Thursday, October 18, 2012
One of 2012's America's "Top Dentists" hasn't practiced a single day of dentistry since his training days were over in 1986.
Dr. Mark Silverberg did graduate from dental school, but instead of becoming a dentist he followed his life's calling to medical school.
And despite working as a board-certified anesthesiologist, not a dentist, in Chicago for more than twenty years, the Consumers' Research Council of America-- an organization that provides the public with "information guides for professional services"-- chose Silverberg to receive top honors in its Guide to America's Top Dentists.
As part of an ABC News investigation into how "Top Doctor" awards are handed out, Dr. Mark Silverberg sent away $183 and received a "museum grade" wall plaque to showcase his undeserved award. According to the Consumers' Research Council of America, the plaque was a way to commemorate Dr. Silverberg as "among the nation's most excellent" dentists.
Dr. Silverberg said, "It's a sham. I've practiced zero days of dentistry in my life- and I still received this award for being one of America's Top Dentists."
About Consumers' Research Council of America
Consumers' Research Council of America offers "Top Doctor" awards across nearly two-dozen specialties including Top Cardiologists, Plastic Surgeons, Obstetricians, Surgeons and Pediatricians.
The organization says doctors are selected based on a point system that considers experience, training, membership in professional associations, and board certification.
Any doctor who earns enough points qualifies to be included on the list. The company first sends doctors a flattering letter congratulating them on their "impressive achievements," and invites them to be included as one of America's Top Physicians. Doctors are then encouraged by a second company, "State License Documentation"- or SLD- to buy plaques and trophies that cost anywhere from $99 to $530.
The companies claim "no fees, donations, sponsorships, or advertising are accepted," but the small print reveals otherwise.
Mailings obtained by ABC News show that Consumers' Research Council of America receives money for the award plaques SLD sells to doctors.
And some doctors make a big deal about these awards to attract patients—hanging plaques in waiting rooms, touting awards on their websites and even issuing formal press releases announcing their selection.
Just Who is on Top Doctor Lists?
ABC News uncovered sobering details about the Consumers' Research Council of America selection and review process.
Their database of "Top Physicians" includes doctors with serious criminal and disciplinary records.
Dr. Conrad Murray, convicted of manslaughter for administering a lethal overdose of the anesthetic propofol to Michael Jackson in 2009, is still listed as a "Top Cardiologist," according to the Consumers' Research Council of America.
A "Top Pediatrician" according to the Consumers' Research Council of America is also a convicted serial child rapist charged with the molestation of 103 children. Dr. Earl Bradley is currently serving 14 life sentences in addition to a 160-year prison term, yet he remains on the Consumers' Research Council of America "Top Pediatrician" list.
Top Doctor Awards Lists
Dr. Janet Fleetwood, a medical ethicist and a Professor in the School of Public Health at Drexel University in Philadelphia said, "I'm horrified, as a medical ethicist…and as a patient, and a patient advocate as well- that that kind of thing is going on."
But ABC News discovered that these few cases are not just random oversights.
ABC News cross-referenced the Consumers' Research Council of America's "Top Doctor" lists with state medical board disciplinary databases- information easily available online for anyone to see.
ABC News' investigation looked at over 150 doctors with disciplinary records from 7 states- California, Connecticut, Delaware, Florida, New Jersey, New York, and Texas. And ABC News found that the Consumers' Research Council of America listed nearly one-third of those doctors with disciplinary records as "Top Doctors."
Dozens of these "Top Doctors" were charged and found guilty of serious allegations including fraud, harassment, assault, rape, negligence and sexual exploitation of children.
But experts are concerned because patients use top doctor recognitions and plaques as a way to compare and select doctors.
Fleetwood said, "you have information from the state boards that tell you that this physician has been involved in some very bad things, and then you have this award- there's a real problem."
"We're leading patients through those awards, to those physicians," Fleetwood said.
Was Patient a Victim of a 'Top Doctor'?
Maribeth Chase, a 77-year-old retired speech pathologist, had surgery at Shawnee Mission Medical Center in Shawnee Mission, Kan., for bleeding between her skull and her brain in 2007.
But after Maribeth Chase's two-hour surgery by neurosurgeon Dr. Robert Tenny, her family says nothing went as expected. She couldn't talk or move an entire side of her body and instead of going home in a fully functional state in one to two days as they claim Tenny had said, Chase ended up on life support and dead in a matter of weeks.
Only later did her family learn that an instrument had slipped during surgery injuring her brain. In a settlement that did not include an explicit admission of liability, the chase family received more than $1 million, including some of Tenny's own personal money.
And only later did the Chase family discover that Dr. Robert Tenny was listed as a "Top Surgeon," according to the Consumers' Research Council of America.
Chase's daughter, Claire Chase, told ABC News: "The idea that he is listed as a Top Doctor that would be recommended is just unthinkable to us."
But Tenny remains listed as a "Top Surgeon" despite more than a dozen medical malpractice cases against him between 1983 and the time of Maribeth Chase's surgery in 2007.
A representative from Shawnee Mission Medical Center confirmed for ABC News that after an internal hospital investigation and review, Tenny is no longer on staff at Shawnee Mission Medical Center.
But Tenny is still listed as a top surgeon on the Consumers' Research Council of America website and is still practicing medicine.
Repeated messages left for Dr. Robert Tenny by ABC News were not returned.
The Consumers' Research Council of America
The Consumers' Research Council of America denied ABC News' repeated requests for an interview but in an emailed statement said:
"Consumers' Research Council of America, CRCA does not do interviews but will be happy to respond to your email. Regarding Physicians, we use education as the most heavily weighted criteria. All physicians are Board Certified and many have additional education making them the top in their respective fields of medicine. Not all physicians have traditional medical practices that service patients. Many of these highly educated physicians are involved in the research area of medicine and are responsible for many of the advances the medical industry that has witnessed over the past few decades. The CRCA web site lists the State Medical Boards for every state. The Medical Boards monitor and regulate physicians and are responsible for implementing and enforcing any disciplinary actions. We list these with contact information so consumers can check on their physician for free. There is a private company that provides this service but they charge a fee. If you think it would be beneficial to list that company on our web site we would be happy to do so. Again, to make things perfectly clear, we primarily evaluate Physicians based on education and credentials. We do not police the medical industry and do not know who is late on their taxes, has past due child support or has criminal records. State Medical Boards that serve that function and it is why they are listed in the web site. We share your opinion that consumers should be aware of who they are dealing with and thought it was important to include the listing of the State Medical Boards."
In an effort to track down someone from the Consumers' Research Council of America, ABC News went to the address listed on their order form: 2020 Pennsylvania Avenue NW- Suite 300A in Washington DC. But this address, just 4 blocks from the White House, turned out to be a post office box.
To obtain more information about this process, ABC News also repeatedly requested information from SLD, the California company that sells the actual award plaques to doctors.
After numerous phone calls and emails to SLD, ABC News received yet another email from an anonymous representative -- this time from SLD -- stating: "I understand that you are doing a story on Top Doctors. Listed below is a partial list of companies that do Best Doctor lists. Each company has a different way of determining what qualifies someone as a top doctor. It ranges from some companies using high education such as board certifications to some companies allowing you to just purchase your way on to the list. Here are some links that you may want to check out."
The email then listed about 10 companies that name top doctors.
And none of the SLD representatives ABC News spoke with was willing to provide the name of a contact person who worked at the Consumers' Research Council of America.
While no one from SLD would comment on the connections between the two companies, ABC News uncovered further information linking the two companies including documents which show an SLD email address was used to register the Consumers' Research Council of America website.
Top Doctor Awards Are Numerous and Confusing
ABC News found that there are dozens of different companies in the business of awarding some version of "Top Doctor" awards.
And while many of these designations are clearly egregious, some "Top Doctor" companies are more selective than others.
Castle Connolly, a research company founded in 1992, asks actual doctors to nominate top doctors—a way to find out who doctors themselves would go see if they were sick.
Dr. Jean Morgan, Vice-President and Chief Medical and Research Officer of Castle Connolly said, "Our mission really is to try and inform the general public of good doctors."
Castle Connolly has partnered with more than 40 magazine, newspaper, and websites for top doctor feature issues including regional magazines like Boston Magazine and Indianapolis Monthly and national magazines like US News and World Report.
In an interview with ABC News, John Connolly, President and CEO of Castle Connolly, said "We have a research team of 11 people who work full time who check on the backgrounds, education, and disciplinary records."
Yet ABC News found a few doctors on the Castle Connolly top doctors list who have been disciplined by their state medical boards in the last few months, including a radiation oncologist in Connecticut who was charged with a civil penalty of $5000 for treating the wrong side of a cancer patient's mouth with 29 separate radiation treatment sessions in 2006.
But within 24 hours of being notified of ABC News' findings, Castle Connolly sent an email to ABC News notifying us that doctors with disciplinary records identified by ABC News "have been removed" from the Castle Connolly "Top Doctor" lists.
Castle Connolly told ABC News they formally update their lists at least annually and that their lists are in a constant state of being updated.
Still, Castle Connolly is not without its critics, including many doctors who say Castle Connolly's selection process is nothing more than a popularity contest.
Dr. Kent Sepkowitz, Vice Chairman of Clinical Affairs in the Department of Medicine at Memorial Sloan-Kettering Cancer Center, said although Castle Connolly does "winnow out the lousy doctors for the most part," Castle Connolly is "absolutely a popularity contest."
"It's a popularity contest and like all popularity contests it becomes exclusive, self-fulfilling and over time loses its connection to the original attribute that was being evaluated," said Sepkowitz.
Castle Connolly told ABC News the nomination process is the basis for selecting top doctors, but it is not the entire selection process.
Top Doctors Bring in Patients
Once announced, the prestige of a "Top Doctor" award attracts patients, and money, to doctors and hospital systems.
Fleetwood said, awards can "bring patients in, and it can convince patients who are in your waiting room that you are the physician that, in fact, they want to see."
And so hospitals spend a great deal of effort to get as many of their doctors on some "Top Doctor" lists, earning bragging rights for the hospitals, especially in competitive city markets with multiple hospital systems.
A hospital employee from a large urban hospital who wishes to remain anonymous told ABC News that a senior hospital administrator sent an email offering a $300 American Express gift card to the first 100 doctors who nominated their peers for a top doctor award on the Castle Connolly website, spending a staggering $30,000 on gift cards to try to increase the number of top doctors chosen from their hospital. John Connolly told ABC News "I've never heard of anybody offering or receiving money. If you've heard of it, you ought to expose them."
Castle Connolly insists doctors "cannot and do not pay to be listed," but Castle Connolly does admit they do get money from American Registry, the plaque company that sells actual plaques to doctors.
And full access to profiles of top doctors on the Castle Connolly website is free to the public only for doctors whose hospitals have paid a minimum of $11,000 to become part of Castle Connolly's 'Partnership for Excellence Hospital' program.
Connolly said hospitals that pay the $11,000 fee "are paying to make the physician bios available to consumers," and said hospitals that pay more than $11,000 are able to promote more of their departments or centers on the Castle Connolly website.
Doctors Buy Their Way on to TopDocs.com
The website "TopDocs.com" is not affiliated with Castle Connolly or Consumers' Research Council of America and does not claim to rank doctors in any way. But a spot on TopDocs.com is available to any physician who pays for membership, regardless of true top doctor status.
In a telephone interview with ABC News, Mr. Michael Dougherty, President and CEO of TopDocs.com, said "a couple of hundred" physicians have paid to be on their website.
Documents obtained by ABC News show the cost to buy a spot on the website ranges anywhere from $1500 to $10,000, in addition to an annual fee of $1600.
Dr. Sepkowitz said, "here we are awarding stars to whoever can pay the highest dollar rather than according to a system of worthiness."
In reference to the actual name "TopDocs.com," Dougherty told ABC News, "We are not inferring in any way that the doctors in the site are top doctors."
But when asked if his website's name could be misleading patients into thinking they are viewing profiles of actual top doctors, Dougherty said he "has never had anybody say they are confused about it."
Fleetwood said these sound-alike, look-alike awards "can be very misleading…and potentially bring a patient to a doctor to whom they wouldn't otherwise go."
Doctor Rating Systems in Doubt
The dubious nature of some of these awards have led experts to question the rating systems altogether. Sepkowitz said, "the beauty of the doctor-patient relationship is that it is not quantifiable, and the magic that takes place when it does work is the last sort of thing that these sorts of ratings could measure."
Unfortunately, many patients are now left in doubt of a rating system they once trusted. Fleetwood said, "Patients need to be very careful about award lists and should "be as skeptical about these listings as possible."