You’ve certainly seen them. Whether you’re sitting in a doctor’s waiting room, perusing the magazines on the table or thumbing through an in-flight magazine, top-doctor awards are everywhere.
These publications claim to have found the best doctors in your city and ranked them all onto one, helpful list that’s consumable by the public.
In theory, this is a really good idea. The healthcare industry is notoriously opaque and consumers, reporters, non-profit organizations, watchdogs, even politicians have been trying to shine light into it for decades.
Top doctor awards are, at their best, an attempt to actually present patients with the physicians who are actually leading their fields based on research, reviews and recommendations.
But is this really what happens? In this article, we’ll take an honest look at top-doctor awards in the medical field and whether or not they actually do what they claim.
In a nutshell, here’s what our research found:
Are top doctor awards real?
In short, the majority of top doctor awards are paid programs, meaning that physicians can pay for the distinction of being listed even if they have little, legitimate medical merit to back it up.
So there’s our answer, now we’re going to look at why that’s the case, why it matters to you and what you as a potential patient can do to avoid putting your spine into the hands of the wrong doctor.
Before we do, however, it’s important to make a caveat:
There are no perfect doctor rankings or awards systems, but there are some that are more credible than others. In this article, we’re focusing primarily on top-doctor awards that exist on a sponsorship basis (i.e. physicians pay to be highlighted as a top doctor in the publication).
Why Top Doctor Awards Exist
1. Market Demand
The first, sad reason that top doctor awards exist, especially for spine surgeons, is because there is a demand for surgeons in the market.
Back pain is one of the most common medical problems facing Americans. According to data from Georgetown University, 65 million Americans report having recently experienced some kind of back pain.
For 16 million Americans, back pain is a chronic problem, sometimes requiring expensive surgery and days off of work. Between direct and indirect costs, managing chronic back pain costs Americans an astounding $12 billion each year and 83 million days of work.
Given these numbers, it’s not surprising that spine surgeons are clamoring to be at the top of patient’s lists when they’re considering surgery. It can be a lucrative business and many require a steady stream of surgeries and patient visits in order to stay open.
Top doctor lists are just one of the many marketing techniques that these surgeons will use in order to promote their services to potential patients.
2. Lack of Transparency
It’s understandable that patients would want to find the best doctor possible to manage their care. This is especially true when back pain is due to the spine. Though some back pain can be healed through physical therapy, medication, or other treatments, sometimes an operation on the spine is necessary. One of the most important bones in the body, the spine not only allows us to stand up straight, but also protects the spinal cord that connects our brain to the rest of our nervous system. If something goes wrong with your spine, it can impact not just the back, but the entire body.
Sadly, finding a reliable doctor to operate on your spine is easier said than done. Because spinal surgery is so lucrative, the competition for patients is particularly fierce. That, coupled with the fact that there aren’t many resources for patients to make an informed decision, makes top-doctor lists particularly prevalent and somewhat unverifiable.
Top-doctor lists, on the other hand, are quite easy to find, easy to understand and seem compelling. But are they really?
A Brief History of Physician Advertising
Up until the 1970s, it was illegal for physicians to advertise their medical services. This restriction not only helped them differentiate themselves from other, unlicensed healthcare providers, but was seen as a way to maintain the honor of the profession. Medicine was an incredibly specialized field, so ran the argument, and patients didn’t have the necessary expertise to assess competence. Advertising was seen as a form of manipulation, or even an attempt by inferior physicians who weren’t able to compete with their peers on the strength of their expertise.
A series of lawsuits, however, significantly changed the ethos of the profession. Doctors had the right to advertise just like any other professionals. Preventing them from doing so threatened their ability to support their practice and make a living for themselves.
Since these lawsuits, we’ve seen an explosion in physician advertising. This has come with both pluses and minuses. On the plus side, patients have access to more information to guide their decisions. On the other hand, some of that information, as we have seen, is less than helpful and comes from less-than-reliable sources. Top-doctor awards are no exception.
Trophies for All?
Take awards. If you’ve been to a doctor’s office, no matter the specialty, you’ve probably seen some sort of plaque hanging on the wall, recognizing them for their achievements within their fields.
Or perhaps you’ve seen these awards when you’re thumbing through the pages of a magazine or looking online for a doctor. They tend to honor doctors as being among the top in their field within their city, region, or state.
It may be tempting to pick a doctor based on the number of accolades they’re racked up, but be cautious. These awards don’t always reflect excellence or expertise.
In fact, they’ve been known to go to individuals who don’t even practice medicine at all.
That’s what one healthcare reporter with ProPublica found out, much to his shock. He received a call from a company called Top Doctor, informed him he’d been selected by his peers for his excellence in medicine.
The catch: He’d have to pay $289 for the recognition and $99 for a plaque to prove it. When the reporter told the receptionist that he was a reporter, not a doctor, she told him he could receive the award anyway.
While it might be easy to chalk this story up to a simple mistake, other incidents show the more sinister side of this awards industry.
Reporters from ABC uncovered a particularly unsettling story. In a shocking instance of medical malpractice, a neurosurgeon allowed an instrument to slip and damage the brain of an elderly woman during surgery. She died several weeks later, and her family successfully sought over a million in damages in an out-of-court settlement. Despite this incident – and over a dozen medical malpractice suits against him – the doctor remained listed as a “Top Surgeon” by the Consumers’ Research Council of America.
Now, it would be incorrect to say that all, or even most, top-doctors are simply marketers trying to cheat the system. On the contrary, many legitimately think that they’re being nominated based off of some sort of merit. They’ll receive an email or a phone call saying that they’ve been chosen as a top doctor in their field and that they can claim their reward (a brochure, magazine placement, photoshoot, plaque, etc.) for a fee.
These awards, in other words, don’t mean much of anything. They’re designed by for-profit companies to get doctors to shell out for expensive and meaningless awards. And while such accolades are usually harmless, the story from ABC shows that they occasionally conceal serious problems with a doctor or practice that consumers have a right to know about.
What about Top Doctor Awards generated by peer votes?
Most top-doctor publications these days, likely due to the increased scrutiny placed on the industry, have an award system that’s generated by peer votes.
Essentially, publications will poll a large sampling of physicians in the area and ask them what doctors they would recommend for certain specialties; doctors can usually only choose one physician and can’t vote for themselves. Then, after the results come in, the publication will see which doctors were recommended the most by their peers and present them as top doctors.
This system is certainly more credible and verifiable and, truthfully, isn’t a bad indication of the physicians in your area that have a good reputation.
However, like all things, the peer voting system is not immune to manipulation or bias.
For instance, doctors in big group practices tend to vote for each other which puts a small practice at a disadvantage.
For example, orthopedic groups in many areas are comprised of hundreds of physicians. These practices will include surgeons specializing in hands, knees, hips, shoulders, elbows, sports, pain and spine. So naturally, they will refer their patients to each other and support each other in these award surveys.
There is nothing fundamentally wrong with this practice as many of these physicians are deserving of the award, but this should be kept in mind when assessing a spine surgeon because a neurosurgeon is at a natural disadvantage due to having much fewer numbers compared to orthopedic surgeons.
We’ve all turned to reviews at some point in our lives – especially as review platforms like Yelp, Google, Facebook and others have risen to the limelight over the past couple of years and local companies have continued to move their services online. No longer do we need to ask friends and family for good restaurant or coffee shop recommendations rather we can just type a generic search into Google and see the thoughts of dozens of other people who’ve actually been there.
However, as the use of reviews for products and industries like food service or hospitality have grown, so have their use for health care professionals.
According to regulations from the Federal Trade Commission (FTC), all paid endorsements must come with a disclosure – which means that it’s illegal for companies to pay clients to leave positive feedback on Google Reviews. It also violates Google’s own policies to post reviews about your own business or leave negative comments about a competitor so as to damage their reputation.
These rules are well-intentioned, but they can’t possibly prevent all violations.
Additionally, Google has implied that having more positive reviews for your business, along with other factors, can help you outrank your competition in search results. This incentivizes underhanded behavior from businesses and services that don’t naturally generate reviews like a coffeeshop would.
The FTC received no less than 3 million consumer complaints in 2018, and it can take Google several days before they can assess a review that has been flagged as violating terms and take it down. What’s more, Google specifically states that it will not interfere in disagreements about the facts of a situation, since there’s no real way for the company to know the truth of the matter.
So are review platforms even worth your time as a consumer?
In short, yes. But you have to look for the right ones and know what you’re looking for in a review as you’re doing your research.
When it comes to finding a good, reputable surgeon for your spine, there are a number of factors to take into consideration. In the section below, we’ll share some of the most important things you should be looking for in a spine surgeon and tools to help you do it effectively.
How to Check A Spine Surgeon’s Reputation
Like we’ve mentioned previously, the healthcare industry is famously hidden from the eye of the public. Some of this is for the protection of patients and their privacy and some of it is just plain and simple bureaucracy in action.
Finding information isn’t always easy, but it does exist if you know where to look and what you’re looking for. If you begin your search online, as about 80% of people do, here’s how you can find what you’re looking for.
Let’s start with reviews:
Good Review Platforms for finding a Spine Surgeon
Not all review sites are created equal. With sites like Google and Yelp, anyone can leave a review – even someone who has never actually been a patient of the doctor in question. Other websites, however, are far more reliable.
Zocdoc is a website that allows you not only to read reviews about physicians, but to book appointments as well. Once you’ve made your appointment and seen the doctor, you’ll be able to leave a review on Zocdoc. In fact, Zocodoc follows up with you via email to ask for your review.
Once you submit your review, it is reviewed by an actual Zocdoc employee. If it meets all the guidelines for safe and fair reviews, it will be posted online. Zocdoc also partners with several independent patient survey providers and often includes from these providers in a doctor’s profile. These partners also make sure that the reviews they collect only come from real patients. Because of these precautions, Zocdoc is a far more reliable source than other sites that aren’t as thorough in weeding out fake reviews.
Healthgrades takes similar steps to ensure that reviews are reliable. While anyone with an account can leave a review, each review goes through an auditing process to make sure it adheres to community guidelines. Vitals, another doctor information and review site, only allows patients to rate a doctor once a month, to limit the number of repeat reviews influencing the overall rating. It also compiles information from state medical boards, federal websites, hospitals, and other sources, so you have plenty of data to help you make your decision.
In the end, no review site can be 100% reliable 100% of the time, but the sites listed above do a good job at weeding out bad reviews and are worth at least taking a look at when you’re working to find a spine surgeon that meets your needs.
Reading Reviews for Surgeons: Some Guidelines
When approaching the vast and volatile world of online reviews as a consumer looking for a spine surgeon, there are some important things that you should bear in mind.
1. Grammar Matters
Some online reviews are spot-on; others say more about the person writing them than they do about the physician being reviewed.
You likely have a grid for this if you’ve ever looked at Amazon reviews for a product. The quality of some reviews are just better than others and most of us have the ability to determine which reviews we think are more reliable simple based on the way they’re written.
If you were doing research for a paper, would you trust a website that was highly emotional in tone, had lots of spelling and punctuation errors, and ranted about the same point for sentences on end? Probably not. Solid reviews might contain a spelling error or two, and reviewers certainly have a right to express negative emotions when they’ve received poor service. But if a review seems excessively angry or particularly poorly written, you may want to second-guess its conclusions.
You should take the same approach when looking at health care reviews.
2. A Reviewers with a Rocky Past
If the review is on Google reviews, it’s worth checking out the person’s profile and taking a look at the other reviews that they’ve left. If you see a bunch of negative comments about all different kinds of organizations, from restaurants and bars to hotels and doctor’s offices, that can be a sign that the negative review isn’t an indicator of the doctor’s skill.
Or, if you see that the person has only left one review ever, it could be an indication that they’re being incentivized to leave a review or they’re just trying to blow off some steam.
3. Take Cumulative Ratings into Account
When looking at reviews for a product online, you probably rarely let one isolated review determine whether or not it’s worth purchasing.
In the same way, you shouldn’t let one isolated review on the healthcare provider be the only factor in why you do or don’t decide to visit.
Rather, take a step back and look the surgeon’s cumulative ratings. A physician who has a one star rating out of 100 reviews likely is not a surgeon that you want to visit. On the contrary, if you see your surgeon has a 4.3-rating out of 100 reviews, that’s a pretty good indication that folks are happy with his services.
4. What do the reviews focus on?
Finally, it’s also worth bearing in mind that many patient reviews focus on the administrative staff rather than the doctor.
While it’s part of a doctor’s responsibility to hire professional, helpful administrators, the occasional administrative mistake doesn’t reflect on a doctor’s surgical skill or expertise. If you see dozens of reviews complaining about double-bookings or hours-long wait times, then you may want to consider another practice.
If, however, it’s just a one-off complaint, then maybe you shouldn’t write off a practice altogether.
Assessing a Spine Surgeon
If you’ve read through reviews and still feel as though you don’t have enough information to make a decision, there are plenty of other ways to assess a physician’s qualifications. Here are a few criteria you can have in the back of your head when you’re trying to determine the best spine surgeon for your needs.
1. Is my surgeon board-certified?
The first and most important thing to do is to make sure a physician is board-certified. As the story from ProPublica demonstrates, it’s possible that someone without a medical education – let alone a board certification – could receive a top doctor award.
Check the websites of the American Board of Medical Specialties (ABMS), the American Board of Physician Specialties (ABPS), or the American Osteopathic Association (AOA) to see if your doctor’s name is listed as a certified physician.
If, however, you don’t see anything, don’t panic. Certification is not a one-time occurrence; because medicine is always advancing and new research constantly being produced, doctors are obligated to update their certification multiple times over the course of their careers.
If you don’t see your doctor’s name, it’s possible that they have been re-certified, but their credentials haven’t been updated online yet. Call the medical board in question and double-check before you write a physician off altogether.
2. Does my surgeon have any associations?
Another way of verifying a doctor’s credentials is to take a look at the letters that follow their name. While all doctors will have either an M.D. for “medical doctor” if they practice allopathic medicine or a “D.O.” for “doctor of osteopathy” if they practice osteopathic medicine, some doctors will also have another series of letters that follow their name. Most of the time, this series of letters will begin with an “f” to indicate that they are a fellow of some kind of medical association based on specialty.
Look for these letters after a doctors’ name and do some research to see what organization issues them. If it is a recognized and well-respected medical society, then that’s probably an indicator that the doctor keeps high standards and would be a good physician to trust with your care.
For example, Dr. Lim has M.D., FAANS following his name. This means that he’s a medical doctor and a Fellow of the American Association of Neurological Surgeons.
Talk to Your Neurosurgeon
Above all else, the best way to determine whether or not you trust a physician is to simply sit down and have a conversation with them. That one consultation can tell you a lot.
Do they recommend surgery right out of the gate? What kind of surgery are they suggesting? What is the demeanor of the surgeon? Does he seem rushed or agitated that you’re coming to him for a second opinion? Does he take his time with you and try to understand your specific symptoms and pain? What is his office staff like? What kind of people does he surround himself with?
Getting answers to these questions will help you build a better picture of who the surgeon is, what kind of philosophy he takes to surgery and, quite likely, how he’ll care for you in the operating room.
Yes, it might be an awkward conversation, but a physician who puts his or her patients first will be glad to provide clarity. Listen carefully to their answer and use your best judgment. If you don’t feel safe, then you should seek out another physician to help you.
Spine surgery is not only an incredibly high-stakes procedure, but it’s also a deeply personal matter. You’re essentially putting your entire nervous system in the hands of a doctor. Having an honest, trustworthy, and compassionate physician is of the greatest importance.
You cannot be too careful when it comes to selecting a doctor.
We offer this advice not to make you worried or anxious, but to make you feel empowered. You can and should seek out the best possible medical care.
Awards and reviews, though well-intended, can often make that task harder than it needs to be. But by doing your research and asking the right questions, you can find a doctor who will give you the care you need to live a full and satisfying life, free of debilitating back pain.
“Top Doctors” do exist, but you may need to look harder than a magazine on a table or a plaque on the wall.