To get good medical care, you need to form a relationship with a primary care physician. This should be a family practitioner, an internist, a pediatrician (for children), or a general practitioner. But given the complexities of modern medicine and the limits to the knowledge any person can absorb, your primary care doctor will feel it necessary to refer you to a specialist for many health care problems.

If you have a primary care doctor you trust, you will naturally want to put considerable stock in his or her recommendations. But it is useful to have some knowledge of the area's best specialists so that you can discuss the choices with your primary care physician.

In an effort to identify some of the Bay Area's best specialists, we surveyed roughly 17,000 area physicians and (at the same time we were asking them to rate hospitals for CHECKBOOK, Volume 6, Number 1) we asked them to tell us which specialists, in 24 different fields, they "would consider most desirable for care of a loved one." More than 700 physicians responded with thousands of recommendations.

The list below contains the names of physicians who were mentioned at least three times by other Bay Area physicians. Names appear in the specialty category chosen by the surveyed physicians. In some cases, a physician may be mentioned in more than one specialty; the number of mentions listed with each appearance reflects the number of times that physician was mentioned under that specialty category; the mentions were not combined. For example, Dr. Robert Mitchell was mentioned 15 times under cardiac surgery, 13 times under thoracic surgery, and 5 times under vascular surgery.

Immediately following each physician's name we report the number of mentions received in our survey - the more the better.. An asterisk (*) after the last name indicates that the physician is listed in The Official ABMS Directory of Board Certify Medical Specialists, 4th Edition, 1992-93, as board certified in the specialty (or pediatric equivalent) under which he or she is listed; a dagger (+) indicates that the physician is not certified in that specialty but is listed as certified in some other specialty. We have also indicated the year of medical school graduation, as reported in the ABMS Directory.. In cases where we did not find a doctor listed in the directory, we have reported what we were told by the doctor's office staff. Board certification means that a physician has taken several years of practical training in a field after graduating from medical school and has passed a difficult exam in that field.

Obviously, there are some possible biases in a list like this. Doctors could recommend themselves or close colleagues or other doctors with whom they have financially beneficial back-and-forth referral arrangements. Since we asked for recommendations in 24 specialty fields, however, it is likely that most doctors were mentioning many specialists with whom they had no financial connection.

It is also possible that some doctors who got favorable mentions did so just because they are well-known. They might have also gotten negative mentions from other doctors if we had asked for negatives.

Nonetheless, favorable mentions by a number of doctors are likely to be a good sign. Our list should steer you to some very good candidates.

Keep in mind that we didn't ask about all specialties, so some physicians did not have en opportunity to be included on our list. Also, there were some cases where we couldn't read the specialist's name a rater wrote down, where we couldn't locate a mentioned specialist, or where we couldn't be sure which of two specialists with the same name was the one the rater had in mind.