Photograph by Dilip Vishwanat
But first, answers to a few questions occasionally posed by readers:
Does the St. Louis Magazine staff select these doctors? No — other doctors do. Best Doctors, Inc., a respected 19-year-old company founded by doctors affiliated with the Harvard Medical School, contacts physicians in the St. Louis region who have been included on a previous Best Doctors list and asks them this question: "If you or a loved one needed a doctor in your specialty, to whom would you refer them?"
What happens to the newly nominated doctors? Best Doctors checks for licensing and certification requirements and any disqualifying disciplinary actions. Doctors who withstand the company's vetting process are added to the list.
Is the list updated in other ways? Yes. Each year, Best Doctors contacts the office of every doctor for thorough fact-checking (location, contact information, availability to patients, etc.). The list is updated accordingly.
Can physicians pay Best Doctors to be included? No.
Can physicians pay St. Louis Magazine to be included? No.
So this is really the best of the best picking the best? Yes.
Where can I learn more about Best Doctors and its processes? Call 800-675-1199 or visit bestdoctors.com.
View the Best Doctors 2008 List
Select Doctor Interviews & Medical Stories
Dilip Banerjee, M.D.
Cardiologist
Patients First Health Care
"There are so many discoveries and new treatments in heart disease. That's what brought me to Saint Louis University and cardiology. Helping someone have a productive life and getting back to work — that's what I find gratifying. There is a continuous evolution of treatment of coronary artery disease. It's improved in all dimensions in terms of medications. That has helped keep patients symptom-free and alive longer. Cardiology is one of the most sought-after specialties in internal medicine. I love it. I'm glad that I decided when I was young that is what I wanted to do."
M. Susan Heaney, M.D.
Pediatrician
Cardinal Glennon Children's Medical Center
"I like the whole spectrum of pediatrics, but I've done a lot of work with teenagers. That transition phase from child to adult is so interesting. I get to deal with the patient rather than just the parents and, I hope, work with them on setting some healthy patterns for the future such as, 'Don't smoke, don't drink, don't engage in risky behaviors,' what they do that's good for them — art, music, sports, dance — and what their support systems are. We are also doing more immunizations. We now have immunizations for cervical cancer, meningococcal meningitis and a pertussis booster. In the end, I like to help them become healthy adults."
Cardinal Glennon Pediatric Emergency Department
St. Anthony's Medical Center
The $5.6 million Cardinal Glennon Pediatric Emergency Department at St. Anthony's is a haven for any parent living outside the St. Louis city limits. Windows decorated with the colors of the rainbow mark the entrance to the children's emergency center — the only one of its kind south of I-44. Inside, vivid colors and children's toys and books decorate what is a fully equipped pediatric wing. The department includes 23-hour observation rooms, as well as conscious sedation where kids are monitored full-time while under anesthesia.
Dr. James Cahalin worked in pediatrics at St. Anthony's for 14 years before being appointed the department's director. He expresses pride in its capabilities: "We can handle any life-threatening emergency [in children] ranging from birth to 18 [years old]," he says.
Patients are treated in either of the two trauma rooms or one of 16 private treatment rooms decorated with different colors and themes and equipped with TVs and DVD players. Assistant nurse manager Linda Pullen says the center is enormously community-oriented, and it's constantly receiving donations. The walls along the parent waiting room are even decorated with child-safety plaques drawn by area grade-school students.
Since it opened last December, the center has seen around 1,300 patients monthly, about 200 more per month than originally projected.
"If you're a parent in the county," says nurse Barb Houska, "it's a no-brainer." —Dan Michel
Richard J. Rothman, M.D.
Ophthalmologist | Retina and Vitreous Consultants
"My interest in ophthalmology relates to fascination with vision, as well as the medical and surgical aspects of the specialty. There have been dramatic advancements in medical retina treatment, particularly in the drug treatment for macular degeneration. We can now preserve vision in most patients with exudative [wet] macular degeneration and improve vision in a third of patients. Recent surgical advances involve the use of smaller instruments, which allow for faster operating times and recovery. My favorite part of the specialty is surgery. It allows me to focus on a single issue and often provides patients with significant visual improvement after a single procedure."
Karen Halverson, M.D.
Radiation Oncologist | St. Luke's Hospital
"Years ago I was able to direct a patient to the appropriate care. He tracked me down 10 years later and said, 'Thank you so much. The advice you gave me made all the difference in the world.' This ability to make an impact on someone's life — that may be by curing their cancer, directing their care, helping with pain or just being a good listener and being kind and considerate — it's very gratifying. It's just icing on the cake that it's intellectually stimulating. I'm very analytical, and I love the research part of my job. Every time I see a patient, I try to determine 'Why am I doing this treatment? What is the purpose? Where should I be directing my beam and why?' Every case is a little different. It's almost like being a detective."
Michael R. DeBaun, M.D.
Pediatric Hematologist/Oncologist
St. Louis Children's Hospital
"I enjoy the opportunity to make a difference in the lives of children. There's an intellectual challenge along with the art of medicine rolled into one patient. Also, the sickle cell team at St. Louis Children's Hospital believes in a vision: the rite of passage for children with sickle cell disease to attend a summer camp. Generally, these children are left out of that rite of passage because they tire easily and have other physical issues. But with the support of our sickle cell team and donations from family and friends, we have been able to have Camp Crescent for the last seven summers. We help them indulge in swimming, sports and all sorts of activities. It's about seeing the joy on the children's faces."
The da Vinci S HD Surgical System
St. Luke's Hospital
It's the kind of machine science-fiction writers once could only predict. A doctor sits at a 3-D imaging machine at one end of an operating room, while at the other end, a four-armed machine does the actual surgery with increased visibility and range of motion.
The da Vinci S HD Surgical System, a 3-D endoscopic surgical tool, scales and steadies a surgeon's movements and facilitates minimally invasive procedures that allow patients less blood loss, minimized tissue damage and abbreviated recovery times. Although it is used mostly for laparoscopic prostate surgeries, the da Vinci can also be used for reconstructive kidney operations and some gynecological procedures.
"Trying to get around angles in the pelvic region is hard with particular instruments," says Dr. David Bryan, one of three doctors who make use of the system at St. Luke's. "The da Vinci can move in more ways than the human hand."
Bryan says the tool provides a great advantage in the operating room. "There is much more precision and meticulous dissection," he says. "The visualization is amazing."
Although the da Vinci is not ideal for every patient or procedure, Bryan says its uses are growing. He hopes to start using the system for heart-valve repair sometime in the near future. —Dan Michel
Cherie A. LeFevre, M.D.
OB-GYN | St. Mary's Health Center
"I am the director of the St. Louis University Vulvar Vaginal Disorder Specialty Center. Our center treats women who have long-term problems like chronic vaginitis, pain or dermatological conditions. These are higher-level problems than routine gynecological complaints. It's a very private matter for many women, and they don't feel comfortable discussing these conditions with their physicians. In the general OB-GYN office, the standard 15-minute appointment makes it difficult to address. Many physicians are not necessarily aware of these conditions and the treatment options available. Magazines are beginning to write more about these issues, and that allows women to realize that they are not the only one. Because we are an academic practice, we are able to afford an hour appointment for each new patient. It's very rewarding to be able to help women who have been suffering from these problems for anywhere from many months to 20 years."
Cynthia X. Ma, M.D.
Medical Oncologist/Hematologist | Alvin J. Siteman Cancer Center
"What prompted my decision to pursue a career in medical oncology was the desire to relieve the suffering of patients with cancer. Chemotherapy appeared so primitive to me and caused so many side effects when trying to help cancer patients. I thought I could really use my research background from my Ph.D. training in basic science and my clinical skills to contribute to the development of novel therapeutics for these patients. I have a few trials of small-molecule inhibitors in treating patients with breast cancer. Some of these agents have shown very promising activity. I am also interested in looking at predictors of responses and how these drugs work. The goal is to narrow down which person we should be treating with these drugs. It takes time, but I'm hoping it will happen."
Heart Lifeline Alliance
Missouri Baptist Medical Center
When dealing with heart attacks, the difference between life and death can be a matter of minutes. This is the impetus for Missouri Baptist's involvement in the Heart Lifeline Alliance, a partnership it formed with Air Evac Lifeteam and rural hospitals surrounding St. Louis to ensure that acute heart attack situations, especially STEMIs (ST-elevation myocardial infarctions), are responded to quickly and efficiently.
Air Evac Lifeteam and ARCH Air Medical Service are the helicopter transport groups Missouri Baptist uses to serve the alliance. The idea is to help people in rural areas get emergency care not offered in their hometowns.
One of the 17 people whose life has been saved by the program is Verna Pewitt, who was airlifted to Missouri Baptist after a heart attack earlier this year. The 77-year-old Iron County, Mo., resident recalls that day clearly. "Everything went so smooth," she says. "I was in recovery by the time my husband could drive up [to St. Louis]."
Dr. Stuart T. Higano, director of Missouri Baptist's Acute MI (Myocardial Infarction) Committee, helped start the program after witnessing its success in his 20 years at the Mayo Clinic. "I've gained great respect for air transporters," he says. "It's very impressive when you see their operation."
The hospital's operation is impressive as well. Once notified of the situation, doctors meet air transport patients at the door and can relieve a blood clot in less than 90 minutes.
This service is the future of medical transport for those living in rural America. In fact, the Missouri legislature recently ruled that the Department of Health and Senior Services must establish protocols for transporting heart attack and stroke patients to appropriate care centers.
Learn more about Air Evac Lifeteam, including how to become a member, at lifeteam.net. —Dan Michel
Harry L. Wadsworth, M.D.
Endocrinologist/Metabolism Specialist
St. Louis Medical Clinic
"With endocrinology, it's problem-solving, and you can see results. When you speak of diabetes in particular, it's a true collaboration with the patients. The advances in just the drug tools in the last decade have been the most exciting thing. We can use these tools to really approach it differently. Before, the types of tools were limited. Even the types of insulin were limited. For me, the diversity of what I see is professional gratification. Everybody is different, and every treatment plan is customized."
Michele Woodley, M.D
Gastroenterologist, Missouri Baptist Medical Center
"There are several parts of gastroenterology that I'm really excited about. One is celiac disease, which is an old disease. The treatment is nutrition — a different diet — which I really like. As a female gastroenterologist — and there aren't many in St. Louis — I see a lot of patients with irritable bowel syndrome. Many people have a hard time seeing a gastroenterologist. They are talking about very difficult issues they are having. In particular, it is a big problem for women, and there is a lot that can be done. It's really neat to see someone who has been suffering for decades, and you make them feel better. There is nothing in the world that matches that."
Michael C. Mauney
Thoracic Surgeon
Missouri Baptist Medical Center
"I have had a real fascination ever since medical school with the heart. Every time I open up someone's chest and see their beating heart, it is still an awesome sight. I enjoy the complexity and acuity of cardiac and thoracic surgical disease, such as repairing a torn aorta or removing a large, malignant tumor of the lung. It's quite satisfying to come across something that is unexpected or challenging and to have to think outside the box to resolve that problem. Although I am the captain of the team, a good outcome is equally dependent on the 10 to 20 other members of our outstanding cardiothoracic surgical team who will directly take part in the patient's care. I have benefited greatly from the outstanding experience of all three of my partners: Drs. Nick Kouchouklos, Peter Murphy and Michael Murphy. Seeing the patients come back in a month with their family and they're feeling much better, that's the ultimate rewarding feeling."
BioMed 21 and the BJC Institute of Health
Washington University
Last summer, the Washington University School of Medicine began construction on its largest building ever: the BJC Institute of Health at Washington University. Located in the heart of the Washington University Medical Center campus, the building will provide 300,000 square feet of research and laboratory space, largely dedicated to the university initiative called BioMed 21.
Launched in 2003, BioMed 21 is the School of Medicine's $300 million project to enhance interdisciplinary research by joining scientists and clinician-researchers with different areas of expertise. "We're bringing people together who have different backgrounds, tools and skills to tackle pressing clinical problems," says Dr. Larry Shapiro, Wash. U.'s executive vice chancellor for medical affairs and dean of the School of Medicine. Professions that may not normally have an association with biology and medicine, such as chemistry, materials science, engineering and physics, are being brought on board to encourage advances in medicine.
The building, which is supported by a $30 million gift from BJC HealthCare, will also house five Interdisciplinary Research Centers that address specific diseases: the Center for Cancer Genomics (which will use BioMed 21's genome sequencing of cancer cells to tailor treatments to different patients), the Center for the Investigation of Membrane Excitability Disorders, the Center for Women's Infectious Disease Research, the Hope Center Program on Protein Misfolding and Neurodegeneration, and the Center for Interdisciplinary Studies of Diabetic Cardiovascular Disease.
One of the biggest challenges for the project is one of culture within the institution. In working together, these researchers must overcome language barriers of field-specific terminology to communicate with others outside of their area of expertise. Should those obstacles be overcome, the potential regional benefits are clearly significant: Such interdisciplinary collaboration will put St. Louis at the forefront of medical research, developing local clinical expertise and delivering the best treatments via the latest equipment.
"BioMed 21 is a program that will take some years to realize," says Shapiro. "It is a vision for the future of biomedical research that will pay huge dividends in better patient outcomes."
Cannon Design, an international architectural, engineering and planning firm with an office in downtown St. Louis, is the project architect for the building, which is scheduled to be completed in December 2009. Learn more about the BioMed 21 initiative at biomed21.wustl.edu. —Amy Recktenwald
Physician interviews by Shera Dalin
