America’s Best Steakhouses? Caveat Emptor (Buyer Beware)

Readers who have traveled by air in recent years will be familiar with sections that appear in the airline magazines, heralded by a banner reading “America’s Best Steakhouses.” Listed beneath this marquis will be a number of restaurants in cities around the U.S. When I’ve examined these lists, I often find restaurants that I recognize, some of which do not represent, in my mind, the best steakhouses. More to the point, some of the most famous steakhouses in the country never seem to appear. More recently, I’ve begun to see America’s best plastic surgeon, America’s best orthopedic surgeon… with glossy photographs of white-coated physicians describing their practices and locations.

Putting two and two together, I’ve come to realize these are little more than slick advertising schemes. In essence, the magazine offers you the moniker of “best” in your field if you pay them a fee. Furthermore, it appears that the quality of your work goes up the more you pay. Perhaps “America’s most self promoted” should replace the word “best” in these lists.

While the magazine editors, no doubt, defend this by explaining that they vet each potential participant, it seems unlikely that the size of the photograph actually correlates with the quality of the doctor. Based on what I can see, the doctor’s “quality” is most closely associated with his willingness to pay. This modus operandi is becoming more common, as several national magazines now list the best hospitals and best physicians under similar circumstances.

Recently, I was approached by one prominent national magazine and offered the opportunity to participate in a best doctors’ feature, but I declined. Nonetheless, if anyone reading this blog is desperate to see a glossy photograph of me listed among the country’s best doctors, simply forward $65,000 to my address and I’ll be happy to comply. And I promise to remember to smile.

About Dr. Robert A. Nagourney
Dr. Nagourney received his undergraduate degree in chemistry from Boston University and his doctor of medicine at McGill University in Montreal, where he was a University Scholar. After a residency in internal medicine at the University of California, Irvine, he went on to complete fellowship training in medical oncology at Georgetown University, as well as in hematology at the Scripps Institute in La Jolla. During his fellowship at Georgetown University, Dr. Nagourney confronted aggressive malignancies for which the standard therapies remained mostly ineffective. No matter what he did, all of his patients died. While he found this “standard of care” to be unacceptable, it inspired him to return to the laboratory where he eventually developed “personalized cancer therapy.” In 1986, Dr. Nagourney, along with colleague Larry Weisenthal, MD, PhD, received a Phase I grant from a federally funded program and launched Oncotech, Inc. They began conducting experiments to prove that human tumors resistant to chemotherapeutics could be re-sensitized by pre-incubation with calcium channel blockers, glutathione depletors and protein kinase C inhibitors. The original research was a success. Oncotech grew with financial backing from investors who ultimately changed the direction of the company’s research. The changes proved untenable to Dr. Nagourney and in 1991, he left the company he co-founded. He then returned to the laboratory, and developed the Ex-vivo Analysis - Programmed Cell Death ® (EVA-PCD) test to identify the treatments that would induce programmed cell death, or “apoptosis.” He soon took a position as Director of Experimental Therapeutics at the Cancer Institute of Long Beach Memorial Medical Center. His primary research project during this time was chronic lymphocytic leukemia. He remained in this position until the basic research program funding was cut, at which time he founded Rational Therapeutics in 1995. It is here where the EVA-PCD test is used to identity the drug, combinations of drugs or targeted therapies that will kill a patient's tumor - thus providing patients with truly personalized cancer treatment plans. With the desire to change how cancer care is delivered, he became Medical Director of the Todd Cancer Institute at Long Beach Memorial in 2003. In 2008, he returned to Rational Therapeutics full time to rededicate his time and expertise to expand the research opportunities available through the laboratory. He is a frequently invited lecturer for numerous professional organizations and universities, and has served as a reviewer and on the editorial boards of several journals including Clinical Cancer Research, British Journal of Cancer, Gynecologic Oncology, Cancer Research and the Journal of Medicinal Food.

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