When 2-year-old Joshua Bridgett needed a tonsillectomy last fall, his mother was not satisfied with the surgeons suggested by friends, relatives and even her son's pediatrician. "None of them seemed quite right," said Sandy Bridgett of Upper Marlboro.
Wanting a thorough search for the best physician available, she called Dial "Doc-tors," a medical matching service that promises to match patients with the right doctor through a computerized listing of physicians and dentists in the District, Maryland and Northern Virginia.
Bridgett, who said she was pleased with the physician the service helped her pick, said she called it because she thought it was an independent referral system. (Its name comes from its telephone number, D-O-C-T-O-R-S.)
While Dial "Doc-tors" is a free consumer service, it is not independent and its selection is limited to about 1,000 physicians, one-sixth of those licensed in the Washington area.
That is because Dial "Doc-tors" is a well-financed medical marketing system designed to attract patients to the hospitals that fund it. And that has created a furor in the Washington area medical community among physicians and institutions that are excluded from participating in the system.
The Washington Healthcare Corp., Fairfax Hospital Association and Holy Cross Hospital initially funded the service in the Washington area at a reported cost of $600,000 each. Only doctors on staff or with privileges to practice at Washington Hospital Center and Capitol Hill Hospital, which are part of the health care group; Fairfax, Commonwealth, Mount Vernon and Jefferson Memorial hospitals, part of the Fairfax association, and Holy Cross Hospital are included in the Dial "Doc-tors" listing. About 200 dentists listed with the service pay individual fees.
"It's our hope that if callers do need hospitalization that the physician will bring him to our facility," said Fairfax Hospital Association Vice President Don Harris.
"We are an information and appointment service for consumers and a marketing service for hospitals and doctors," said Jeremy Miller, vice president of the Health Information Service, which oversees the local operation of Dial "Doc-tors." The service is also available in Houston, Dallas and the Denver-Boulder area.
Since the service was introduced in the Washington area last year, some physicians and local medical societies have criticized it for not assisting low-income residents who lack medical insurance.
"We're getting calls from [low-income] people who did dial 'Doc-tors' and Dial 'Doc-tors' referred them to us," said Angelo Troisi, director of the Medical Society of Prince George's County.
Others complain that its extensive television and radio advertisements promising to "Choose the Right Doctor for You" are misleading because they do not explain that a limited pool of doctors is involved.
One of the critics, Dr. Richard Feldman, is an internist who practices at Prince George's General, Leland Memorial and Doctors' Hospital.
"Who's to say that the perfect doctor only goes to Fairfax, the Washington Hospital Center or Holy Cross?" he said. "There may be a doctor for you who's right around the corner, but they won't tell you about him."
Area medical societies traditionally have provided free referral services, but information has been limited to professional data about educational background and medical specialization. "Real pretty basic stuff," according to a spokeswoman for the D.C. Medical Society.
Callers to Dial "Doc-tors" can get information ranging from an individual physician's fees, specialization and education to his or her marital status and hobbies and whether his or her style is more like TV doctors Marcus Welby's or Trapper John's.
Area calls are answered at the company's headquarters in Boulder, Colo., where callers are asked about the characteristics they are looking for in a physician. The interviewer then narrows the choices through the computerized listing and discusses with the caller specific details about the doctors, including their location, fees and insurance policies.
"Within 15 minutes they can shop across the entire data base," according to Miller. About 1,500 items of information are collected on each doctor.
With the growing popularity of health maintenance organizations, ambulatory care clinics and franchised dental centers, such computer services have become increasingly important to private-practice physicians and hospitals that are competing for patients.
Nationally, an estimated 25 to 35 percent of the population do not have their own regular physicians and it is largely these people that services like Dial "Doc-tors" hope to reach.
In some cases, individual hospitals have implemented their own computerized referral systems, which list only doctors affiliated with their facilities. Alexandria Hospital's "First Call" is one of them.
"Everybody's competing for patients, but they're obviously competing for paying patients," said Dean Montgomery, director of the Northern Virginia Health Systems Agency.
To Dr. Charles Greenhouse, a Silver Spring obstetrician, inclusion in the Dial "Doc-tors" listing has added 75 to 100 new patients in the past six months to the files of his group practice in Silver Spring.
Dial "Doc-tors" official Douglas Minnick said the service refers patients when it can match them to physicians who accept Medicare patients, but he was unable to say how many of the participating physicians do so. Federal regulations that prevent Medicaid referrals based on any kind of fee system prevent them from serving those patients, according to Minnick.
Dial "Doc-tors" does have an extensive list of government and other services that it gives to callers it cannot match. "No matter who calls, we can at least tell them where to go," Miller said.
Dial "Doc-tors" added the names of its financial sponsors at the end of its advertisements after members of the District and Prince George's medical societies complained. It also altered the firm's name by dropping the word "consumer" because of concerns that it could be considered a community-based service, Miller said.
Sandy Bridgett said she heard about Dial "Doc-tors" on a television commercial and called it because she thought it was an independent service. "I felt like they'd be a little more objective," she recalled.
Still, Bridgett said she was delighted with the doctor with whom she was matched. Dial "Doc-tors" even placed the call to set up an appointment for her.
"When we met [the doctor], he was exactly how his description said. I couldn't have found anybody better," Bridgett said. Her son was operated on at Children's Hospital in the District.
Susan King of Centreville, Va., used Dial "Doc-tors" to find an obstetrician. She chose to have her first child, born in January, at Fairfax Hospital.
"It's better than sitting and looking through a phone book," King said.