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December 21, 2005

BehindTheMedspeak: Is your doctor a quack?


Are you sure?

Because doctors can fool you.

Let me tell you a little story, all the more profound because every word of it is true.

Once upon a time, in a galaxy far, far away, I went to UCLA Medical School.

I got to be friends with some of the members of the class a year ahead of me; I saw them on rotations, in the mail room, what have you.

While in med school and for some years thereafter I lived in an wonderful old Spanish–style apartment building that was walking distance from UCLA.

My downstairs neighbor was a member of the class that finished a year ahead of me; he was a GP in solo private practice in Malibu and liked to drop the names of his famous show business patients.

He had the most beautiful clothes.

He had a Ferrari, bright yellow as I recall, and a Porsche and a string of flight attendant girlfriends over the years, but finally settled down with one in particular who was just nutso.

Screaming, crying, fighting, noise, things being thrown against the wall and breaking, doors slamming so hard the building shook, loud music, the works emanated from their place.

But the apartment and the rent and the location were so great I just didn't want to move so I endured their craziness for years.

Among the other members of this guy's class had been my dorm residence advisor when I was an undergraduate; I remained friends with him, touching base maybe every couple years or so.

Once I mentioned that I was living above his med school classmate and I started going on about what a bozo the guy was and the ex–residence advisor started laughing really hard.

What's so funny? I asked.

He said my neighbor had graduated last in their class: #121 out of 121.

No one could believe UCLA Medical School would actually let him graduate, he was such a doofus.

He knew nothing, screwed up everything and half the time didn't even show up.

But you know the old joke, don't you, about what they call the guy who graduates last in his med school class?




One day, maybe eight or ten years after I'd graduated, I happened to be reading Los Angeles magazine, the annual issue featuring "The Best Doctors in Los Angeles."

And guess what?

My downstairs neighbor, Dr. Last–in–his–class, who would occasionally tell me about pet treatments out of left field that he used in his practice, was named "The Top GP in Los Angeles."


So that's why I asked, at the top of this post, "Are you sure?"

But I digressed, didn't I?

The AMA provides a free online resource that will at least give you some basic information about a doctor — specialty certification and his or her city and state, at a minimum.

It's called DoctorFinder but it has the most arcane web URL you'll ever see, as you'll notice if you look up at it after you go there.


Feeling lucky?

But maybe now you're just getting warmed up, what with your nifty online searching skills and all.

OK, then — how about we take it to the next level?

DocFinder, also free, offers more detailed information, but it's limited to data provided by licensing boards in 19 of the 50 states.

There are links to websites with information for many of the states not among the 19.


There's much more here, in an excellent survey by Vauhini Vara of sites offering data and reviews of doctors; it appeared in this past Monday's Wall Street Journal.

December 21, 2005 at 10:01 AM | Permalink


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There are 2 problems: when medical sector is private they can fool you because of money when it belongs to state they can fool you because they do not get enough salary and do not think that they should work for that salary.

Posted by: ambulance doc | Jan 15, 2006 4:40:32 PM

Many thanks for the clear-up!

(I have no sense of direction either. Neither does my brother but he won't admit it. I wonder if it's genetic?)

Now I have to go undo something.

Posted by: Flutist | Dec 21, 2005 4:56:56 PM

Hi, Flutist. You're right. It's Mark Twain. And I thought it was Mark Twain but remembered reading something about Benjamin Disraeli saying it or there being a controversy over who said it. And since I thought it was Mark Twain I decided it must be Disraeli. This is what happens when you have a brain like mine, that can remember everything, but nothing of real importance (or accuracy obviously)!

And just to give you more information than you ever wanted, this is how I sometimes decide directions, because I am perpetually lost in the real world. No sense of direction. None. So if I think I should turn left, I will often turn right...knowing that the probability of my hunch being wrong is very high. Hey, just like today, I have a 50-50 shot of it working either way! ;)

Ironically, it can all be cleared up on bookofjoe. Joe himself attributes the quote to Disraeli in August: http://www.bookofjoe.com/2004/08/behindthemedspe_3.html

But then by October he has discovered that Mark Twain said it and gives us a source even: http://www.bookofjoe.com/2004/10/the_internet_an.html

What a difference a few months can make! Hopefully, you will see that kind of improvement out of me also by February.

Posted by: Shawn Lea | Dec 21, 2005 4:00:22 PM

Uh-oh. It was Disraeli said that? I go around telling people it was Mark Twain. It was Disraeli, really? Hmm. I have to go do something.

Posted by: Flutist | Dec 21, 2005 1:15:22 PM

Before the recent advent of quality indicators, studies showed that most patients rated their doctors high or low based on personable skills: Did he talk to me? Did he ask me if I had any questions? Was he nice?

Same for malpractice. The best doctors are not necessarily the ones NOT getting sued. It's the nicest ones.

Doesn't make much sense at first. But when you think about it, What the hell do we know about what's wrong with us or not? That's why we're going to the doctor. All we know is how we are treated during the visit.

And, lastly, and I'll get off my high horse, if you are going to choose a doctor based on reports and reviews from Web sites, make sure you read about how the data is collected, the size of the ratings groups, etc. They are all very different - and the same doctor can get an A+ using one set of criteria and a D- using another.

It reminds me of the joke I hear a lot in medical circles regarding data... The patient tells the heart surgeon in a small, rural community that he was considering using him for his procedure but he saw he only had a 50% success rate. Why so low?, he asked. One of them died, the doctor replied.

As Benjamin Disraeli said...Lies, damn lies, statistics.

Posted by: Shawn Lea | Dec 21, 2005 12:00:27 PM

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