Finding a physician isn’t easy. It’s a matchmaking process that involves linking patients and physicians by such intangibles as trust, honesty or being a good listener. The issue is frustrated by a fundamental question that typically drives physician selection: Is the doctor in the patient’s health plan? Where does quality care come in? Everywhere. It’s […]
Finding a physician isn’t easy. It’s a matchmaking process that involves linking patients and physicians by such intangibles as trust, honesty or being a good listener. The issue is frustrated by a fundamental question that typically drives physician selection: Is the doctor in the patient’s health plan?
Where does quality care come in? Everywhere. It’s a given.
“I don’t think people have to worry about the threat of some bumblebum taking care of them,” says cardiologist Dr. Michael Keelan. “There always will be bad apples… but it’s tougher and tougher for people like that to exist. There was a time when they could exist in a vacuum in a solo practice. But there is too much going on with oversight.”
Which is where the emphasis on matchmaking enters in. If quality care is a given, the physician-patient relationship rises as the most prominent concern in choosing a doctor.
For the fourth time in the past 13 years, Milwaukee Magazine has endeavored to help patients in the pursuit of finding a good match in a physician. We expanded the number of specialty areas, acting on advice from the Milwaukee County Medical Society. We turned to survey experts to determine the best route to solicit credible opinion on this issue, and they advised that the most unbiased results would come from a pure, random survey of thousands of healthcare professionals. We took their advice. By far, this top physicians survey is the largest undertaking since Milwaukee Magazine first provided a physician guide in 1987.
Chatting with some of these top doctors revealed some common themes. All were quick to note that there are many worthy physicians whose names would not surface in this kind of survey.
Dermatologist Dr. Evonne Winston made the list for the first time this year. She values the recognition but hopes that it alone will not sway a patient’s decision to seek her care.
“I would feel bad if a patient only saw me because I was on the list or wouldn’t see me because I wasn’t on the list,” says Winston. “It’s just another piece of data.”
What matters, says Winston, is whether patients and physicians connect to work together to remedy medical problems or sustain health to prevent illness or disease.
“I believe more than three-quarters of the medical interaction is whether your personalities click,” says Winston. “Day-to-day medicine is pretty straightforward stuff… so you have to be good on a personal level.”
That said, Winston and other physicians say the list provides a valuable service, as it’s derived from the most reliable source for such information Ð healthcare professionals.
“Let’s face it,” says Winston, “we are going to have some of the inside dope.”
All told, 2,500 doctors and 2,500 nurses were asked to name the top physicians in 27 specialties. Those sent surveys were randomly selected from a pool of 4,331 doctors and 16,727 nurses from data provided by the state Department of Regulation and Licensing. They included doctors of medicine (MD), doctors of osteopathy (DO) and licensed nurses in the metropolitan area of Milwaukee, Waukesha, Ozaukee and Washington counties. Follow-up reminder postcards were sent to all 5,000. When a final cutoff was made, 10 percent of the surveys had been returned, a response rate survey experts describe as credible.
Physicians responded in greater numbers, with a nearly 13 percent response rate. Slightly more than 7 percent of nurses who received surveys responded. Of the 502 ballots received, 64 percent were from physicians and 36 percent were from nurses.
Among the 502 respondees, there were just six who objected to the survey, all of whom were physicians. That translates into less than 0.02 percent of responding physicians who refused to answer. Extrapolated over the entire pool of physicians polled, that would translate to about 47 of 2,500 who would likely refuse to respond. Other nonresponders likely fall into the categories of no time, survey tossed because deadline had passed or never saw the survey because it was lost in burgeoning stacks of incoming mail.
Of more than 1,500 physicians nominated, 216 rose to the top, garnering a minimum of 10 votes for most specialty areas, with a high of 77 votes. On average, top physicians earned a minimum of 30 votes from their peers, although the spreads ranged. Among nurses, the average number of votes for top physicians was nine. Family, geriatric and psychiatric medicines were the only specialties where physicians with as few as six votes made the list. In geriatric medicine, there were fewer than a couple dozen physicians named, resulting in a small pool who rose to the top. In family medicine and psychiatry, scores of physicians were identified as top in the field, but only a few repeatedly so.
Together, the 216 doctors named garnered more than 4,000 votes from physicians and nurses alike. Nurses and physicians agreed on the top physician in eight categories. In six specialty areas, nurses named physicians who didn’t surface on the final list, which combined votes from nurses and physicians.
Those who returned the surveys took the task to heart. While there were 27 medical specialty categories listed Ð and many commented that more should have been included Ð respondents refrained from simply filling in the blanks. Some felt comfortable enough to slide in names in virtually all areas. Most were selective, listing names in as few as half the categories, a handful or even just one, suggesting these healthcare professionals are unwilling to provide a name just to fill in a blank.
That is indeed how doctors we spoke to responded when asked for a referral. If they can give one, they do. If they can’t, well, they can’t. And even if they can, there is no guarantee it will be a good match. The reason, they say, is that finding the right doctor is a highly subjective affair.
“We all know people have different tastes,” says Dr. Edmund Duthie, who practices geriatric medicine. “People that I have been to, who I think are the finest physicians I have ever met Ð wonderful, smart doctors, caring, easy to talk to Ð and I have recommended them to neighbors and friends, and they’ve come to me and said, ÔHe’s a dud. I couldn’t connect.’
“Matchmaking has blown up in my face time and time again. There is a chemistry between people. You can be referred to someone with impeccable credentials, and your experience doesn’t mirror that.”
So why bother with the survey? It’s a tool, a guide, a reference for people who are faced with choosing a physician for themselves or their loved ones.
There is no single best resource to find a physician. Rather, multiple factors can, do and should come into play (see “Medical Matchmaking,” page 92).
“There is no science to measure quality when it comes to physicians,” says endocrinologist Dr. Jay Findling. “Unfortunately… their HMO book turns out to be the most important list.”
Ultimately, though, it’s knowledge of patients, their medical history, their lifestyle and nurturing a personal relationship that also surfaced as a common thread among top physicians.
Spending time with patients in a bottom-line, get-them-out-the-door era was mentioned as among the factors these physicians felt may have given them an edge.
Another distinction they cited is a tie to academia. It may be that their academic roles put them at a different level or give them more exposure through teaching and training Ð a sort of built-in name recognition that could cause them to rise to the top of a ballot, though that wasn’t a survey criteria.
Radiologist Dr. Jack Sty has written more than 300 papers and six textbooks. While important, he doubts those publishing credentials were sole determinants for how well he fared in the survey.
“I imagine I provide a helpful service to people who need questions answered,” Sty says of why he rose to the top among radiologists. “People who need help call, and they get it, and that’s what they need.”
So, in that vein, here is the largest list of physicians Ð 216 in 27 different categories Ð considered top in their field, presented with the hope of providing a helpful service.
Physicians who gained the greatest number of votes from doctors and nurses are noted in bold at the top of each specialty. Physicians are then listed in order of the number of combined votes received. In cases where there was a tie, physicians are listed alphabetically.