My eyes narrowed when the woman on the voice message told me to call about my “Top Doctor” award. They needed to “make sure everything’s accurate” before they sent me my plaque, she said.
It was a titillating irony. I don’t have a medical degree, and I’m not a physician. But I am an investigative journalist who specializes in health care. So I returned the call. I spoke to a cheerful salesperson named Anne at a company called Top Doctor Awards. For some reason, she believed I was a physician and, even better, worthy of one of their awards. I asked how I had been selected. My peers had nominated me, she said buoyantly, and my patients had reviewed me. I must be a “leading physician,” she said.
That’s what many patients looking for a good physician assume. They figure that such awards are backed by rigorous vetting and standards to ensure only the best doctors are recognized. Hospitals and physicians lend credibility to the facade by hanging the awards in their offices and promoting them on their websites. But medicine is complex, and there’s no simple way of determining that some doctors are better than others.
“It says you work for a company called ProPublica,” Anne said.
I responded that I did and that I was actually a journalist, not a doctor. Was that going to be a problem, or could they still give me the Top Doctor award?
There was a pause. Clearly, I had thrown a curve into her script. She regrouped quickly. Yes, she decided, I could have the award. Anne’s bonus, I thought, must be volume-based.
Then we got down to business. The honor came with a customized plaque, with my choice of cherrywood with gold trim or black with chrome trim. I mulled over which vibe better fit my unique brand of medicine.
“There’s a nominal fee for the recognition,” she said, reverting to the stilted cadence of someone reading a script. “It’s a reduced rate. Just $289. We accept Visa, Mastercard, and American Express.”
That sounded a little spendy to get past the ProPublica bean counters. I hesitated.
“The plaque commemorates your achievements and, more importantly, communicates the achievements to your patients,” she said, moving in to close the sale. “It’s a great achievement. I would hate for you to miss it. I can get it to you right now for $99.”
I accepted the offer, and that’s how I became a Top Doctor. It beats years of hard work and drowning in debt from medical school. And it gives me just that right amount of heft when I dole out advice to snuffling colleagues in the newsroom: Go home before we all get sick.
Obviously, the Top Doctor Awards company has questionable standards. I called up actual health-care experts. Not surprisingly, they took a dim view of the awards business. “Any competent doctor doesn’t need one of these awards unless he wants to stroke his ego,” says Michael Carome, MD, of the advocacy organization Public Citizen.
Of course, some for-profit doctor-rating companies are more legitimate than others. John Connolly, cofounder of the company that puts out the Castle Connolly Top Doctor awards—not to be confused with Top Doctor Awards—said his company depends on nominations by physicians to identify Top Doctors. The company has a research team, he said, that checks the license, board certification, education, and discipline history of each nominee. Connolly believes it would be “very difficult” to game the nominations but gave me a verbal disclaimer.
“We don’t claim they are the best,” he said of his company’s honorees. “We say they are ‘among the best’ and ones we have screened carefully.”
While doctors do not pay Castle Connolly to be named a Top Doctor, they can pay for an enhanced profile in its online listings. The company brings in additional revenue by teaming up with magazines to do promotional issues in different cities and regions. “The Top Doctor issue is typically the number one newsstand and advertising seller,” Connolly says.
You’ve seen the glossy photo spreads in magazines featuring “The Best” plastic or orthopedic surgeons or other specialists. Those might be special advertising sections by New York City–based Madison Media Corporation. All they’re doing is piggybacking on the work of companies such as Castle Connolly. A doctor who gets one of these awards can buy an ad to be listed in the publications, says John Rissi, president of Madison Media.
So how does Rissi know “The Best” doctors in his ads are actually the best? “I guess in this world it’s hard to find the absolute best,” he says. “It’s all through reputation and interpretation.”
John Santa, MD, fairly snorts at that. He spent years measuring health-care quality for Consumer Reports magazine. Anything that relies on nominations, he says, will be gamed by doctors with financial ties to one another: partners who work in the same practice or doctors who refer patients to one another. “If you look at these methodologies, they are rife with economic and relationship biases,” Dr. Santa says.
I decided to dig further into how Top Doctor Awards targets its honorees—without pointing out that I was one of them. Donna Martin, who works in client services, told me Top Doctors could be nominated by their peers because of their achievements. But there’s also a “full interview process” that includes questions about education and awards.
My ears perked up when she said a research team is also involved, but when I asked for more detail, Martin said the specifics are proprietary. Later, I called her again. How good could their methods be if I was one of its Top Doctors? She said she would look up my account and call me back. I’m still waiting.
What about my fellow Top Doctors, the actual physicians who share my award? Did they understand the dubious honor they’d received? I called Lewis Maharam, MD, who practices sports medicine in New York City. He said he wasn’t surprised that Top Doctor Awards wanted to honor him. “I’m sort of in that echelon,” he said. “If you’re finding people that don’t deserve [the awards], then maybe you’re onto something.”
I told Dr. Maharam that I am also a Top Doctor.
“That’s pretty strong evidence that it’s not legitimate,” he said, changing his tone. “It might have been that my assistant just sent in a check.”
Dr. Maharam said doctors are so busy that it’s easy to take advantage of them. It’s good to be included in the lists of honored physicians even if they are questionable because it draws in patients, he said. But now that he knows my story, Dr. Maharam said he will ask how the doctors are chosen and he might not pay the fee to renew his award. I decided not to take it personally.
I smiled like a proud parent when my faux-cherrywood-and-gold Top Doctor plaque arrived in the ProPublica newsroom. The salesperson had asked me what she should list as my specialty. The whole thing is so silly that I probably couldhave said neurosurgery. But I hadto tell her the truth, so I went with “investigations.”