It is a perilous time to be sick. Medical error kills 400,000 Americans a year, making it the third leading cause of death after heart disease and cancer. When facing a serious medical problem, it is imperative to consult with top experts to achieve the best possible outcomes. And yet, in my 30 years of managing complicated medical cases, I have seen far too many intelligent and successful people get terrible results because they failed to seek out expert opinions and consider all of their options. Some think that procuring a second opinion from a brand-name doctor will suffice. But that is a mistake. What you really need is an expert opinion. Whether it is a surgeon, an oncologist, or another kind of specialist you seek, be sure that you are consulting with experts who spend the majority of their professional lives totally focused on your specific condition—that is, not just an ob-gyn, but an expert in high-risk pregnancies; and not just a brain surgeon, but someone who is an expert at removing meningiomas from the base of the skull, if that is where yours is located. Here are four tips for finding the best medical experts.
Who are the most prolific authors on your disease?
Expertscape.com, a physician-created search engine, is a great resource for finding doctors committed to the scientific study of your condition. When you type, say, “lymphoma,” into Expertscape, it searches all the articles about this disease in the National Library of Medicine’s Medline database, and produces a list of worldwide authors, ranked according to the number of papers they have written. Practicing physicians who also conduct research are more likely to know which treatments have been proven most effective for your problem and to be current on the latest advances. But it is important to remember that while prolific publication can be a good indicator of how devoted an expert is to your disease, it does not always mean that they are going to be the right specialist for you. Very often, however, they can point you toward a physician near you who is doing excellent work.
Review the medical advisory boards of the top disease philanthropies. For nearly every disease there is an organization devoted to its treatment and cure. Go online to check the medical advisory boards of the top organizations for your disease. Are any of these doctors practicing near you? Might they be seeing new patients or be open to a phone consultation? Pick up the phone or send an e-mail explaining your problem; tell them how much you appreciate their commitment to your disease and/or their articles on it (which you can find at Expertscape.com or PubMed.gov); then ask for guidance. Always let the doctor know that you respect his or her time and are willing to pay for a phone consultation if necessary. Even if the physician is unavailable, he or she may be able to provide a top reference.
Do what doctors do: Call the stars of medicine.
I do this all the time for clients, yet most people do not think to try it: Call or e-mail the chair of surgery or medicine at any one of the best teaching institutions in the country and politely ask for a referral. Robert Udelsman, MD, the chair of the department of surgery and surgeon-in-chief at Yale–New Haven Hospital in Connecticut, says he gets inquiries like this about twice a week. “Maybe it’s a colleague, someone I can’t remember from medical school. I don’t even know who most of these people are, but they say, ‘Rob, can you help me out? I’ve got my uncle, my aunt, my daughter . . .’” Dr. Udelsman says. “I do a quick e-mail, I figure out who the right person is, and I try to refer them on . . . or at least get a contact who can help solve the problem.” While it is true that doctors can be competitive, the ones at the top of their game really do want to help and will often guide you to colleagues who are also really good.
For significant problems, go to significant institutions.
Small community hospitals can handle all sorts of common medical issues. But if you have a significant problem or suffer from multiple health issues, you need to employ an expert at a large institution where they have the experience and technology to anticipate complications. “If you have appendicitis, a gallbladder that needs to be removed, hypertension, or a tendency toward high glucose—but not frank diabetes—these are things that can be managed just about anywhere,” says Anthony D’Amico, MD, a professor of radiation oncology at Harvard Medical School and the chief of genitourinary radiation oncology at Brigham and Women’s Hospital and Dana-Farber Cancer Institute. “But if you’ve got cancer, significant heart disease, complications of diabetes—these are life-threatening issues, and you don’t want any unexpected situations to get in the way of expert care. So you have to go somewhere where that’s what they do.” Search the websites of the academic medical institutions near you—ones that have entire departments devoted to your condition. Consult with physicians whose research interests best match your problem. And always ask your doctors, What portion of your time as a [cardiologist/oncologist, etc.] do you spend on this specific type of condition/procedure? You want to know that you are in the hands of an expert, and not someone for whom your disease is a novelty.
Leslie Michelson is the CEO of Private Health Management and the author of The Patient’s Playbook: How to Save Your Life and the Lives of Those You Love.