Monday, February 23, 2009

Are Prestigious Physicians the Right Prescription?

If it were easy to know how to choose a good physician, then everyone would have one. As discussed in prior postings, it’s tough just to define a good doctor, let alone find one. There is no surefire way to select a high quality physician. Methods and advice that sound like a winning strategy, just don’t reliably deliver. For example, you are ecstatic to have an appointment with a renowned doctor at a prestigious medical center, but his fame might be from rat research, not from patient care. You feel privileged to consult with a medical school’s chief of surgery, but it may be residents and other training physicians who are actually doing your operation. You feel fortunate to have an appointment for your asthmatic son with a specialist who lectures widely on lung diseases and has authored several textbooks. However, he might be a much more skilled writer and public speaker than he is a treating physician. You are reassured that your cardiologist is a wizard at placing stents in clogged coronary arteries. However, while he might be a technical magician with his medical gadgetry, he might be less skilled in determining who actually needs them. While technical skill is important, medical judgment is paramount. I’d rather have no stent, than to have one placed by the world’s leading stent placer. The irony is that a patient, who receives a stent that is not truly needed, feels that he has received excellent care and has averted a catastrophe. The doctor, the patient and his family and the hospital all feel like winners, but I’m not so sure.

So, if fame, notoriety and prestige are not the prescriptions for choosing a doctor, what should patients do? Check the next posting for some pointers.


  1. I found your thoughts quite compelling. It amazes me how "good doctor" or "the best" is based on nothing that has to do with reality. Keep it going. Thank you.

  2. Being an overweight, underactive arthritic woman in her 50s, I have seen more doctors than I can count. To me, what makes a good doctor is not letters behind his name, the medical center he/she is linked to or how many lectures or books he/she has to his/her name. What makes a good doctor in my eyes is a doctor that makes me feel like a person, not a patient. I am not looking for a winning personality - I am looking for someone who cares about how I feel and why. I think that kind of doctor is few and far between and it is hit or miss when you find one. Luckily, I have found a few of those lately. Thank God.