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Want the 'best doctor'? We can help, not list

June 23, 2008 | 12:47 pm

Bestdoc300_2 If only the L.A. Times Health section would compile a list of the area's best doctors. Think of the reader convenience ... not to mention a fundamentally flawed judging process and inherent conflicts of interest.

Among the thousands of doctors in Los Angeles County, we simply couldn't be sufficiently familiar with all of them to decide who should be on the list -- and who shouldn't. Too many factors go into being "the best."

We could list those physicians we knew to have a good clinical reputation, to be experts in their particular specialty. But we'd be certain to miss many, many others. And even the most knowledgeable might not be willing, or able, to provide the kind of communication you or your condition need. One doctor may have more experience than a younger colleague but be too busy to listen to your particular concerns. Another physician may keep up with the cutting-edge treatments but not have the skill or wisdom to make them useful to you.

We could list those doctors we've seen personally, or interviewed professionally, but that opens up a wealth of potential and real conflicts of interest (on both our part and the physician's part) that I don't need to belabor. Suffice to say that readers deserve better than a doctor hoping for a mention on a "best doctor" list or a journalist who has gotten special treatment from said doctor.

We could ask readers to send us their preferences, but higher-volume docs and those more likely to push their patients toward such feedback could easily stack the deck.

We could use a research firm, as do many publications, including New York magazine. But let's take a look at how that list is compiled:

For starters, it's winnowed from a longer one. That longer list is based on a peer-review survey. That survey is based on those forms returned by medical professionals in the region. Those professionals include some randomly selected doctors (not all doctors), doctors from the previous guidebook (keep reading for those pitfalls) and the top officials at local hospitals (of course, they wouldn't be predisposed to vote for their own). The published list is further adjusted in various ways. Here's a rather thorough explainer.

Here's how a physician, writing for Slate, described that list a couple years back: "It's high school all over again, a life lived at the mercy of cruel arbiters of who is up and who is down."

He goes on to say: "Of course, the list isn't really about accuracy or quality. It's about sales -- not only of doctors' services but also of fancy plaques, directories, and pen-and-pencil sets fitted into paper weights."

Some of the most knowledgeable -- and caring -- doctors I've seen would never make a "best of" list, largely because their priorities are their patients, not publicity.

So instead, we prefer to tell you how to find the best physician for your particular needs. Check out Susan Brink's story How to find the best medical care in this week's Health section or the Ask Us question (a very good one) that prompted this post, Diagnosed with cancer? Here's how to find a doctor in your neighborhood.

Doing your own research isn't as easy as calling a number in a directory, but you'll be much likelier to get the "best" for you.

-- Tami Dennis

Illustration: Melinda Beck / For The Times