The fact that these ads provide little or no information about each doctors' array of services seems to suggest that they are not intended to generate
demand for any particular healthcare service. This conclusion is buttressed by the omission of patient testimonials. They do, however, aim to elevate the
name and face recognition of featured physicians, implying that patients who need such services should settle for nothing less than a best doctor.
Do doctors pay, directly or indirectly, to be featured in such promotions? For some years, I have been ranked as a top doctor in local and national
listings, though I have yet to come across my face in an airline magazine. I have received repeated solicitations to "update my information" on various
ratings websites, notes of congratulations on my selection, and offers to purchase expensive commemorative plaques and the like. I have never paid a penny,
but other physicians may leap at these opportunities.
Yet business is not the whole story. These ads also make powerful appeals to ego and pride. To be featured in this way probably makes some physicians
proud. Being singled out suggests that we provide high-quality care, and some patients may assume that we are superior to colleagues who are not mentioned.
Even physicians who feel initially disinclined to participate may fear that by not submitting our information we would undermine our standing among
patients and colleagues.
Physicians who long to be counted among the best probably have something else in mind as well, whether we have ever admitted it to ourselves or not. Many
physicians suffer from a need for recognition, feeling that we are chronically under-recognized and under-appreciated. Beholding our names on a
best-doctors list provides at least temporary relief from nagging self-doubt, boosting self-confidence and professional pride.
If magazines tell us what we want to hear -- namely, that we are the best -- most of us are disinclined to put up much of a fight. If they choose to make
such proclamations in forums frequented by patients and colleagues, so much the better. In a world where tycoons, sports figures, and beautiful people are
routinely singled out as the best, who could blame hardworking doctors for wanting a piece of the action?
Interestingly, even the ratings services themselves seem to operate under the same reputational imperatives. Some "top doctor" ads feature ratings of the
rating services themselves. One, for example, singles out Castle Connolly as "the nation's leading provider of information on top doctors." The top doctors
and the ratings services appear to be entwined in a symbiotic relationship, each promoting the other's reputation and business prospects.
Yet how seriously do doctors themselves, who are best equipped to evaluate the level of their colleagues' excellence, take such ratings? In my own case and
that of many colleagues with whom I have spoken, the answer, surprisingly, is not so much. For each physician featured in such advertisements, many of us
can name at least three local colleagues whose expertise we regard at least as highly. Moreover, I am honestly not sure that I am one of America's best
Admittedly, I was well trained, I have been practicing medicine for some time, and I try to care for patients as I hope a colleague would care for one of
my loved ones. Yet am I really among the very best, or merely someone whose professional dossier happens to score well with different ratings algorithms?
Perhaps I have a few more publications or grants than some colleagues, but this does not establish that I would do a better job in caring for any