TOP DOCTORS (Philadelphia Magazine)

Why not the best? Our exclusive guide to the doctors more doctors recommend.
By Carol Saline

There's a popular story circulating in the medical community about three doctors who are waiting at the pearly gates for admission to heaven. St. Peter asks the first doctor what he did while he was alive. "I was an oncologist," he says. "I spent my time helping cancer patients."

"Excellent," St. Peter replies. "Come right in." He repeats his questions to the second doctor, who says, "I was a researcher and spent my time trying to find a cure for AIDS." He, too, is immediately ushered into heaven.

Now it's the third doctor's turn. "I was the medical director for a large managed care insurance company," he says. St. Peter pulls out several thick books of tables and a calculator, works quietly for several minutes, and tells him, "It looks like I can approve you for five days in heaven, and then you're out of here.

Obviously, managed care has radically altered the practice of medicine-not just for patients, but for doctors as well. Some might even question why we bother to produce a best doctors list when many of our readers belong to health plans that won't allow them to use the physicians mentioned. We do it because we believe that medical care, however beleaguered it may be at present, is still about excellence.

Compiling a list like this is a long and painstaking process influenced by opinion and reputation. We use the peer jury system, so the opinions come from the medical community, not from patients. For this year's list, we started with the Washington, D.C.-based Center for the Study of Services, a nonprofit consumer research organization whose book, Consumers' Guide to the Best Doctors in the U.S., will be published this spring. They supplied us with a raw list of doctors in our region, which they created by surveying nearly every office and hospital-based physician in Bucks, Montgomery, Chester, Delaware, Philadelphia, Burlington, Camden and Gloucester counties and asking them to recommend who they'd "consider most desirable for the care of a loved one." I took their findings and then made follow-up phone calls to over 100 physicians-at least four in every category-to refine the list to those people considered by their esteemed colleagues to be the top practitioners.

We did not include specialties like anesthesiology and pathology in which patients rarely have any say in choosing the doctor. We also omitted psychiatry, because we covered that field in our December '97 feature "Philadelphia Magazine's Top Therapists." Our emphasis remains on clinical practice, which is why we excluded doctors who spend less than half their time dealing with patients. That means you won't find any eminent researchers, academics, or department chairs bogged down by administrative duties like infectious-disease specialist Michael Buckley, who's been promoted and now spends only about 15 percent of his time with patients. Also missing are some "Top Docs" from previous lists who are nearing retirement and have seriously cut back their hours.

Lists like this are never perfect. They almost never mention those great doctors quietly working in suburban settings who don't publish papers or rise to renown, so nobody knows how wonderful they are except their lucky patients. By and large, the doctors on this list are for people with serious medical problems, and because they're so busy, they may not, in fact, be the best choices for routine care. You probably don't want to content with the aggravation of getting an appointment and then sitting for hours in a waiting room to check out whether your sore throat is strep or a virus.

Finally, a word of caution. No matter how hard we strive to choose the best, we inevitably get a few calls from disgruntled patients outraged that we've appointed a doctor with whom they've had a horrible experience. Unfortunately, doctors are human; they make mistakes. That's why they carry malpractice insurance. We're human, too, and occasionally we make mistakes. But not often.

REPRODUCTIVE
ENDOCRINOLOGY (INFERTILITY)
Arthur Castelbaum, Abington
Martin F. Freedman, Abington