Best Docs 2007: The Specialists

 

Boston may be a medical mecca, but with some of the country’s longest waits for appointments, it sure doesn’t always feel that way. After talking to local healthcare experts to single out the specialties seeing the
greatest demand, we rounded up a list of M.D.s who stand out to their peers as the best in their fields. We can’t guarantee you’ll get in to see our picks tomorrow. But when you do, you’ll know you’re in great hands.


Boston may be a medical mecca, but with some of the country’s longest waits for appointments, it sure doesn’t always feel that way. After talking to local healthcare experts to single out the specialties seeing the
greatest demand, we rounded up a list of M.D.s who stand out to their peers as the best in their fields. We can’t guarantee you’ll get in to see our picks tomorrow. But when you do, you’ll know you’re in great hands.

 

About the List

Our list of top-ranked doctors was created by the Boston-based company Best Doctors (bestdoctors.com), founded in 1989 by Harvard Medical School–affiliated physicians. Every two years, Best Doctors polls the medical profession, asking, “If you or a loved one needed a doctor in your specialty, who would you choose?” Only physicians identified by their peers in previous years as “best doctors” receive the Best Doctors in America survey.

Note: Some of the specialists on this list are accepting patients only by referral, or only patients with certain conditions. Be sure to call ahead and check the doctor’s availability with his or her staff before making any changes in your healthcare.

For an index of all 76 specialties and subspecialties, click here!

Cardiology

Dr. Paula A. Johnson

Vital Stats: Chief of women’s health, Brigham and Women’s Hospital; 22 years in practice.
Clinical Notes:
Intense demand for cardiology services is nothing new; what’s different these days, Johnson says, is “we are for sure seeing a larger number of women,” as they realize that heart disease isn’t something that just affects their fathers or husbands. Add to that an influx of much older patients (thanks to the life-extending ability of modern medicine), and local cardiologists are finding themselves caring for a wider swath of the population than ever. When she considers how her specialty is trending, Johnson cannot help but feel a little concerned about our overall health. “We’re seeing increasing rates of type 2 diabetes, we’re seeing sedentary lifestyles [both risk factors for cardiovascular disease], and when you put that together, it does not predict well in terms of where we’re going.”
What’s Hot, What’s Not:
Older patients are more prone to arrhythmia, or abnormal heart rhythm, which is spiking demand for technology like implantable defibrillators. At the same time, as minimally invasive techniques for performing heart bypass and valve replacement take hold, the need for full-on open-heart surgery is declining.
What’s Next:
More research and emphasis on early intervention. “We now know that as children we begin to lay down plaque in our arteries. So imagine a day when we’re able to know what a patient’s risk is, and understand how to decrease it, maybe even before they’re born.”
Doctor’s Orders:
Aside from covering the basics of exercise and a good diet, know what your cardiovascular risk factors are, and partner with your physician to address them. And if you have cardiovascular disease, take every step possible to avoid having it lead to a heart attack.
See all top cardiologists…

 

Dermatology

Dr. Robin Travers

Vital Stats: SkinCare Physicians, Chestnut Hill; 10 years in practice.
Clinical Notes:
As a resident, Travers was told that as primary care docs took over more and more skin-care procedures, “we had to prepare ourselves for the likelihood it would be difficult to find a job.” Fast-forward to today, when the average wait time to see a Boston dermatologist is almost two months. “Demand has blossomed,” she says. Swelling her patient ranks are the 40-to-60-year-olds representing the first generation “who sought out tans and felt comfortable baring their skin,” and are now dealing with the effects of sun damage.
What’s Hot, What’s Not:
While dermatologists are seeing a run on wrinkle-minimizing injectibles like Botox and the laser treatment of blood vessels, Travers says, full-face laser resurfacing (which can require several weeks of recuperation) is on the decline.
What’s Next:
Drugs that will put what’s been called the “heartbreak of psoriasis”—a chronic inflammatory skin condition that affects an estimated 7.5 million Americans—into remission.
Doctor’s Orders: Use gentle cleansers and a nightly retinoid like Retin-A or Renova. And sunscreen, sunscreen, sunscreen. “Every single day, sunny or cloudy, summer or winter, whether you’re a girl or a guy!”

See all top dermatologists…

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Gastroenterology

Dr. Jacqueline Wolf

Vital Stats: Beth Israel Deaconess Medical Center; 27 years in practice.
Clinical Notes:
The media put a spotlight on gastroenterology back in 2000 when Katie Couric famously underwent an on-air colonoscopy on the Today show; more recently, stars like Jimmy Smits have touted the colon cancer–screening procedure. Though Wolf hasn’t seen studies proving it, “I’m sure that’s had an impact on people getting procedures,” she says. A slew of new drugs for GI disorders is also increasing demand for gastroenterologists’ services, but for Wolf, it’s business as usual: With women M.D.s being a scarce commodity in her field (some estimates peg them at just 8 percent of the total), she’s had a bustling practice for years.
What’s Hot, What’s Not:
Wolf says that the most common complaints, such as IBS and constipation, are as prevalent as ever; what’s changing is the pharmaceutical landscape. Sulfa-based drugs for inflammatory bowel disease, for instance, are on the way out, as physicians turn to new treatments without this troublesome ingredient (many patients are allergic to sulfa, or simply can’t tolerate it).
What’s Next:
Interest in virtual colonoscopy, a kind of CAT scan, is growing. But before it really
catches on, Wolf says, researchers will have to come up with an improvement on the standard colonoscopy prep; even for virtual procedures, patients must first undergo this grueling, hours-long process to flush out their works.
Doctor’s Orders:
Know your family history; especially with colon cancer, it will tell you if you have increased risk and give an idea of when you should get screened. And, no surprise when it comes to all things digestive: Always, always opt for healthy foods.

 

See all top gastroenterologists…

 

Internal Medicine

Dr. Somava Stout

Vital Stats: Medical director, Revere Family Health Center (a Cambridge Health Alliance program); four years in practice.
Clinical Notes:
Board certified in internal medicine and pediatrics, Stout has seen firsthand the staggering demand for primary care, the healthcare entry point that internists (along with similarly scarce family practitioners) provide: Since she joined the Revere facility in 2004, its patient load has grown about 200 percent a year. “So few doctors are entering primary care, doctors who are in it are leaving it, and that’s leading us toward a crisis,” she says. “I think it’s been projected that by 2011, about 14,000 patients a day will enter Medicare. It’s really amazing—and somewhat frightening—to think about what will happen.”
What’s Hot, What’s Not:
Prevention and testing are at the top of the primary care docs’ to-do list, Stout says, as they work to stave off greater burdens of illness for their patients down the line. The flip side? Fewer and fewer have time to do actual procedures.
What’s Next:
Getting out of the office to help build a healthier community. At the Revere center, for instance, the doctors join in with patients’ walking groups, and travel to the supermarket with them to help them learn to read nutrition labels.
Doctor’s Orders:
Stay connected to other people who also have an interest in health, like finding a buddy to exercise with. “It’s okay to just do little things every day, as long as you stay committed to walking down that path.”

See all top internists…

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Obstetrics/ Gynecology

Dr. Ed Huang

Vital Stats: Medical director of gynecology, Massachusetts General Hospital; 11 years in practice.
Clinical Notes: At Mass General, Huang helps oversee a department that went from zero deliveries in 1994 to about 3,500 a year today. Obstetrical practices across Boston are putting up higher numbers these days, he says. “We’re getting to the point where the baby boomers’ kids are having kids, but also I think the pendulum is swinging back toward bigger families. It seems like now couples are really considering that third or fourth baby.”
What’s Hot, What’s Not: As in other specialties, outpatient OB-GYN procedures are fast replacing inpatient ones. Ten years ago, the number-one gynecologic procedure Huang performs—a treatment for urinary incontinence called a minimally invasive sling—would have involved abdominal surgery and several weeks’ recovery. Now it’s a day surgery requiring a few small incisions made under local anesthesia.
What’s Next: A reliable screening test for the deadliest gynecologic cancer: ovarian, whose symptoms mimic those of many everyday ailments.
Doctor’s Orders:
Rather than obsessing over “Am I seeing best doctor I possibly can?” look for an M.D. you can build a strong relationship with. “Part of people’s healing is not physical—it’s the confidence they get from their physician, and how much that person inspires them and takes an active role in their well-being."

See all top obstetricians/gynecologists…

 

 

Ophthalmology

Dr. Lucy Young

Vital Stats: Massachusetts Eye and Ear Infirmary; 22 years in practice.
Clinical Notes: With the number of Americans 65 and older projected to grow by 50 percent by 2020, Young says her clinical practice is “going crazy” keeping up with age-related eye conditions like macular degeneration, the leading cause of severe vision loss in that demographic. As much as aging, overindulgence is also taking a toll on Bostonians’ eye health: The ongoing obesity epidemic means a higher rate of diabetes, which in turn can damage the capillaries in the retina. “And it’s not just hurting your eyes,” Young says, “but your kidneys, your heart, the blood vessels in your feet. Everything goes.”
What’s
Hot, What’s Not: Patient demand for corrective laser eye surgery like LASIK (reportedly the most common elective surgery in the United States) remains robust, but Young says innovative drug therapies have actually begun to displace laser technology when it comes to treating certain diseases.
What’s Next:
Tiny implants that consistently deliver medication to the eye could do away with repeated injections (yikes!) for some afflictions.
Doctor’s Orders: Wear UV-blocking sunglasses when you venture outside, and get a jump on potential vision problems by having a baseline examination when you hit 40. And nourish those peepers—not to mention the rest of you—with a balanced diet that includes fish oils. (Young, known around MEEI as an amateur Iron Chef, practices what she preaches here: “I’m always cooking up a storm of healthy food for my family, drawing on my time in both China and Brazil, and improvising. For me, it’s therapy.”)

See all top ophthalmologists…

 

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Orthopedics

Dr. Lyle Micheli

Vital Stats: Director of sports medicine, Children’s Hospital Boston; 35 years in practice.
Clinical Notes:
Having suited up for football, rugby, lacrosse, and boxing during his years at Harvard, Micheli is going strong into his 60s (though he hasn’t played rugby for a while, the good doctor still bikes to work daily). That gives him a lot in common with the folks flocking to orthopedists today. As other in-demand specialists face a wave of obese or sedentary patients, Micheli and his colleagues are seeing a countertrend: older Bostonians who are demanding a lot of their joints as they turn to exe
rcise to feel young. “You know that picturesque little French village scene with the old people walking around with their canes?” he says. “People don’t want to be that picture anymore. People want to ski when they’re 71.”
What’s Hot, What’s Not:
Thanks to advances in arthroscopy (a minimally invasive, camera-aided operation), orthopedic outpatient surgery has boomed. Of the two dozen or so operations Micheli performs weekly, only two or three require hospital admittance. Well on the way out: fusing joints, a once common procedure to protect arthritic hips and the like.
What’s Next: Instead of using metal or plastic to shore up joint injuries, orthopedists may one day be able to implant cartilage grown from a patient’s own cells.
Doctor’s Orders:
Consider taking a chondroitin sulfate–glucosamine supplement, and dig into those (complex) carbs. Exercise, but don’t overdo it—if you’ve been relatively slothful, try increasing your physical activity by just 10 percent a week, and go for something that’s easy on the joints. (Micheli’s delighted Mayor Thomas Menino has joined him as a cycling devotee. “I mean, can you imagine the mayor of Boston a generation ago riding around the city on a bicycle?”)

See all top orthopedists…

 

 

 

Plastic Surgery

Dr. Brooke Seckel

Vital Stats: Private practice, Concord; 26 years in practice.
Clinical Notes:
As baby boomers put the squeeze on the healthcare market as a whole, Seckel—who founded the Lahey Clinic’s Center for Cosmetic and Laser Surgery before striking out on his own—says he’s been surprised to find a different group filling his waiting room lately: 30-to-45-year-old women who’ve had their kids and are busy getting back into shape. He’s also noticing more and more men looking for tighter tummies and smoother skin. “I love it—seeing these tough guys, even construction guys, coming in and having their faces done, and they don’t blink an eye.”
What’s Hot, What’s Not:
New laser therapies have made a big dent in harsher traditional procedures like chemical peels and dermabrasion, and Botox has made the brow-lift operation virtually obsolete. Meanwhile, partly due to the recent re-introduction of the silicone gel implant, the popularity of breast enhancement is holding steady.
What’s Next:
Technology that allows doctors to remove fat without making an incision, eliminating the need for liposuction (currently one of plastic surgery’s most common procedures). Researchers are experimenting with using infrared, radio frequency, and ultrasound to dissolve fat under the skin; Seckel, who’s consulted on tests using potbellied pigs, predicts we’ll see this become reality in the next two years.
Doctor’s Orders: Well-kept skin will delay the need for a facelift, so steer clear of the sun and smoking. Keep a lid on your stress level, too, as high amounts of cortisol, a.k.a. the “stress hormone,” have been shown to damage collagen—not to mention clog arteries, which sets the scene for heart attacks, strokes, and high blood pressure. So get yourself to a yoga class, already!

See all top plastic surgeons…

 

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Urology

Dr. Richard Babayan

Vital Stats: Chief of urology, Boston Medical Center; 27 years in practice.
Clinical Notes:
Urology (which tends to the urinary tract and the male reproductive system) is another specialty feeling the pressure of a rapidly graying population. “It’s like the old commercial about transmissions,” Babayan says. “‘You can see me now or you can see me later, but sooner or later you’re going to see me.’”
What’s Hot, What’s Not:
Babayan uses a high-tech robot in about 95 percent of the prostate cancer operations he performs—which means less pain, less blood loss, and quicker recovery. But overall, prostate surgery is becoming rarer, as new drugs help make going under the knife a last resort.
What’s Next:
Gene therapy, which has shown the potential to combat sexual dysfunction as well as prostate tumors.
Doctor’s Orders: Ditch the cigarettes (smoking is the top cause of bladder cancer). And for guys, ditto the macho I-don’t-see-doctors-unless-I’m-sick attitude. “If men start coming in at an early age, we can pick up many prostate cancers very early on, when they’re curable.

See all top urologists…

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