Staff Reporter

It's not particularly hard to find out who the top people are in a given specialty. Ask around about who's the top gastroenterologist or plastic surgeon, and chances are the same few names will pop up over and over again.

But how does that buzz get started? Is it purely based on ability, or are other factors such as research, community involvement or a knack for public relations involved?

"At the very foundation it is the quality of the work and practice," said Grace Cheng, vice president for marketing and public relations at Cedars-Sinai Medical Center. "The affiliation with an institution adds valuable research and expanded resources. You build off that and word of mouth."

Maybe so, but there are plenty of doctors doing very fine work who don't show up on magazine lists of the top specialists. For that kind of designation, a little star power doesn't hurt.

Indeed, when it comes to medical fame, a twist on an old adage might be appropriate: It's not what you know, it's who you treat.

A case in point is Dr. Arnold Klein, perhaps the world's most famous dermatologist because of his treatment of pop superstar Michael Jackson, whose skin pigmentation has been the subject of a good deal of media coverage. Klein has attracted other celebrity clients and is widely regarded as one of the top specialists in his field.

Of course, if a specialist is attracting a lot of famous clients, there's probably a good reason.

"If it is someone famous using a doctor, there is a presumption that the doctor knows what he is doing," said Dr. Michael Langberg, the chief medical officer at Cedars-Sinai.

Some doctors become famous only within the medical community, thanks to coverage in medical journals. These publications, Langberg said, use entirely different criteria than the consumer press when they make their selections about top specialists. Here, he said, the prestige of the hospital or medical school that the doctor is affiliated with becomes a factor. So do the number and type of research grants the physician gets.

Surgeons have different criteria for attracting buzz, too, the opposite for those who gain fame in the lab.

"God only gives out a certain amount of (surgical) talent," said Dr. Robert Watkins, a professor of orthopedics and co-director of the Center for Spinal Surgery at USC. "The best technicians are not the guys discovering the genetic sequence for spinal cord injuries."

Being a pioneer in a special field, especially one in which there is a high risk, plays an enormous role in the fate of a doctor.

"People become household names, like in the '50s and '60s with doctors like Jonas Salk (polio vaccine) or Michael Debakey and Christian Bernard (in heart surgery)," Langberg said. "They always look to the first one."

Then there is P.R. the hiring of professional publicists to spread the word about a doctor and his work. Most public relations professionals believe their skills have now become an important element in helping someone become famous in medicine.

"You can be the best tap dancer in the world, but if no one turns on the light, all you will hear is the patter of little feet," said Dick Guttman, a veteran Los Angeles-based publicist. "Certainly, doctors get the benefit of good publicity."

One corporate public relations executive who has worked for doctors said he creates P.R. kits for his clients that are sent to reporters. He also routinely tries to set up meetings with editors of medical trade journals, reporters who cover the medical profession and lifestyle writers.

"This is how they get to be known," he said. "They make the medical columns or get a quote in Newsweek or Time. It's how you become an authority."

The Internet, he said, is becoming a valuable tool in this arena. All someone has to do is look up a particular disease, and a doctor's name will surface. These mentions are gold for a publicity hound.

For all of that, medical experts and publicists agree that word of mouth one patient talking to another is the best way for a crack doctor to become well known. Larry Hagman chose Dr. Leonard Makowka to handle his liver transplant not only because he was considered the best surgeon available until his recent retirement, but also because his mother, actress Mary Martin, was treated by him.

Pat Kingsley, one of the top entertainment publicists in Hollywood, chose Robert Watkins to operate on her neck because Debra Winger recommended him, and not because of his clippings about treating top athletes.

"Debra told me that I should go to him, and he only operates on the spine," Kingsley said. "I was very impressed, and he did the surgery."

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