Alexis Simendinger, the White House correspondent for National Journal magazine, was in Sarasota for a board meeting at her alma mater New College of Sarasota, when she got an urgent phone call. Her mother had been diagnosed with a rare adrenal tumor and needed immediate medical attention. Right after the meeting, Simendinger went online, putting to use her journalist's skills to find the best doctor.

Simendinger spent weeks searching the Internet, combing through articles in professional journals, then e-mailing and calling doctors and other experts from these articles, asking them who was best equipped to handle her mother's kind of tumor. She read online bulletin board postings from people who had the same condition and noted which doctors they preferred. She researched the top hospitals. Eventually, she narrowed the search to one surgeon at Yale University in Connecticut, several hours from her mother's home in West Virginia.

Her mother, however, wanted to have surgery as soon as possible in the same hospital that had conducted the lab tests. She had worked as a nurse in this hospital-a National Institutes of Health hospital, one of the best in the country-and was comfortable with the surgical team (although she didn't know the doctor). Flying to a strange city to a strange hospital seemed too unnerving. In addition, her endocrinologist had recommended that a surgeon at this hospital perform the procedure.

Simendinger, however, had discovered that this surgeon had no reputation in the tiny subspecialty that treated her mother's tumor. "It's a small world, and people had never heard of him," Simendinger says. "I told her the best doctor was at Yale."

Nonetheless, her mother decided to go with the convenient surgeon-a decision that nearly cost her life. The physician performed a risky procedure that a more skilled surgeon would probably have avoided, and Simendinger's mother almost died on the operating table. The next day, fighting for her life, she had to have emergency surgery-an organ transplant, no less-because of the damage done to her during the original surgery. She ended up spending four and a half months in the hospital instead of the four days her doctor had originally predicted. While Simendinger credits the formidable skills at NIH for saving her mother after the operation, she believes a better doctor would have prevented her mother's ordeal. What did she learn from the experience? "Try to get the absolute best specialist," she emphasizes. "Remember, you're allowed to shop. Even if it's trouble, even if you have to travel, it's worth it."

As frightening as Simendinger's story is, it's not uncommon. In 1999 the Institute of Medicine estimated that up to 98,000 Americans die each year from preventable medical mistakes in hospitals. In another report, the Institute stated that "more people die from medical mistakes each year than from highway accidents, breast cancer or AIDS." And while most patients will not be the victims of outright mistakes, who can say how many might have lived longer or returned to health sooner if their doctors had been better diagnosticians, more informed about the latest therapies, or just clearer in explaining things to patients and their families? Choosing the right doctor can save your life. But what makes a doctor the best? And how can you judge how good a doctor is?

In an ideal world, your brother-in-law is a great doctor. If you need a specialist, he'll give you the inside scoop on who's brilliant, meticulous and compassionate. But where can you go if you're not lucky enough to have a doctor in the family? Best Doctors, a Boston and Aiken, South Carolina, company whose primary business is to find, for a fee, the best doctors for customers with serious and complicated medical conditions, has been assembling lists of the best doctors in America for 10 years. The company sends tens of thousands of surveys to doctors all around the country, asking them, "If you or a loved one needed a doctor in your specialty, to whom would you refer them?"

This year, Best Doctors sent out about 35,000 surveys. The doctors who received the surveys were carefully chosen. All were specialists, and most had made the best doctor list the previous year. The company's researchers believe that doctors who have been recognized as tops in their specialty, are the logical choice to nominate and vote on other top doctors in that field. Each doctor receives a survey based on his or her specialty-cardiologists vote only on cardiologists, for example. When the surveys come back, Best Doctors tallies the votes and checks to make sure the top vote getters are board certified and have up-to-date licenses. Doctors who are not taking new patients or who are doing only administrative work or research are eliminated. Out of the 814,000 doctors in the country, 30,000 made the list this year. Thirty-six of them are in Sarasota and Bradenton, and SARASOTA Magazine has been granted the exclusive right to publish this list, which we present on the following pages.

As carefully researched and well-respected as the Best Doctors list is, however, it's just one factor to consider in choosing a doctor. "These lists are a starting point," agrees Susan Edgman Levitan, a Harvard Medical School professor who ran the Picker Institute, which collects patient feedback about healthcare. Informed patients should consider other sources of information as well.

Nurses, for example, often have great insight into the quality of care different doctors deliver. And they have their own opinions about what makes a good doctor- "someone who collaborates and communicates," says Vicki Long, the nursing director of ICU at Sarasota Memorial Hospital. And some doctors are in a position to know more about their peers than others. "Ask the E.R. doctor," says Dr. Bill Colgate, an emergency room physician at Sarasota Memorial Hospital. "They know who does the right thing at two in the morning and who your doctor's partners are. You might have the best doctor, but partners can be shaky."

"I would consult an internist," says Dr. Carlos Caballero, who, not surprisingly, is an internist. "I've been here for seven years, and it's trial and error. I'm down to a couple of specialists in every field. As an internist it's a major part of my job. I'm the feeder person. You store a bank [of information] and eventually say, 'Well, all right, he's not going to see my patients again.'"

Levitan says even doctors who deal with many other doctors may not understand what matters most to patients. "We find there's a huge gulf between what doctors think is important and what patients think is important," she says. Doctors usually cite superior technical skills; and while patients want doctors with those skills, they also put a superior bedside manner at the top of the list.

"For doctors it's an either-or situation," Levitan says. "But patients want both," she says. And a good bedside manner is not just a touchy-feely thing: "Doctors can't be effective as healers if they can't talk about what's going on."

Health care professionals are starting to understand that bedside manner-in other words, an ability to communicate with patients, their families and other medical professionals-has a lot to do with how patients fare in the long run. In a landmark paper by the Institute of Medicine, called "Crossing the Quality Chasm: A New Health System for the 21st Century," national healthcare experts point out that most Americans are sick with common and chronic diseases, such as hypertension, diabetes and asthma. These ailments require a team approach-lots of doctors, therapists and health care settings over a long period of time. A doctor who can't-or won't-communicate about long-term care issues such as nutrition, exercise, therapy and medicines will fail to provide "safe, high-quality care," concludes the paper.

Colgate, the emergency room physician and Sarasota Memorial's vice president of medical affairs, says he weighs technical ability and bedside manner equally when he's looking for a doctor. He wishes patients could have access to inside hospital information, such as mortality and complication rates. "If I had a loved one who needed colon surgery or a child's brain surgery, I would sure want that," he says. Hospitals, including Sarasota Memorial, are working on releasing some of this information, he says, but it's tricky. All hospitals will have to have identical ways of recording this data; otherwise, the most meticulous institutions and the institutions that handle the most complicated, high-risk cases, will be penalized for their honesty.

Still, doctors and hospitals are bound to become more responsive to patients whether they want to or not. "There is increasing consumerism in medicine," says Colgate. "The public is demanding more and more accountability. It's the biggest driving force right now." He notes that dozens of Fortune 500s, including FedEx, AT&T, IBM and Pepsi, have formed a group called Leapfrog, which is evaluating hospitals and staff, and will force the healthcare industry to address issues of quality.

So how do you find the best doctor? You must take an active role in the process, say the experts. Keep in mind that most of your medical needs can be satisfied within the local medical community. However, only a few specialists in the world can treat rare and complicated conditions; if you are diagnosed with such a condition, it's essential to do an exhaustive search.

Begin with your primary care physician's recommendation, but don't stop there. The Internet is a godsend, and patients-or their families-can find endless material online about their conditions and the people who treat them. The Internet can also spread misinformation, however, so it's important to consult only reputable sites. Best Doctors has an award-winning Web site www.bestdoctors.com to help consumers, but there are others: www.medlineplus.com, which is a National Library of Medicine Web site, gives access to thousands of medical articles, and www.nih.gov is a clearinghouse of information about diseases and clinical trials. Almost every disease has an official association or organization that offers up-to-date information about treatments along with support networks of people who are willing to talk online about their experiences.

After satisfying yourself that the doctor has a solid clinical reputation, you need to evaluate his or her customer services, because those can significantly affect your well-being.

Talk to people with your condition to find out if the doctor is open and warm or rude and aloof. Then interview the doctors on your list-and be bold. Ask them how many patients they've seen with your condition, how many surgeries they've performed and how many patients have died in surgery. Best Doctors has an online checklist of questions to ask doctors based on your particular condition.

And while many people shrink from asking their doctors such questions, Simendinger says that after her mother's ordeal, she's more convinced than ever that patients should learn all they can about their doctors' abilities and experience. "Find the best for yourself," she urges. "When you're really sick, you need an advocate. Someone who will be inquisitive, dogged and persistent. Don't be afraid to ask challenging questions. You're not there to be a friend."

THE BIG EIGHT

Based on 500,000 patient surveys, these are the qualities the Picker Institute found most important in a physician.

1. Access to care. Can you get an appointment easily? Can you talk to the doctor directly or get information when you need it and not get the runaround?

2. Respect for patient preferences. Does the doctor care about what the patient wants? Does the doctor care about cultural and religious preferences?

3. Coordination of care. Does the doctor have smooth connections to specialists and labs?

4. Information and communication. Does the doctor clearly explain what's wrong? Does the doctor explain options? Does the doctor talk about nutrition and exercise?

5. Emotional support. Does the doctor understand the need to discuss fears and anxieties?

6. Involvement of family members. Does the doctor take the time to respond to family members-or agree not involve them-depending on the patient's preferences?

7. Physical comfort. Does the doctor care about pain management?

8. Hospital discharge. Does the doctor explain what medicines to take, what their side effects are, what to do in an emergency, describe danger signals and when to resume normal activities?

THE LIST

The Sarasota doctors who made this year's list of The Best Doctors in America.

Allergy and Immunology

Hugh Harmon Windom

4040 Sawyer Road, Sarasota, FL 34233 * (941) 927-4888

Cardiovascular Disease

Randy B. Hartman

Heart Center of Sarasota, 1540 S. Tamiami Trail, Sarasota, FL 34239-3033 * (941) 365-0433

Dermatology

Philip M. Catalano

1416 59th St. W., Bradenton, FL 34209-4696 * (941) 792-2934

Alfred D. Hernandez

1849 S. Osprey Ave., Sarasota, FL 34239-3614 * (941) 957-4767

Cathy P. Milam

1750 S. Osprey Ave., Sarasota, FL 34239 * (941) 364-8220

Susan H. Weinkle

5601 21st Ave. W., Suite B, Bradenton, FL 34209-5432 * (941) 794-5432

Family Medicine

Patricia Morales Fine

121 Avenida Messina, Sarasota, FL 34242 * (941) 349-6161

Randy B. Powell

Intercoastal Medical Group, 921 S. Beneva Road, Sarasota, FL 34232 * (941) 365-7390

Gastroenterology

Michael S. Hall

2650 Bahia Vista, Suite 207, Sarasota, FL 34239 * (941) 366-8960

Elliot Livstone

1515 S. Osprey Ave., Pine Tree Center, Suite C-11, Sarasota, FL 34239 * (941) 955-0000

Thomas A. O'Malley

2650 Bahia Vista, Suite 207, Sarasota, FL 34239-2625 * (941) 366-8960

Geriatric Medicine

Bruce Eugene Robinson

1700 S. Tamiami Trail, Sarasota, FL 34239 * (941) 917-7197

Nephrology

Marc Silverstein

Nephrology Associates, 1921 Waldemere St., Suite 413, Sarasota, FL 34239 * (941) 893-8668

Stephen Zendel

Nephrology Associates, 1921 Waldemere St., Suite 413, Sarasota, FL 34239 * (941) 917-6585

Neurology

Alan B. Grindal

Neurological Associates, 5831 Bee Ridge Road, Sarasota, FL 34233 * (941) 308-5700

Obstetrics and Gynecology

Washington C. Hill

1700 S. Tamiami Trail, Sarasota, FL 34239 * (941) 917-6260

Ophthalmology

Harry B. Grabow

Sarasota Cataract Institute, Building F, Suite A, 3920 Bee Ridge Road, Sarasota, FL 34233-1258 * (941) 921-7744

Harris S. Silverman

The Eye Associates, 6002 Pointe West Blvd., Bradenton, FL 34209 * (941) 792-2020

Orthopaedic Surgery

William R. Kennedy

1818 Hawthorne St., Sarasota, FL 34239 * (941) 365-0655

Otolaryngology

Michael Gurucharri

Ear, Nose and Throat Associates, 2010 59th St. W., Suite 3500, Bradenton, FL 34209 * (941) 792-2455

Robert Philip Hillstrom

Facial Plastic Surgery Center, 250 Second St. E., Suite 4B, Bradenton, FL 34208 * (941) 749-1566

Seth Irwin Rosenberg

Florida Ear and Sinus Center, 1961 Floyd St., Suite A, Sarasota, FL 34239 * (941) 366-9222

Herbert Silverstein

Florida Ear and Sinus Center, 1961 Floyd St., Suite A, Sarasota, FL 34239 * (941) 366-9222

Pediatrics (General)

Patricia Juarez Blanco

2401 University Parkway, Suite 202, Sarasota, FL 34243 * (941) 360-1266

Donald Scott Featherman

Comprehensive Child Care Associates, 943 S. Beneva Road, Suite 102, Sarasota, FL 34232 * (941) 955-5191

Plastic Surgery

Braun H. Graham

Sarasota Plastic Surgery, 2255 S. Tamiami Trail, Sarasota, FL 34239 * (941) 366-8897

Robert Philip Hillstrom

Facial Plastic Surgery Center, 250 Second St. E., Suite 4B, Bradenton, FL 34208 * (941) 749-1566

James H. Schmidt

Sarasota Plastic Surgery, 2255 S. Tamiami Trail, Sarasota, FL 34239 * (941) 366-8897

Psychiatry

Parlane John Reid

1625 S. Osprey Ave., Sarasota, FL 34239-2929 * (941) 917-7182

Pulmonary and Critical Care Medicine

Bruce M. Fleegler

Lung Associates of Sarasota, 1895 Floyd St., Sarasota, FL 34239 * (941) 366-5864

Radiation Oncology

Alan H. Porter

Sarasota Radiation-Medical Oncology Center, 3663 Bee Ridge Road, Sarasota, FL 34233-1003 * (941) 924-8700

Rheumatology

Jeffrey L. Kaine

Venice Arthritis Center, 411 Commercial Court, Suite C, Venice, FL 34292 * (941) 484-4409

Richard A. Yonker

Sarasota Arthritis Center, 3500 S. Tamiami Trail, Sarasota, FL 34239 * (941) 365-0770

Surgery

Edward L. Bradley III

1600 Baywood Way, Sarasota, FL 34231 * (941) 923-1331

Thoracic Surgery

NOTE: IN OUR JUNE ISSUE, WE PUBLISHED AN INCORRECT NUMBER FOR DR. BRADLEY. THIS IS THE CORRECT NUMBER.

Thomas F. Kelly

Cardiovascular Associates, 1880 Arlington St., Suite 103, Sarasota, FL 34239 * (941) 365-9411

Urology

Winston E.I. Barzell

Urology Treatment Center, 1921 Waldemere St., Suite 310, Sarasota, FL 34239 * (941) 917-8488