Choosing a Doctor

by John Tennison, MD, Copyright 2003

Are all doctors the same?

In a word, “No.”  Even if people who attend medical school typically have above-average intelligence, there is still considerable variation in intelligence and ability among physicians.  Unfortunately, not everyone gains admission to medical school based on merit.  Therefore, making choices as a health-care consumer can feel like a blind shot in the dark.  Fortunately, there are many sources that, when taken collectively, can help you make an informed and intelligent choice.  Many of these sources rank doctors or the institutions at which they have trained or been educated.  No one source of information should be the sole determinant of the doctor you choose.  However, if you discover that a particular doctor and his/her educational background are ranked highly across many sources, such consistency in rankings will stand a greater chance of being true as compared to a doctor who is only ranked highly by a single source.  This is not unlike visiting a novel city and asking how to get to City Hall.  If 9 out of 10 people say that City Hall is at 3^rd and Main Streets and one person says City Hall is at 5^th and Elm Streets, the truth is probably that City Hall is at 3^rd and Main Streets.  So it’s probably best to start at 3^rd and Main Streets.  If it turns out that City Hall is not there, you then might want to check at 5^th and Elm Streets.

How are medical institutions ranked?

          There are many ways that medical institutions are ranked.  It is therefore very important to make sure that the ranking(s) that you encounter are germane to your individual needs.  For example, if you are looking for a good psychiatrist, an institution’s ranking highly in urology is probably not relevant to your choice.  In general, there are five broad ways medical institutions are ranked:

1.)  Health-Care Consumer Perspective

2.)  Medical Student Perspective

3.)  Medical Specialty Trainee (“Resident”) Perspective

4.)  Quality of Research Perspective

5.)  Faculty/Staff Perspective

For example, you might be well-served as a health-care consumer in a highly-ranked academic medical center.  However, a resident at such a training site might be overworked and miserable, and therefore be having second thoughts about their choice for a training site.  However, as a health-care consumer, the compulsive attentiveness and “pain” of a medical student or resident trainee might serve you well, even if that student or resident is tired or over-worked.

One ever-popular source of rankings from the health-care consumer perspective is U.S. News and World Report’s annual “Hospital” ranking.  However, even if you are not going to be "hospitalized", these rankings are a reasonable guide to choosing expertise in an area relevant to your needs.

U.S. News and World Report also publishes an annual ranking of medical schools from a medical student perspective.  Another well-known ranking of medical schools is The Gourman Report.  In general, both of these ranking systems correlate with the rankings from a Health-Care Consumer Perspective.  However, this correlation is not perfect.  For example, a medical school that is ranked low from a student perspective might have isolated examples of excellence in particular medical specialties.

Are foreign medical schools as good as those in the United States?

            There is much more variation in the quality of foreign medical schools as compared to medical schools in the United States and Canada.  Some foreign medical schools are every bit as good, or even better, than some in the United States and Canada.  However, since there is not a reliable accreditation process to reveal the quality of foreign medical schools, health care consumers should look for evidence of equivalency in medical school curricula before choosing a doctor who graduated from a foreign medical school.  However, one exception to this wisdom would be if you speak a language other than English, or speak English poorly.  In such a case, you might find that going to a physician who attended a medical school where training occurred in your native language allows for the best communication between you and your doctor.

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