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

12:47 PM, June 23, 2008

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

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Tami Dennis, who takes the word "skeptic" to previously uncharted territory, is editor of The Times' Health section. She's adamant that pitches promoting awareness days, weeks or months are, by their nature, non-stories. And, because she's an adult, she refuses to use words like "veggies," "tummy" and "yummy."
Rosie Mestel, Health section deputy editor, studied genetics before abandoning flies, fungi and DNA for health/medical writing. Her hero is the biologist Ernst Haeckel, whose jellyfish paintings inspired snazzy chandeliers. Her favorite toast-spread is Marmite, a British delicacy made of yeast extract. Her least-favorite word is "millenniums."
Susan Brink has made health and medicine her beat for 26 of her 28 years in the business. She’s covered a wide range of disease and health policy stories, and is always on the lookout for fresh angles. Few things make her happier than busting through preconceived notions to give readers an accurate view of people behaving as…well, real people.
Melissa Healy is a staff writer for the Health section reporting from Washington D.C. Healy's a veteran of The Times' National staff, having covered the Pentagon, Congress, poverty and social welfare, the environment, and the White House before shifting to Health in 2003. She writes frequently about mental health and human behavior, about federal health policy, prescription medication and ethics in medicine. More wonk than wellness freak, Healy chooses to believe in the health benefits of coffee and wine, and considers water a better work-out medium than beverage.
After a brief stint as a sports writer, Shari Roan turned to health journalism and has covered the topic for The Times for 18 years. She is the author of three books and the mother of two daughters, both teenagers who refer to her as a "health freak." She likes to jog, watch baseball and is very happy that dark chocolate contains some health benefit.
Jeannine Stein writes about fitness, sports medicine and obesity for the Health section. She’s a gym rat from way back and never met an elliptical trainer she didn’t like. Well, maybe one or two. She tempers exercise with a steady diet of reality television because she believes it’s all about balance.