitals” and tend to provide a wide range of services, often with the latest technology. On the other hand, many “Best Doctors” practice at less prestigious hospitals. Remember that most conditions requiring hospitalization need excellent physician and nursing care and do not require high tech procedures available only at major centers. Sometimes the bigger hospitals fall down in basic bedside care, personal attention, staffing, infection control, cleanliness, noise control, etc. You want a doctor who will associate himself with quality hospitals.

5) Availability: If you are sick, can you get to see your doctor at his office, or does his staff discourage unscheduled visits? When you are hospitalized, does he come in during the emergency or does he leave your care to a beginner (i.e. a resident) and then show up the next day? Or perhaps he never sees you in the hospital and leaves all your care to covering doctors; and then when he sees you after discharge, does he know what transpired?

6) Coverage: Does the doctor have coverage by other doctors who are highly qualified?

7) Diagnostics: Is your doctor a good diagnostician? Does he take the time to do a careful history? Does he do a meticulous physical examination? Does he spend enough time to avoid mistakes? Does he analyze test results carefully, or does he just stuff them in your chart? Is he thoughtful, open to suggestions, prone to original and wise ideas, and receptive to second opinions?

8) Communication: Does the doctor call back when you request that? Does he explain things in lay terms and then allow for questions. Does he provide important information such as the side effects of medicines he prescribes? Is he detail oriented so that he keeps track of flu shots, colonoscopies, mammograms, etc. Does he maintain a legible and detailed medical record and will he let you read it? Does he communicate to your family when indicated? If he orders tests, does he get back to you with the results in a timely manner? Does he discuss your case with the consultants whom you have seen?

9) Testing: Is he careful to only order essential tests and is he cost conscious? Does he have any financial conflicts of interest when it comes to testing or surgical procedures?

10) Compassion and other signs of human connection: Kindness, caring, optimism and compassion go a long way in bridging the mind and the body.

11) Office procedures: Does he have an office staff which is knowledgeable and caring, or does his staff put up barriers to your reaching the doctor. Does he close down his phones in the middle of the day and leave you to decide if you need to go to an emergency room? Is his office neat, clean and professionally run? Is the office adequately equipped? Are they cooperative in helping with insurance issues, test scheduling, and referrals? If you need to see a consultant, do they help you make arrangements if needed?

This list is not complete, but you get the idea. If you think that this list is too stringent or fantastic in concept, remember that there are doctors out there who meet most of these criteria. Sure you can use the “Best Doctor” lists, but don’t stop there. Try to get more information and then make up your own mind as you try to find “Best Doctors” for you and your family. If you have questions, email us at the Ocean Grove Record, at mail@oceangroverecord.com.