Why It’s So Difficult, But So Crucial, to Rank Medical Expertise in Rheumatology

expertscape logo, gray background
Expertscape is a digital physician ranking and search tool that helps both patients and referring physicians easily locate experts in numerous specialties.

When faced with a challenging case, how can you find a knowledgeable US rheumatoid arthritis expert? It depends on the criteria of judgment! Take this query to a medical professional and the subjective factors could include availability, hospital affiliation, and perceived expertise. But present that question to an online ranking tool such as Expertscape and the results may be very different.

Here’s the challenge: with the exception of numerical results, all rankings are subjective. So, in this sea of subjectivity, Expertscape — an online tool for identifying and objectively ranking medical knowledge — determines the top experts for 29,000 different medical search terms.  

How does it identify and rank medical knowledge? The formula is simple: Expertscape searches the PubMed database for all published medical journal articles about the topic, limiting that search to the past 10 years. 

Next, each article receives a score based on year of publication (recent is better), category (reviews score higher than opinion letters), impact factor of the journal, and other criteria. Each article author receives a score, with experts gaining more points for first authorship. Finally, all the scores are tallied, and a list of top experts is generated. Expertscape computes this for more than 29,000 topics for thousands of institutions and individuals every month.

Clearly, Expertscape’s criteria only reflect a few of the myriad factors that yield expertise. Yet many medical professionals swear by this platform. Why? Providers need quality referrals and consultations when dealing with rheumatologic conditions. Many will need to ensure that treating acute conditions won’t complicate the underlying rheumatologic condition. And, in the absence of personal connections, tools like Expertscape can help meet that need.

The Case for Ranking Colleagues

Andrew Schneider, DPM

It’s no secret that the availability of specialty care varies drastically across this country.  According to Andrew Schneider, DPM, a Houston-based podiatrist in private practice, “Especially in rural areas, you see a real gap in specialists. Physicians tend to be generalists: they know a little about a lot, but don’t really specialize. These doctors often end up sending patients into cities for problems they can’t treat.” As such, says Dr Schneider, Expertscape could be very valuable. “I see it as a worthwhile tool, especially for doctors who don’t have a network.”

For Tali Lando, MD, an assistant clinical professor at New York Medical College and an attending surgeon at Maria Fareri Children’s Hospital in Valhalla, New York, Expertscape also has value as a personal consultation tool. Living in a major metropolitan area, she has access to a wide pool of colleagues if she needs to refer a patient for outside care. “I’m in New York, so it’s fairly easy to find the mecca of experts,” she says, “even if it’s obscure. But once you get farther out, it’s very difficult to find that. If it’s really easy to search and user friendly, I think it could be helpful.”  

Still, while Dr Lando doesn’t view Expertscape as a referral source, she says, “I would find a tool like that valuable when dealing with an obscure medical problem.” In fact, this exact issue came up recently in her practice. “I had a patient this year who came in with an ENT manifestation of a rheumatologic problem. The child had hoarseness and had just been diagnosed with Sjögren syndrome.” 

Tali Lando, MD

While Dr Lando knew the cause of the symptoms, she had a very specific question: “I wanted to know if injecting steroids would help this patient. And what I wanted was to find out who is the expert in this relatively rare rheumatologic disease, who will have experience treating this very specific problem in a young child.”

Unaware of Expertscape, Dr Lando began what she describes as her own “detective work.” She says, “I go to PubMed and look up the specialty. But it’s confusing, because sometimes 10 names pop up on the same article, and then you have to track them down.” Clearly, she says, shortening the process would be useful. – which is exactly what Expertscape does.

A Measured Approach to Evaluating Expertise

In acknowledging the value of Expertscape, both Dr Schneider and Dr Lando note that, as with any ranking tool, this platform may occasionally miss its mark. As Dr Lando says, “Some great providers don’t have the resources to get published, even if they’re an expert in their fields.”

This is especially true because the criteria for publication can be daunting. As she explains, “I have this very specific interest in swallowing disorders in infants. I actually have a huge referral base because I’ve given talks about treatment protocols. I’ve even written a paper, but I couldn’t get it published because it was hard to get rigorous statistical data.”

Given her own experience, Dr Lando acknowledges that experts like herself would be overlooked by Expertscape. To help overcome potential gaps, she says, “I like the idea of adding an element [to the platform] that ties into a secondary search option like physician websites.”

Barring such additions, however, Dr Schneider still believes Expertscape’s ranking methodology is appropriate. “I don’t see a real problem, because you have to have your search results ranked somehow. I’d rather it be based on academics, connecting me to people who are more active in research. Those are the people you want to consult with anyway, rather than finding people who are ranked based on something subjective, like Google reviews.” 

The Country’s Top Rheumatoid Arthritis Specialists, According to Expertscape

Understanding the value — and potential shortcomings — of the Expertscape ranking system, we embarked on a quest to find this nation’s top rheumatoid arthritis specialists. After eliminating internationally based experts and providers who’ve moved on from research or clinical care, this is who we discovered:

Roy Fleishmann, MD

Roy Fleishmann, MD

According to Expertscape, Dallas-based Dr Fleishmann is the top rheumatoid arthritis expert in the United States, based on his 109 published studies since 2010. A practicing rheumatologist for more than 20 years, Dr Fleishmann is affiliated with several hospitals, including UT Southwestern Medical Center, Medical City Dallas, Texas Health Presbyterian Hospital Dallas, Baylor Scott and White Medical Center–Irving, and Medical City Plano.

Arthur Kavanaugh, MD

The second-ranked expert for rheumatoid arthritis? With 93 articles published since 2010, this distinction goes to Dr Kavanaugh, who is based in San Diego and affiliated with UC San Diego Health. He currently provides patient care at two separate offices in Southern California.

Mark Genovese, MD

With 96 published articles, Stanford University Medical Center’s Dr Genovese fell just below Dr Kavanaugh, earning a third-place ranking on the Expertscape platform. Still, for physicians seeking a quick consultation, he may prove a more attractive choice. Dr Genovese’s Expertscape listing comes with a helpful addition: a “Consult Me” box that links directly to his provider website. In contrast, consulting with the two higher-ranked experts requires some of Dr Lando’s so-called detective work, as their listings contain no specific links. Still, a quick Google search returned accurate contact information for both physicians.

As a test case, our exploration of Expertscape’s top rheumatoid arthritis specialists was a testament to this tool’s potential benefits. With minimal eliminations, the returned results instantly yielded the top 3 US-based physicians, easily accessible and clearly involved in researching and treating patients with rheumatoid arthritis. Though other skilled experts may have been overlooked, those found by Expertscape would certainly provide quality consultations, in addition to being reliable sources for referral. In short, though focused exclusively on published work as a criteria for ranking, Expertscape helps rural and urban practitioners quickly find qualified specialists, while offering valuable consultation opportunities for medical experts.