Best Doctors in Hawaii 2010
The list of the 325 best doctors in Hawaii was determined by the doctors themselves.
Almost no recurring feature we do is requested as frequently as our Best Doctors list. We have run an updated version every two years, and in between installments, we regularly get calls from readers asking for a copy of our latest Best Doctors issue.
Starting this year, we will make this an annual feature, not only to meet this reader demand but to offer the most current list available. The list is researched by Best Doctors in America, which surveys physicians nationwide, asking, “If you or a loved one needed a doctor in your specialty, to whom would you refer them?”
The process is more elaborate than that, of course, and you can read about it in it detail at the Best Doctors website. We’ve trusted this resource for its impartiality and because no doctor may buy his or her way onto the list—the doctors on the list are there by peer acclamation only.
Our usual caveat: the methodology favors specialists and doctors at larger, urban hospitals, who are more likely to have a higher profile than their peers at smaller, rural facilities. If you’re happy with your current doctor and don’t see her or him on the list, even Best Doctors in America would assure you that there’s no need to switch doctors.
Dr. Neil Manago does more than put people to sleep for a living; he also provides pain-management care to patients after their surgery. “More and more we’re responsible for the patients beforehand to make sure they’re optimized for surgery, as well as postoperatively, to minimize the amount of trauma to their bodies,” he says.
Manago decided to become an anesthesiologist after doing a medical rotation with his older brother Reid (see Reid’s listing on page 48) when he was in medical school. Neil Manago has been practicing for more than 20 years and helped co-found the Physicians Anesthesia Service, which now includes 11 anesthesiologists, including his brother.
“All our partners are very compatible,” he says. “It’s nice to have [my brother] there; we’re pretty close so it’s a good working relationship.” Manago is also chief of the Department of Surgery at Kapiolani Medical Center at Pali Momi.
He spends his days in the operating room, working with surgeons at Kuakini Medical Center, Pali Momi and The Queen’s Medical Center. He arrives at the hospital at 6:30 a.m. and meets with his first patient to go over his or her medical history and explain the different types of anesthesia—general, local or regional. “We do a lot of orthopedic surgery, total joint replacement and sports therapy, which includes ACL surgery, shoulder surgery, knee surgery,” he says. For these types of surgeries he works with regional anesthesia to numb the leg or arm; this provides prolonged nerve blockage and cuts down on recovery time.
He also assists in more complex procedures, such as spine or heart surgeries. “The interesting part is that you see a lot of the
results instantly for the things that you do,” he says. “You have a direct and immediate impact on people.”
Dr. Laurie Seaver was one of the first resident medical geneticists in Hawaii, and is still one of only a small handful. Physicians often refer their patients to her and she helps both in diagnosing genetic disorders and putting together treatment plans.
“My job is never boring,” says Seaver, who frequently researches relatively unknown disorders for her diagnoses. “There is something new every day. Every patient teaches me something different.”
She sees patients—from infants to the elderly—who have various birth defects and metabolic or genetic disorders. For example, Seaver works with children who have fetal alcohol syndrome, or a cleft lip or palate, as well as patients with Down syndrome or Huntington’s disease. “A lot of the things I see I can’t cure, they’re genetic,” she explains. “But I help families understand the disease and what part of it is treatable.” She works closely with genetic counselors in educating the patient and family members and provides a support system for them.
Seaver also works with the state Department of Health and, once a month, sees patients on the Neighbor Islands. She visits patients at The Queen’s Medical Center and Kapiolani Medical Center for Women and Children. In 2002, these organizations formed Hawaii Community Genetics, of which Seaver is the medical director. “It was a community effort to put everyone’s resources together to develop this program,” says Seaver, who moved here from South Carolina in 2005. “It was truly a calling to come and help this program.”
“Sometimes I think of myself as a translator,” Dr. Michiko Bruno says. “It’s hard for people to understand their diseases; they don’t know what to expect. I may not be able to cure them, but I try to translate the diseases in ways that allow them to cope and handle them better.”
Bruno is a neurologist who specializes in movement disorders, such as Parkinson’s disease or Tourette syndrome. In diagnosing a patient, Bruno sometimes calls friends or family members to get their perspective on the patient’s behavior. “It’s almost like being a detective,” she says. “It’s not just MRIs or lab tests and coming up with a diagnosis.”
Some of her cases involve little-known neurological disorders. About a year ago, she helped solve a medical mystery when she was asked to give a second opinion for a woman in her early 20s, who was in a coma that her doctors couldn’t explain. Bruno studied the woman’s medical history, which reminded her of a case she had read about. “It was about a new disease called paraneoplastic syndrome, where you have a cancer and, in order to try to fight that cancer, your body develops an antibody immunity, but that antibody mistakenly starts attacking the brain.”
Bruno contacted the Mainland doctor who had done the research and asked if he could test for the same antibody. The Queen’s Medical Center was able to send the physician the patient’s sample and it came back positive for the antibody. “Then we were able to find that she did, in fact, have cancerous tumors in her ovaries. The surgeon was able to remove them and she was back to normal. It was really amazing.”
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