Friday, April 1, 2011

Top Doctor (Cardiology) Steven Beaudette, M.D., F.A.C.C. Photo by John Hession.

Top Doctor (Internal Medicine) Douglas DeSantis, M.D. Photo by John Hession.

Top Doctor (Colon/Rectal Surgery) Jeffrey Harnsberger, M.D. Photo by John Hession.

Top Doctor (Hand Surgery) Robert Heaps, M.D. Photo by John Hession.

Top Doctor (Breast Surgery) Kari M. Rosenkranz, M.D. Photo by John Hession.

Top Doctor (Ear, Nose & Throat Surgery) Joseph Paydarfar, M.D. Photo by John Hession.

Top Doctor (Cardiology) Steven Beaudette, M.D., F.A.C.C. Photo by John Hession.

Looking for the list of winners?

Click here for all the results of both the Top Doctors Poll and our Readers' Poll.

The following are Q&As with six of our 2011 Top Doctors, plus selected responses to our survey questions. Click here to see the complete list of winners in both the Top Doctors Poll and the Readers' Poll.

Q&As

Steve Beaudette, M.D., F.A.C.C.
Cardiology
SNHMC/SJH/New England Heart Institute

Why medicine? Why this specialty? My interest in medicine was cultivated at an early age watching my mother care for heart patients as an intensive care nurse at Catholic Medical Center.

Most rewarding aspect of your work? Helping patients through life threatening acute cardiac events and then guiding them through lifestyle changes that leads to improved long-term health.

Rx for staying healthy? First and foremost, regular exercise - at all ages. This should be combined with a healthy diet, refraining from smoking and seeing your doctor regularly.

How do you put patients at ease? Taking the extra time to make sure they fully understand their cardiac issues and the options for testing and treatment.

What do you do to relieve stress and leave work behind? I am blessed to have a wonderful family and extended family with whom I spend my free time. I'm also a passionate fan of all our amazing New England sports teams.

What can patients bring to the patient/doctor equation? Open two-way communication is so important. Come prepared with your questions and concerns. If you think you are going to forget something, write it down.

What do people need to understand about medicine? Medical care in 2011 is a team effort. I'm privileged to work with dedicated and skilled teams of nurses, pharmacists, therapists and technicians who work together to provide the best care for our patients.

Do you have a motto or philosophy? Provide the care that you would want a family member to receive.

Douglas H. DeSantis, M.D.
Internal Medicine
PRH

Why medicine? Why this specialty? Combination of science and art in a constantly changing profession.

Most rewarding aspect of your work? Long-term relationships with patients and families.

Most difficult aspect? Paperwork.

Rx for staying healthy? Common sense eating and exercise.

What do you do to relieve stress and leave work behind? Play mandolin, exercise and yoga.

Exciting development in your field? The explosion of breakthroughs in genetics.

What do people need to understand about medicine? Understanding that not all things can be fixed and there is a price to pay for any medications or procedures.

Do you have a motto or philosophy? Nothing in moderation will harm you.

Jeffrey Harnsberger, M.D.
Colon/Rectal Surgery
Elliot/DHMC

Why medicine? Why this specialty? I was interested in medicine as a kid; I can recall watching old medical shows on TV, being intrigued particularly with surgical procedures. Later, working as an orderly during graduate school, it became apparent to me that medicine was the field I wanted to pursue as a career. During my residency in general surgery at Dartmouth-Hitchcock Medical Center, I became interested in the surgical management of colorectal cancer, inflammatory bowel disease, as well as anorectal disease.

Most rewarding aspect of your work? There are many elements that are rewarding. A difficult operation that technically goes very well, seeing a patient post-operatively who is recovering and is happy or a patient who says after surgery, "Thanks, doc, for giving me my life back." I think the greatest reward however, is simply the privilege of having patients place their faith, trust and confidence in me as a surgeon, for treatment of diseases that are life-altering or life-threatening.

How do you put patients at ease? I try to be forthright and honest, even if it is not what the patient wants to hear. I think this helps them understand the challenges related to their treatment so they can best accept and prepare for what lies ahead. I also try to emphasize the positives and the importance of focusing on factors which are under the patient's control, thus avoiding dwelling on the "what ifs."

Any misconceptions about your specialty? Some patients still have the misperception that the specialty of colon and rectal surgery is the equivalent of "proctology" of many years ago. Colon and rectal surgery however, encompasses far more than the surgical treatment of anorectal disease such as hemorrhoids, as exemplified by the breadth of surgeries encompassed during fellowship training in colon and rectal surgery.

Exciting development in your field? The progressive application of laparoscopic techniques, including use of the robot for performing various colorectal surgeries.

Do you have a motto or philosophy? In the words of Jim Valvano, former head basketball coach at NC State, towards the end of his courageous battle with cancer, "don't give up ... don't ever give up."

Robert Heaps, M.D.
Hand Surgery
SNHMC/Elliot/CMC/BASC/SJH/New Hampshire Orthopaedic Center

Why medicine? Why this specialty? I come home most days feeling like I have made a difference in someone's life. Every day is unique. I have had an interest in Orthopaedic Surgery since I was a teenage patient. The influence of a few mentors along the course of my education and training helped to direct that interest in Hand and Upper Extremity Surgery. I still love what I do.

Most rewarding aspect of your work? Working with a patient with a serious injury, and getting them back to work or play. Most patients are still very appreciative of our efforts.

Most difficult aspect? The fact that more and more control of medical care is being taken away from the patient and physician.

What makes a great doctor? Kindness and the ability to listen are two important factors beyond training and keeping up to date with changes in technology. I try to remind myself of this when I fell like I'm getting into a rut.

Rx for staying healthy? Managing the work schedule to make time to exercise and enjoy life. I pay close attention to the medical articles that encourage the use of dark chocolate and wine in moderation.

Any misconceptions about your specialty? The importance of hand therapy after some procedures to achieve an optimal result. Success cannot always be achieved with surgery alone.

What do you do to relieve stress and leave work behind? The usual - biking, golfing, skiing, working out. An occasional Friday lunch with my wife, Lisa.

Exciting development in your field? The treatment of Dupuytren's Contracture with an injectable enzyme was approved within the last year. Dupuytren's causes the fingers to contract down and is usually treated with surgery. An injection is appropriate in some of theses patients. It is less invasive and seems to have good early results.

What do people need to understand about medicine? Though we can do more for most patients than ever, medicine is still evolving.

Kari M. Rosenkranz, M.D.
Breast Surgery
DHMC

Why medicine? Why this specialty? Breast surgery is a good match for my interests and my personality. The surgical side appeals to my desire to "fix" things. But unlike some other surgical specialties where the "fix" is short term, breast surgery lends itself to long-term relationships with patients and allows me be an advocate for women and women's health care.

Most difficult aspect? We are privileged in medicine to be a part of patients' lives during difficult, emotional and stressful times. In breast surgery, we often diffuse anxiety by educating patients about the generally excellent prognosis breast cancer carries. Rarely, however, we are the bearers of bad news. I find the delivery of bad news is, and I suspect will always be, the most difficult part of my work.

What's the trickiest procedure to perform? A new and exciting surgical option for some women with breast cancer is the nipple sparing mastectomy. I think it is the most challenging procedure breast surgeons perform today, but the cosmetic outcome makes the effort well worthwhile.

What do you do to relieve stress and leave work behind? The woods are my place of respite. I find I need time alone, with my dogs, to snowshoe, to hike, to engage in any activity that gives me solitude and helps clear my head and restore my energy.

Exciting development in your field? One of the most exciting developments in breast cancer surgery is the trend toward less-invasive, more-personalized therapy. Recent data have shown that most women can avoid axillary dissection even in some situations where cancer is found in the lymph nodes. This less invasive approach reduces complications of surgery and minimizes long-term side effects. New techniques for partial and complete breast reconstruction have improved cosmetic outcomes and provided psychological benefits post-operatively. The field of breast surgery and the multidisciplinary management of breast cancer are changing rapidly.

Joseph Paydarfar, M.D.
Ear, Nose and Throat Surgery
DHMC

Why medicine? Why this specialty? I chose a career in otolaryngology because it is a fascinating surgical specialty. The otolaryngologist cares for patients of all ages and treats an assortment of conditions that can affect our senses, our ability to communicate and our self image. I became particularly interested in treating patients with tumors of the head and neck because of the complexity of the operations, the aesthetic and artistic nature of the required reconstructive surgery and the profound impact this disease and the treatments can have on a patient's quality of life.

What makes a great doctor? My dear friend and colleague, the late Dudley Weider embodied the qualities that I feel make a great doctor: he listened to his patients, had sincere compassion, was humble but confident, was an innovator and was a lifelong learner.

What do you do to relieve stress and leave work behind? Spend time with my family, exercise, and work on my car.

Exciting development in your field? Minimally invasive surgeries including endoscopic surgery for tumors of the skull base, as well as laser microsurgery and robotic surgery for tumors of the throat.

What do people need to understand about medicine? Medicine is ever more complex with "medical miracles" happening all the time. We have incredible technologies, from fancy MRI scanners to surgical robots as well as a variety of sophisticated medicines for an assortment of ailments. However, the best medicine is that which is not found in the hospital or the doctor's office. As individuals, we all possess the ability, to a certain degree, to shape our health - quit smoking, exercise, eat better, loose weight, reduce stress. None of these treatments is easy and none of them are sexy. However, they are simple, inexpensive and have no side effects; and in many cases will go an incredibly long way to keeping us healthy and happy

Do you have a motto or philosophy? I hope for the best, but plan for the worse.

Survey Questions

Rate the healthcare reforms called "ObamaCare" from a 1 (a terrible mistake) to a 5 (a great step forward).

Overall, the doctors who answered are not of one mind when it comes to rating healthcare reforms. About 75 doctors gave it a 1, 60 said 2, 50 doctors chose the middle with 3, 75 gave a rating of 4 and 100 rated it at 5. Here are a few of their comments:

"Change is needed and this is a step in the right direction."

"Don't know yet."

"I give it a 3. Definitely better than nothing. It was a good first step. Ending lifetime caps, pre-existing condition exclusions and ending dropping sick people were the best features. I'd like to see tort reform added and the bill simplified."

"I rate it at a 2. Seems to me government just "pushed things through" without really delving into the details."

"I would give it a four - step in the right direction. It did not go far enough. I would have kept the government option."

"This is not healthcare reform. It is actually health insurance reform. This bill does not address any improvement in the health of our population and reducing cost of healthcare."

What's your favorite "Folk Remedy" and do you actually think it works?

(Caveat: We're not sure how serious the doctors were, so take advice at your own risk.)

"An aspirin a day keeps the doctor away"... and, yes, I believe there is substantial data to say this practice should be utilized by almost everyone.

Honey, tea and lemon for colds and sore throats - it is soothing if nothing else!

Ginger: it is settling for an upset stomach or nausea.

A tablespoon of sugar for hiccups .... works for me!

A tablespoon of vinegar for hiccups - it often or usually works.

Airborne - reduces duration of a cold.

Aloe vera for wound healing.

Arginine improving microcirculation

Arnica Montana for preventing post-op bruising.

B12 and Zinc, to help with colds.

Cracked fingertips: Super Glue
or Bag Balm: Yes!

Camomile tea for colic

Chicken Soup - yes, it works if it is homemade.

Cranberry juice for UTI; and yes, it works!

Dandruff shampoo for cradle cap

Diet and exercise prevents just about everything.

Drinking warm milk with 1/2-1 tsp. of turmeric for common cold, and, yes, it does relieve the congestion.

Drinking wine and beer to prevent arteriosclerosis.

Duct tape for warts - works 60 percent of the time, which is equal to most other modalities.

Fenugreek - to increase mother's milk production

Flat Coke or ginger ale for an upset stomach.

For leg cramps at night, put a bar of ivory soap in a stocking and place it between the sheets while sleeping.

Gargling with warm salt water to treat a sore throat

Ginger root for arthritic pain. It works!

Good nutrition, adequate sleep, regular exercise

Green tea. Drink daily to prevent UTI.

Ice for all injuries, pain and swelling.

Olive oil. Drink to get rid of gallstones. It works only if used with garlic.

Licorice for asthma.

Meditation

Melatonin for sleep

Moist heat on muscle pains.

Place an onion in a room to collect germs/viruses.

Putting Ben Gay on the forehead at night when you have a head cold.

Putting toothpaste on burns. Relieves the pain.

Sleep. A full night's sleep (hard to get in the hospital) can make the difference between recovery or continued illness.

Super Glue for painful dry skin fissures in your hands.

Vicks VapoRub for fungal toe nails

Everyone should be on Omega FA!

Windex for mosquito bites

Warm milk to help sleep

Offer a word of advice to someone considering a career in medicine.

"Strap in ('cuz you're goin' for a ride!)"

"A mentor told me, 'Medicine is a demanding career, more so than non-physicians can understand. It will take over your life if you let it. If you can be happy in life doing any other career, do it. If not, you are meant to be a physician."

"Always remember it is a privilege to care for someone who has entrusted their very life with you!"

"As anything, it's worth it if you love it. Always follow your heart - the work is worth it if you do."

"Be a lawyer."

"Ask yourself whether you really enjoy working with people. If not, consider research or veterinary school."

"It's a great career, but it is much more than that. It truly is a way of life. You will go home at the end of the day and worry about your patients. You will sometimes wonder if you did the right thing. It requires many sacrifices along the way."

"Never stop learning."

"Just do it."

"Medicine is now an industry, without the freedom to take care of patients exactly as you think best."

"Keep your other options open."

"The negatives are outweighed by the ability to make a difference for others."

"Go for it. It is an honorable and respected profession.

"It is not glamorous or a get rich quick scheme, but it is a rewarding way to spend your career working hard."