Hawai’i’s Best Doctors

Every two years, Best Doctors Inc. conducts an in-depth survey among top physicians nationwide. Which doctors would they pick for themselves or their loved ones? Here, we share the Hawai’I results of the 2005-2006 survey.
These lists are excerpted from the Best Doctors in America® database, which includes approximately 33,000 doctors in more than 40 medical specialties. The Best Doctors in America® database is compiled and maintained by Best Doctors® Inc. For more information, visit www.bestdoctors.com, or contact Best Doctors by telephone (888-362-8677) or by e-mail (info@bestdoctors.com).

Who does your hair? Does anyone have a good pet sitter? Do you like your personal trainer? Friends and co-workers seek referrals from each other all the time, but few topics are as important, or as valued, as the name of a trusted physician. The Best Doctors in America database works much like those informal referrals, but relies on expert advice from people who actually possess the medical experience, skills and insight to accurately rate doctors—the doctors themselves.

The research company Best Doctors in America was founded by Gregory White Smith and Steven Naifeh, inspired by Smith’s experiences when he was diagnosed with a brain tumor in 1986. Smith, as he later wrote, “refused to lay down and die on cue,” and, despite being told that he had only three months to live, searched for second, and third, opinions. Best Doctors in America arose out of his belief that finding the right physician and treatments saved his life.

The Best Doctors list is highly regarded for two key reasons: No doctor can pay to get on the list, and the people voting on doctors are their peers, that is, other outstanding doctors. For more on how doctors make the list, see box below.

If your favorite doctor is not on the list, don’t panic. Because of the survey methodology, the list tends to include more urban-based doctors, as well as physicians at larger hospitals, which tend to have more complex cases, requiring multiple specialists and referrals. Readers who are happy with their current doctors have no reason to switch, but, if you’re looking for a new physician, or are looking for a specialist, this list is a great place to start.

The Best Doctors list no longer available online.
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Selection Process: How doctors make the list

How does a doctor get the title “Best?” For the past 15 years, Best Doctors Inc. has conducted a biennial survey, asking physicians, “If you or a loved one needed a doctor in your specialty, to whom would you refer them?” The question seems simplistic, but mimics the actual peer-to-peer referral process that most doctors use.

These initial responses form the basis of the Best Doctors database, which is made up of the top three to five percent of specialists. Only doctors on the database will receive a survey to nominate and vote on other doctors—remember, it’s not a random survey. These specialists then complete a ballot, reporting on doctors in their field or a related field. Doctors may also nominate and provide information on other physicians who they think should be considered in this peer review process.

Doctors who pass muster are then sent surveys, which ask specific questions about their practices. Best Doctors analyzes the surveys, and also checks for licensure, certification and disciplinary actions. The company believes that this system for screening doctors is rigorous and accurate, as doctors are not paid to participate, nor can they pay to be in the database; the only way to be listed is to receive a high enough score.


Don’t Get Out of Joint
Rheumatologist Ken C. Arakawa strives to eliminate chronic pain.

At the Mayo Clinic in Rochester, Minn., where Ken Arakawa, M.D., did his internship, residency and a fellowship, he barely saw one gout case per month. At The Queen’s Medical Center, he sees several per day. That’s due to the ethnic makeup of Hawai‘i, which results in a lot of cases of lupus (common in Filipinos) and arthritis (common in Asians).

“Gout is a diagnosis that is misunderstood; people think not much can be done,” says Arakawa. “Arthritis, too. Patients think, ‘Oh, I’m getting old, there’s nothing I can do.’ But most of the time, there’s an ability to immediately reduce people’s symptoms. Someone will come in with severe pain and within a week can feel fantastic. I might use medication, physical therapy, injections, or, as a last resort, surgery. It’s really a different era.”

His advice to aging baby boomers? “Weight control is important, to lessen the load on your joints. Regular exercise maintains muscular tone around your joints, but avoid activities that have damaging, repetitive motions. Try walking, swimming or biking.”


Prepping for Old Age
Geriatric specialist Linda Ann S. J. Tom helps seniors stay independent.

The largest generation in American history, the baby boom, is hitting its 60s. Boomers aren’t ready to be old yet, not by a long shot. But flash forward a decade or two, and you can see the coming need for a lot of geriatric medicine specialists. Our state is already facing this issue; according to The Healthcare Association of Hawai‘i, the Islands have the fastest growing rate of senior citizens per capita in the country.

“Sixty-five doesn’t cut it. You have to be at least 70, 80 years old to impress me,” jokes Dr. Linda Tom, a geriatric specialist at Leahi Hospital. “It’s true that I see patients who are frail, have weight loss, memory problems or incontinence,” she says. “But there are also many patients who are active and go to Vegas every two weeks. A lot of my practice is helping people from becoming frail.”

Remaining independent is important to older patients. “They want to live alone and be able to function.” She recommends that baby boomers prep by staying physically fit, so they’ll have the balance and strength they’ll need to avoid falls. “Women should be evaluated for osteoporosis and treated if needed; they have good drugs for osteoporosis if you start early,” she adds.

On the Edge
Cardiologist Edward Nin-da Shen looks at the future of heart care.

If you had a heart attack 30 years ago, you would have been up a creek without a pharmaceutical paddle. Today, cardiac care has leapt into the 21st century. Doctors can now use catheters to open clogged vessels, often eliminating the need for open-heart surgery. Statins help lower bad cholesterol. There are even implantable devices that can monitor a patient’s heart and shock it if needed—no need to wait for the cart with the paddles.

Edward Shen, M.D., of The Queen’s Medical Center and John A. Burns School of Medicine, sees even more change on the horizon. He points to stem-cell procedures, such as the experimental one Don Ho underwent in Thailand last December. “Stem cells are cells that have not differentiated,” explains Shen. “They can go on to be more specialized, such as a muscle cell.” According to the National Institutes of Health, it may someday be possible to grow healthy heart muscle cells in a lab, then transplant them into a damaged heart to strengthen it. In the meantime, says Shen, “Watch your cholesterol and blood pressure, and don’t smoke.”

Navigating Change
Barbara Kitashima guides women through menopause.

In their 40s and 50s, many women face a daunting question: To take hormones or not take hormones? Estrogen or estrogen/progestin therapy is used to reduce the symptoms of menopause, such as hot flashes, and to help prevent conditions such as osteoporosis. Yet the recent Women’s Health Initiative study showed the drugs cause an increased risk of heart attack, stroke, breast cancer and dementia. Best course of action? Talk to your doctor, who can evaluate the benefits and risks based on your medical history.

“There’s been a lot of research in terms of hormone therapy, and our goal as physicians is to give as much information as we can, based on the data and facts that we have,” says obstetrician/gynecologist Barbara Kitashima, who practices at Kapi‘olani Medical Center for Women and Children and is a member of the clinical faculty at the University of Hawai‘i John A. Burns School of Medicine.

“Menopause is a major transition, and most women will feel its effects,” she says, “but the symptoms—sleep problems, anxiety, hot flashes and mood swings—do go away. Your life will get better again.”

Time to Panic?
Emergency medicine specialist Frederick Ching on when you should definitely head to the emergency room.

When it comes to having a heart attack or a stroke, a wait-and-see approach can be deadly. Heart-attack symptoms include chest discomfort, breaking out in a cold sweat, neck or jaw pain, nausea or dizziness. The American Stroke Association lists the warning signs of a stroke as sudden weakness or numbness, confusion, trouble with vision, dizziness or a severe headache. But despite the body’s messages, many people wait too long to seek help—about two hours, according to the American Heart Association—because they don’t understand the symptoms or simply don’t want to cause a fuss.

“Strokes and heart attacks—a lot can be done if you get them early,” explains Frederick Ching, M.D., of Straub’s department of emergency medicine. “Sometimes you can bring back people from life-threatening situations.”

Ching admits it can be hard for a layperson to identify an emergency. “There can be nebulous symptoms—for example, a diabetic might not have chest pain with a heart attack. We always tell people, ‘If you think it’s an emergency, or you’d like to be seen, please come in.’ You don’t want to make that mistake and think, ‘What if I’d come in earlier?’”