I just received a flyer in my mailbox from my city magazine asking me to vote for the top docs of 2012. I talked to a veteran of the magazine industry several years ago who told me the back story.
These issues are big money makers for local magazines. They can count on a fair number of plastic surgery ads, ads from large medical groups, and ads from hospitals and other healthcare facilities. It’s usually their most profitable issue of the year.
If you have way too much time on your hand one year, see where all the nephrologists, rheumatologists, or other ologists have their offices. The practices with more aggressive marketing efforts, including large multi-ologist groups, tell all their employees to vote for the docs while they’re at work. The total number of votes is actually kind of low, so the dedicated staff of a large practice can sway the vote that much. If all the “Top Docs” are in the same group, there’s a good chance this is what happened.
Maybe my attitude would change if I ever won one of these things.
Welcome to the wonderful world of “astroturfing”, a rather crude version of “stealth marketing”, as we used to call this slimy practice in the field of public relations.
One of the best (or worst) examples in health care was the American plastic surgery company called Lifestyle Lift that allegedly ordered employees in 32 centers to post fake positive reviews online about their $5,000 quickie facelift procedure. But in 2009, New York Attorney General Andrew Cuomo stepped in, investigated the company for fraud, and ordered Lifestyle Lift to pay $300,000 in penalties (which is roughly equivalent to lunch money for those cosmetic surgeons).
The attorney general’s office said the case was believed to be the first in the U.S. addressing the practice of “astroturfing”. More on this at:
http://ethicalnag.org/2010/03/22/shill-game/
It is a beauty pageant, isn’t it? The sad fact is that family practice docs don’t and won’t get the spotlight because they don’t do anything that is “spectacular” by press pizazz standards.
All good family practice doctors do is work hard to stay in practice, without any of the big ticket items John Q Public seems to feast his eyes on – like all those beautiful people docs chasing the eternal fountain of youth. Maybe if our lust for glitz subsides, we’ll get a chance to show what really important work can get done with primary care medicine in control. I’d daresay that if that happens, some of those full page ads might shrink
I would certainly agree that “Top Docs” lists are about making money, and that they include “very sub” specialists, and that their offices are in fancy neighborhoods. Albert Schweitzer never could have made such a list.
At the risk of self-promotion, I did a blog piece on this topic in my Medicine and Social Justice blog on Oct 13, 2010: “Top Doctors”: Who are they — and who are they not necessarily?” http://medicinesocialjustice.blogspot.com/2010/10/top-doctors-who-are-they-and-who-are.html
Joshua,
Nice post, and feel free to self-promote with good material like this. Your comments made me think of those silly best doctor ads at the back of airline magazines.
I have been going to my family doctor for about forty years. Ever since he was a young doctor and I a young wife and mother. I can always count on him to do the best for me. If it were up to me to vote he would be on my list of top doctors. He not only treats his patients for what ever ails them, but he knows you and lets you know that you are important to him. The problem is that we just don’t have enough doctors available in this category. For one thing, it is so expensive and medical school takes so long that many students who want to go into that field are discourage about even making enough money to pay back their medical school debts. If a student is 24 when they graduate college, they will be almost 30 before they can even get their license. That’s why so many become specialists.
I would like to say though that in one artical about you where you said that you thought it might be right to tell a cancer patient that what they were doing wasn’t working an it was time to focus on keeping them comfortable and getting the most out of the time they have left. I think you had better make sure that you really know that patient well because I think if it were me that would be like a death sentence and to just give up and die. My doctor would never do to me because he knows me. Just a thought.
Martha,
You are absolutely right. The kind of deep personal discussion like the article suggested is only possible if years of trust have built up between the family physician and his patient.
Thanks for your thoughts.
Thank you for a beautiful post.
What you describe is exactly why many of us went into family medicine. Sadly, it is considered to be of no value in the PCMH model of health care.
I sincerely doubt that the writer is demanding that her doctor “transform” his practice.
Wonderful article about Dr. Young in the Dallas Morning News on Tuesday Jan 10th.
Dr. Young was recently appointed as an adviser to the Medicare/Medicaid Center for Innovation — the only Texan on the force.
The body of the article is locked behind a subscriber password, but the link is here:
http://www.dallasnews.com/business/columnists/jim-landers/20120109-trust-your-doctor-to-save.ece