… followed by a second riddle: When Is the “Best Hospital” Not the Best Hospital?
Everyone loves a good riddle. I think it’s because the answer is often clever, maybe a play on words. We chuckle (or groan!) at the answer, and sometimes the first riddle will trigger a handful more… just fun.
I wish I could tell you these two are clever, chuckle-inducing riddles, too. Unfortunately, not only aren’t they funny; they can be deadly.
There are two circumstances under which the description of “best” in relationship to medical professionals or facilities needs to be reconsidered.
“I need knee replacement surgery, so I’ve chosen the best ortho surgeon in town!” my neighbor Joe told me after putting up with a bum knee for years. I had to ask him, “What makes that ortho the best? And why?”
Joe’s reply was that he asked around and “Everyone told me to call him.”
What Joe couldn’t answer was “why?” And as it turned out, after a bit of research, the “best ortho surgeon in town” did have great ratings and a good track record – for shoulder surgery.
Now that may not seem like too big a stretch – if that surgeon is good at replacing shoulders, he might be good with knee replacement surgery, too… But – how can we know? It’s a little like saying that just because your auto mechanic has a great reputation for rebuilding a transmission, it means he might also do a great job replacing a broken axle, or fixing your steering. Or if a lawyer is good at drawing up your last will and testament, she might also be able to keep you out of prison….
But how can we know that?
I think we all want “the best” when it comes time for our care, but we must be sure we’re comparing apples to apples, and applying that label under the right circumstances.
So – back to riddle #1: when is the “Best Doctor” not really the best doctor? When his or her area of specialty is really something else. A very important distinction.
Circumstance / Riddle #2:
The answer to riddle #2 will also inform our question about the “Best Doctor” but it’s probably more likely you’ve had this experience in relation to your local hospital.
When Joe first went in search of an ortho for his knee replacement, he posted the question to our community’s Facebook page. “Where can I find a good surgeon for my knee replacement?”
Neighbor Jean replied quickly. “Find a surgeon from XXX Regional Hospital. They are the best choice for knee replacement. I read that on their billboard!”
I was totally blown away that Jean actually believed the hospital’s marketing and with no more than that, made a recommendation. Further, hospital ratings had just come out – the objective, well-researched ones (more on that in a minute) revealing that hospital’s very high infection rate…making that hospital one of the last places Joe should choose.
You might be quite surprised at how easy it is to be taken in by some of the slick marketing you see and hear, and your opinions may also have been formed by that marketing, even if you don’t realize it. I’m guessing there is one hospital in your locale that claims it’s the best for heart problems – right? Or, the best for diabetes care. Or – the list can go on. But, you may believe them and not realize that your beliefs don’t stem from facts. Instead, your beliefs are influenced by their TV, or radio, or internet, or billboard advertising. Or all the stories you read about them in the newspaper or online, or watch being broadcast on the news… That is ALL good, slick marketing.
Further, there are very well-known publications that publish their “best of” lists every year. Best doctors, best hospitals, best colleges, etc… but did you know that for most, that “best of” placement can be purchased? Yes. Those lists are marketing; a great way for those publications to make plenty of money each time they publish their lists. Then, once published, the hospital can use that “best of” list in further marketing.
Then there are the “Best Doctors” lists you see in airline magazines. Almost all adult passengers look at those very slick lists thinking how impressive those doctors must be if they are the “best”… and yet, what they are really best at is writing checks. (Find those lists alongside the Best Steakhouses and Best Sushi – again – great advertising for the restaurant and great profit making for the publication.)
Most of us succumb to slick marketing without even realizing it. Those who are savvier know how to truly vet a doctor to see what she or he is truly the best at, making sure their reputation is established based on what it is we need them to do for us.
The same is true for hospitals. There are ways to find out what their success rates are, their patient satisfaction, their infection rates, and more.
If you have trouble with your vetting process, then it’s time to contact a patient advocate or care manager to help you. That’s what they are “best” at!
So now we know the answers to our riddles. Don’t be fooled. These riddles aren’t funny.
Instead, do a little homework, or call an advocate to get the right answers for you.
Update March 2019: as published by Marshall Allen, ProPublica: I’m a Journalist. Apparently, I’m Also One of America’s “Top Doctors.”