Forget beachfront property or downtown real estate; the most valuable commodities in the world are time and health, and they can depend on each other. It takes time to find the right physician, and the problem is exacerbated in Sarasota, where seasonal visitors and newcomers may not have established a relationship with a doctor when illness strikes.
"You don't want to be in a situation where your only option is to go to the emergency room," warns Lyn Cassan, manager of marketing communications for Sarasota Memorial Hospital. Health problems that arise unexpectedly can require immediate attention; but few physicians, if any, can see new patients without several months' notice. And even those who already have a primary care physician but suddenly find they need a specialist can feel baffled about how to find the right one.
"People's choices have become more narrow," says William Liss-Levinson, vice president for business development at Castle Connolly Medical, a New York-based healthcare research company that annually publishes America's Top Doctors. "Employers typically now offer only one healthcare option, yet consumers have become accustomed to exercising a greater role in choosing their healthcare. There is an abundance of available information, especially online-but with varying degrees of credibility and understandability."
To help you navigate through this medical maze, Castle Connolly has compiled our exclusive list of the best doctors in Sarasota and Manatee. They begin by asking a random sampling of local board-certified doctors, nurses and hospital administrators to nominate outstanding physicians in various specialties, those "to whom you would send your own family." A physician-led research team then reviews and verifies the doctors' credentials.
To be eligible for the list, doctors must be board-certified and have a minimum of 10 years experience (some specialties may require 12 or more years). Castle Connolly looks at their education, residency, fellowships, the number of nominations, faculty appointments and even disciplinary history. (You can check a doctor's disciplinary record at the Florida Department of Health's Web site, ww2.doh.state.fl.us/irm00praes/praslist.asp. To check a doctor's disciplinary record in any state, check the "Vital Healthcare Info" section at Castle Connolly's Web site, www.castleconnolly.com/healthcare.) Doctors were also evaluated on their office practices, such as the length of time it takes to get an appointment, languages spoken by staff and the health plans they accept.
There are more than 70 board-certifiable medical specialties, and if doctors in a certain specialty were not nominated, that specialty may not appear on the list. Liss-Levinson notes that Florida has a lower statewide percentage of board-certified doctors than the national average. (You can check whether a doctor is board-certified in the specialty in which you're seeking treatment by visiting the American Board of Medical Specialties at www.abms.org.)
"We have good doctors in this town," affirms Dr. Bernard Feinberg, associate chief of medical staff at Sarasota Memorial. And we have a lot of them-currently about 835 board-certified doctors practice in Sarasota and Manatee counties. Only 46 appear in this story; clearly, many excellent doctors do not appear on the listing, which is not intended to be a comprehensive ranking. If you're in the market for a doctor, it should be just one of several sources you use. And it's important to determine not just the "best" doctor, but the best doctor for your needs.
Many hospitals have physician referral services that can help point you in the right direction. Sarasota Memorial's Healthline and physician referral service (call 941-917-7777) are run by people who have a clear understanding of their doctors' credentials as well as their strengths and weaknesses.
Credentials go a long way in distinguishing doctors, but often it's that unquantifiable bedside manner that really pushes them to the top. Happy patients are a doctor's best credentials, which is why Feinberg says word of mouth is the best place to start researching possible physicians. "We [doctors] all have various pieces of paper hanging on the wall, but none of that translates into quality patient care," says Feinberg, who is on the Castle Connolly list and continues to practice internal medicine in addition to his administrative duties.
Sarasota Memorial's Cassan recommends interviewing the doctors you're considering, and asking them as many questions as possible. Don't be afraid to cite information from the Internet. "You want a doctor who wants an educated patient," says Cassan. Pay attention to the doctor's communication style, too. "If he won't let me get a word in edgewise-that concerns me," says Feinberg. If it's your first time visiting, how thoroughly does the doctor investigate your history? "A lot of times it's a mystery that they're trying to solve," says Cassan, so you want "a good detective."
When seeking a specialist, Cassan points out, the primary care physician is not only the smartest place to start, but many times it's required. "Insurance programs usually require a referral from a primary care physician. And some cardiologists will require a diagnosis from your primary care physician before they'll even see you."
The biggest challenge in finding a primary care physician, says Cassan, is finding one who is taking appointments. Sarasota doctors are swamped, and many-like Feinberg-will not take new patients. Once you get the appointment, pay attention to how the doctor manages his or her time. "A physician who has his hand on the doorknob [to leave] as soon as he walks in is probably not for you," says Cassan. Feinberg says the most important thing he learned in medical school is this motto: If you can't be smart, be there. "In other words, if you don't know all the answers, just be there at the bedside and talk to the patient. More often than not you'll figure it out while you're there."
Look for someone who will make the time for you-but who need not be on time. Feinberg advises fellow doctors: "Be late. Make that time. When I'm late, I'm late because I'm with the patient. We schedule 15 minutes for each patient, but if the patient wants half an hour, they get half an hour. We'll stay until the last patient is seen. Of course, you don't like to be 45 minutes behind. But that's the job."
THE WHOLE HUMAN
"I wanted to be a doctor since I was a child," says Dr. Lourdes Espina. "I had a friend with leukemia, and my teacher in fifth grade collapsed from an intracranial hemorrhage." Now the specialist in internal medicine finds joy in the many ways she can help. "To take good care of my patients-it's very comforting," she says.
After graduating from medical school in Spain, the Cuban-born Espina trained at the University of Illinois-Chicago and Tulane University, coming to Sarasota in 2001 to be closer to a Spanish-speaking community. Her patients are now split equally between English- and Spanish-speakers, reflecting the passion for diversity that first led her to internal medicine. "It is complete, the whole human being," she says. "The human being is so beautiful."
Several years ago, a woman in her late 40s sought Espina's care after she'd been diagnosed with a tumor in her abdomen. Fortunately, it was a misdiagnosis. "I told her, 'Darling, you don't have a tumor; you're pregnant,'" she says, still beaming at the recollection. The grateful mother named her new baby Milagros, Spanish for "miracles."
"Now they tell me, 'Because of you we have this child,'" Espina says. "I love my career." -Hannah Wallace
Dr. Helene Hubbard, the "H" in K & H Healthkare, understands that her young patients can't always verbally communicate their troubles; that's what the toy cars and the kid-size kitchen playset are for. "We can see how they're thinking by the way they're playing," she explains. "With some kids, everything is crash-bang, or the monsters are always getting the people. They show us where the conflicts are in their lives."
With a Ph.D. in educational psychology, Hubbard taught at all levels-from kindergarten through training other teachers-before going to medical school at age 38. "That was the coolest thing I've ever done," she says of being a "non-traditional" medical student. Driven to build on her experiences as a teacher, she focused on understanding children's physical, social and psychological framework, becoming part of the very first group of doctors to be board-certified in developmental-behavioral pediatrics.
Hubbard began K & H Healthkare in January 2004, partnered with Karen MacDougall, R.N. They now operate offices in Sarasota and Bradenton-with a third soon to come in Lakewood Ranch-and remain devoted to treating "the whole child and the whole family," says Hubbard.
"What we do isn't magic. We teach the family how to interact," she says. "Then we can show the parents, 'Here's your real kid.'" -Hannah Wallace
ACE OF HEARTS
In his youth, Dr. Daniel Pacifico was inspired to study medicine when his brother-in-law was diagnosed with life-threatening Hodgkin's disease. As the doctors treated the disease, "I saw that there was a chance to make a difference in people's lives," says Pacifico. "That confirmed that medicine was the field for me, where you can really help people tangibly."
A graduate of Philadelphia's Thomas Jefferson University, Pacifico did his residency at Georgetown Hospital in Washington, D.C., where his solution-oriented, hands-on approach made him a perfect fit for working with the human heart. He says the most rewarding part of his job is fixing problems and seeing results.
It helps to love learning new things. Not only must he stay on top of the latest advances in his field (he's excited about new drug-laced stents), but his personal interactions in the office teach him a thing or two as well. "Every day is a new education, just talking to the patients," says Pacifico.
The most important thing he does now may be preventive education-identifying risk factors and modifying behavior early. "Community awareness is something that I'd like to see come out of what I do," he says-not only treating those with heart disease, but also helping those who are healthy to stay that way. -David Higgins
IN THE BLOOD
Florida's Gulf coast seduced Dr. Richard Brown after he attended Super Bowl XXV in Tampa, but the route that led him to hematology and oncology was more circuitous. Ultimately, he realized two of his biggest passions were blood and the Tampa Bay Buccaneers.
A self-proclaimed "die-hard fan" of football, Brown studied social psychology as an undergrad at the University of Rochester, earned an M.B.A. focusing on organizational behavior at Boston University, and did his residency in internal medicine at the University of Minnesota before finding his true calling through a fellowship in hematology and oncology at NYU. "I love the science of it," Brown says. "Just the way blood clots is fascinating."
The complex physiology of both blood and cancer cells is based on a "beautiful balance," says Brown, punctuating his sentences with animated gestures. He's excited about new research that suggests ways cancer can be controlled by targeted treatments, if not cured.
"A lot of my colleagues will make fun of me because I'm an oncologist and they think that's doom and gloom. It's not like that," says Brown. "Unfortunately we have a long way to go, but we have made tremendous progress, and I love seeing that there are people with bad diseases that I treat with strong medicines-I may not cure them, but they live longer with a better quality of life, and that's rewarding." -David Higgins