PUBLISHER’S NOTE: Is “Best Doctors” Healthy?

A Dallas doctor raises an important question, and we provide an answer.

Dr. Robert Tenery, a distinguished Dallas ophthalmologist listed among the best in his field on p. 74, raised an important question in the July issue of Texas Medicine: are “best doctors” lists healthy for patients?

Our answer is an unequivocal yes. That’s why we publish ours every year—to give guidance to our readers in making their health-care decisions. Before we undertook this (admittedly gigantic) task, readers had nothing more to go on than hearsay from friends and neighbors, few of whom are medically informed and whose advice, while well-meant, was usually anecdotal. Instead, we decided to poll the doctors themselves, asking the pertinent question, “If you or a loved one needed treatment, which doctor in this specialty would you go to or recommend?”

Once we complete our balloting among doctors, we convene a select panel of experienced physicians from the Dallas County Medical Society and local hospitals for a review. The purpose of the review is to add doctors who are excellent but not generally well-known and to strike from the list those who may have problems others may not be aware of. The review serves to minimize the “popularity contest” aspect of our list.

Dr. Tenery doesn’t question our methodology, but he does worry about its result. He wonders if our list increases the potential for harm. His argument is that the trust that patients hold in physicians is the linchpin of therapy. If a doctor is not included among the best in a magazine, that trust may be endangered. He questions whether the thousands of doctors not included on the list are any less compassionate or competent than the ones who are.

My answer to him is from personal experience. My own doctor, a general practitioner, didn’t make our list for the first three years. My only worry wasn’t whether he was competent or compassionate but whether he’d be hurt. A patient does form a relationship with his doctor, as Dr. Tenery argues. But what about those doctors, especially in the subspecialties, whom we go to for a particular problem and with whom we have no relationship?

In those cases, our general practitioner usually makes a recommendation. But also in those cases, we are wise to get a second opinion. Where do we get that? From our friends? Our readers know where to get it: from our list.

Compassion is hard to measure. Competence isn’t. Competence leads to respect, and respect leads to reputation.

The fact is some doctors are better than others. (What do you call someone who graduated last in his class at medical school? Answer: doctor.) Some graduated first and some graduated last. Some have performed a surgery a thousand times successfully, and some haven’t. Sociologists call this the bell curve. In almost every group, a very few are excellent, most are able, and some are mediocre.

Our list is not inclusive, but we are confident that those listed have earned the respect of their colleagues. That’s its point. We present it to our readers with the full confidence that they will know how to use it.

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