By Karen Finucan Clarkson

"Finding a doctor only by the Internet is like shopping from a catalog," said Dr. Isabella Martire. "The merchandise can look a lot better when you order it than when it arrives and you say, ‘What is this cheap piece of clothing I just bought?'" Martire, an Olney oncologist, contends that, while the Internet can play a role in identifying and locating a physician, when selecting a doctor, nothing is more important than meeting in person. "You need to ask questions and decide if this is someone you feel comfortable with," she said, "and that cannot be done through the Internet."

While there are dozens upon dozens of sites designed to help people find "Dr. Right," the available information can be incomplete or inaccurate. "If you go online and Google my name, you'll get my Web site and ranking services like healthgrades.com and vitals.com," said Dr. Vivek A. Patil, a colorectal surgeon with Premier Physician Group in Bethesda. "Most of what's out there is limited to just pertinent information – address, phone, education and a little background… As a patient myself, I haven't found much meaningful information on the Web."

Still, millions of people go online each year to search for information about physicians. The Harris Poll reports some 150 million Americans used the Internet last year to obtain health care information. And, Castle Connolly Medical Ltd., publisher of America's Top Doctors, claims that nearly half a million unique users searched its Web site in 2006.

Docs' Top Docs

Ask Web surfers locally which URLs they turn to and the response is likely to be www.washingtonian.com (Washingtonian magazine) and www.checkbook.org (Consumer's Checkbook). Both Web sites charge a fee to access their information and rely on physician opinion to rank doctors.

When Jared S. Hosid began his search for a general practitioner, he turned to the guides. The Bethesda resident began with doctors whose names appeared on both Web sites. Unfortunately, not one of the physicians was accepting new patients. "I then called all the doctors that received favorable ratings on Checkbook but did not appear on the Washingtonian list and still no luck. Finally I settled on a doctor's office that doesn't take appointments…[and] received pretty good reviews on Checkbook," he said.

While few doctors would turn down an opportunity to appear on either list, many note that there are lots of good doctors—doctors they themselves use—who don't make the cut. "The methodology penalizes younger doctors who haven't had a chance to build up as much of a reputation," said Dr. James Heltzer of Champlain Ophthalmology in Bethesda, who made the Washingtonian list.

The two Web sites are among a host of online resources Dorothy Murdoch taps into when looking for doctors and dentists for her family. "I e-mail friends and members of my book group and cross reference their recommendations with names on the best doctors lists and my insurance company's Web site," said the Bethesda resident.

Friends and Neighbors' Top Docs

For many, e-mail and listservs have replaced conversations over the backyard fence a way to solicit medical and dental recommendations. Hardly a week goes by without someone on 20817BB, an online bulletin board for residents of that ZIP code, asking for recommendations for one medical specialty or another.

While Dr. Reed Shnider sees similar requests on his synagogue's listserv, he urges people to consider the source. "You may be looking for a doctor with an entirely different profile," he said.

Shnider, director of Preventive Cardiology and Wellness at Montgomery General Hospital in Olney, noted that not everyone on a listserv has similar values, needs or philosophies. But, he added, "if a name appears repeatedly, that doctor may be worth talking to."

The narrower the topic to which a listserv is devoted, the better chance you may have of finding doctors with particular specialties. For example, a nursery school listserv might be ideal for identifying a pediatrician, while a listserv for ardent cyclists might be the place to get recommendations for an orthopedist.

Patient-designated Top Docs

A broader range of opinion occasionally can be gleaned from Web sites that encourage patients to review their physicians. It is important, however, to consider the site's philosophy. For example, SuggestADoctor.com, as its name implies, takes only suggestions. RateMDs.com, another free service, allows both positive and negative postings, which are anonymous. At AngiesList.com, visitors pay to view the reviews, both pro and con, of patients. Posters must sign-in to use the site, so their identities can be verified by Web site operators.

A major weakness of these sites is the limited number of posts. It's not unusual for a doctor to have just two reviews – one positive, one negative. The more reviews, the more likely visitors are to get an accurate gauge of a physician and her practice. "Look for patterns," said Maria Donnelly, practice administrator for Falls Grove Center for Dentistry in Rockville. Something that appears over and over might be a red flag.

While the experiences of other patients can be informative, there are problems inherent in this type of reporting. It is possible for one angry patient to circumvent some Web sites' checks and balances and post multiple nasty comments. Conversely, a physician's office, wanting to combat such negativity, could post glowing remarks.

Formula-based Top Docs

Some Web sites use a combination of patient reviews or rankings and the physician's education, training and experience to rate doctors. As a result, physicians who attend a highly-regarded medical school might start with an advantage. While some sites describe their ranking formula, others do not. Some, like DrScore.com, are free while others require payment, such as HealthGrades.Com.

Again, low patient participation can argue against using such sites. "Like any study, if I have 1,000 [participants], I'm going to get a more statistically significant result than if only five people took part," said Dr. Barry Nahin, a family practitioner with Family HealthCare in Germantown and Olney.

Qualifications for Top Docs

In addition to subjective information, prospective patients should verify a physician's credentials. The Maryland Board of Physicians (www.mbp.state.md.us) has created a practitioner profile for each doctor licensed to practice in the state. These profiles include any known disciplinary actions by any state medical board; malpractice judgments, arbitration awards or settlements; and convictions for any crime involving moral turpitude.

The state Web site also includes any specialty board certification as reported by the physician and links to the American Board of Medical Specialties (www.abms.org) and American Osteopathic Association (www.osteopathic.org) so that visitors can ascertain the veracity of the claim.

Virtually all major health insurers have Web sites that allow visitors to search based on a range of criteria such as proximity, physician specialty, gender, language spoken and hospital affiliation. When a search is complete, these sites will provide contact and some background information on member physicians and indicate whether the doctor is accepting new patients. Some insurance companies rate their doctors as well, using a combination of factors including cost of prescribed treatments.

Medicare patients can use the government agency's Web site (www.medicare.gov) to identify physicians that agree to accept assignment on all claims. Searches can be done by a doctor's area of specialty as well as location and proximity. The Web site also provides a link to a list of physicians who voluntarily reported information on at least 1 of 74 quality measures to Medicare in 2007 under the Physician Quality Reporting Initiative in Maryland.

The National Committee for Quality Assurance (www.ncqa.org) has developed an objective set of measures that it uses to rate physician performance. Its Recognized Physician Directory includes doctors who have met its standards of quality care in the areas of heart/stroke care, diabetes care, back pain and systematic processes.

Public access to performance measures will increase in the future, predicts Dr. Keith Horvath, director of Cardiothoracic Surgery for the NIH Heart Center at Suburban Hospital in Bethesda. While cardiac surgeons have been reporting data for more than 15 years, other physicians are only just beginning to. "Insurers now understand the power of this data," he said, "and while it's bypassed patients, that's only temporary."

A search of a hospital's Web site is advisable for patients wedded to having procedures performed there. Most hospitals have a physician search mechanism that allows patients to identify doctors with hospital privileges by area of specialty.

Top Docs' Web sites

Some physicians and practices now have their own Web sites. While many are fairly basic, others contain links to interesting medical sites or allow patients to download forms. "That way the paperwork can be done ahead of time," said Dr. Sarah Mess, an Olney and Columbia plastic surgeon. Mess's Web site (www.sarahmessmd.com) includes a photo gallery where prospective patients can view the results of various cosmetic procedures.

Rockville psychologist Joshua Cohen, Ph.D. uses his Web page (www.joshuamcohenphd.com ) to share information about himself. "People need to feel comfortable with their therapist," he said. "They need to someone they can connect with. All the professional training in the world without that connection is useless."

Donnelly at Falls Grove Center for Dentistry looks for health and dental care providers with Web sites. "A practice with a Web site is probably up on technology, and that's important," she said.

Some physician Web sites contain the doctor's or practice administrator's e-mail address, especially important for patients who prefer to communicate electronically. More than 8 million adults in the U.S. sent an e-mail to or received one from their physician in 2008, according to Cybercitizen Health v8.0, a report by Manhattan Research. While an additional 80 million expressed an interest in such communication, only about a third of all physicians currently e-mail patients.

Mess, the plastic surgeon, uses e-mail to alert her patients to changes in the practice. "If I'm offering a new product, such as Evolence, I'll send an e-blast to my patients," she said. "I also do e-blasts for specials on Botox and fillers."

Top Docs' Online Future

Noting that medical professionals have, in many ways, been slow to embrace the Internet, Patil, the colorectal surgeon, expects that to change. "More people are using the Internet to research information about their physician. And while what's out there now is only minimally helpful, it won't stay that way for long," he said. "Social networking sites and chat boards, for example, will be used as stepping stones in the future. Physicians should make sure they're tech savvy or people using the Internet may pass them by."