Through its “Top Doctors” series of books and database, Castle Connolly provides consumers with a directory of tens of thousands of healthcare providers nominated by their peers and screened by a physician-led research team. “We were the first people to ever survey physicians to ask them to rate other physicians,” says Dr. Connolly, who is president and CEO of Castle Connolly, which the Everyday Health Group announced on January 16, 2019, that it had acquired. Everyday Health recently spoke with Connolly about the origins and evolution of Castle Connolly, the medical community’s response to the “Top Doctors” concept, and what the future holds for connecting consumers with the healthcare that’s right for them. Everyday Health: How did you and John K. Castle come up with the idea to start Castle Connolly? John Connolly: It was at John’s suggestion. I had been president of New York Medical College, and John had served as its chairman of the board. I was leaving the College after 10 years and wanted to do something different. John suggested we publish books to help people find good doctors, since so many of our friends would call us and ask for recommendations because of our association with the college. EH: What was the thinking behind having doctors nominated by their peers, as opposed to patients? JC: Patient reviews may be good for some things, like bedside manner. But in terms of measuring clinical excellence, we felt that doctors were the key. They were the ones who really knew. When we were looking for some expertise, we would call members of our medical staff. So that’s why we developed our model of surveying physicians. We stress checking our doctors’ credentials. Is the physician board-certified? Are they on the staff of a good hospital? Is there any disciplinary or malpractice history? Real facts that you can check on. EH: You mentioned hospital affiliation as a criteria for choosing doctors. How should that factor into consumers’ decision-making? JC: Obviously, many of the top physicians are at the top hospitals. But top hospitals vary a great deal. Some might be stronger in one department or specialty than another. If you have a physician and you’re going to be hospitalized, it’s very likely that you’ll be admitted to his or her hospital. So, very often, we suggest you may want to choose the hospital first. If you have a heart condition, for example, you might want to look for a hospital that offers full heart care services. So if you’re admitted to a hospital where your doctor is on staff, you can get the total mix of care that you might need. EH: How did the medical community initially react to the idea of peer nominations, and has that attitude changed over time? JC: Our first book was top doctors in the New York metro area. I sent out 40,000 surveys, and I got dozens of hate mails back. Physicians were very angry that we would undertake such an audacious act as asking physicians to rate their peers. But five years later, when we surveyed 250,000 physicians to create the book and database of America’s top doctors, I didn’t get a single negative letter. It was amazing how the environment had changed. EH: How do you approach asking doctors to choose among their peers? JC: We don’t ask for negative things. We ask them which doctors they consider to be the very best in every specialty. Who are the doctors that other doctors would take their own families to? EH: Even though the target audience is consumers looking for a doctor, do you find that physicians also use the information that you collect? JC: Physicians do use it for referrals, very much so. EH: How did the business evolve to keep up with technology and the internet? JC: We started off publishing books: books on eldercare, on cosmetic medicine and dentistry, by regions — a whole range of targeted markets. And the first surveys in the 1990s were taken with paper and pencil. We had 30 people entering data from physicians’ handwritten nomination forms. Then, around 2000 to 2001, we moved to the internet. Doing our surveys on the internet was much more efficient, and it enabled us to do a lot more with the data in terms of maintaining it and using it. The entire database is now searchable online. EH: What is the screening process to determine which doctors are included? JC: Our selection process is not entirely based on nominations, although that’s the basis. We have a research team headed by a physician that reviews the credentials of anyone we’re considering. We research their education, residencies, fellowships, hospital appointments, disciplinary history, malpractice history. EH: Are there situations where the nomination process isn’t enough to fill gaps in certain specialties or regions? JC: Very often we’ll supplement the surveys by phone calls. Say, for instance, we’re looking for a pediatric endocrinologist in Kansas City, and we don’t have any nominations. Our research team will call pediatricians in Kansas City to ask who the best pediatric endocrinologists are in the area. So we gather nominations like that too. EH: How do you determine what specialties to include, and have there been any changes in the types of doctors listed? JC: We include specialties where a patient can make a choice. A couple of changes occurred in that regard. At one time, we included emergency room physicians. But one of their professional groups asked us not to do that. They didn’t want people going to the ER and asking for specific doctors. We also used to include anesthesiologists. People do have a right to make a choice about an anesthesiologist, but so few patients know that or do it that it just wasn’t useful to include. Today, the only ones we include are in pain management. EH: How often do you update your database? JC: Every year, each physician is contacted. Updates are made for different reasons — if a doctor dies, moves, retires, goes into administration. If a physician still has an active license but they’re not seeing patients, we won’t include them. The whole purpose is to include doctors who are seeing patients, so people can make that contact with them. EH: What is the biggest challenge in helping people choose the best healthcare providers, and what advice would you give consumers looking for a doctor? JC: It’s still such a challenge today to convince patients that they should be checking out a doctor. They should be doing more than picking a name off a health plan directory, or asking their next door neighbor. This is one of the most important decisions they’ll make, and they should make it carefully.
