Presentation to Presentation to The Association of American The Association of American

Medical CollegesMedical CollegesApril 16, 2011April 16, 2011

Presented byPresented by

John J. Connolly, Ed.DJohn J. Connolly, Ed.D..

1

2

www.CastleConnolly.com

Castle Connolly GuidesCastle Connolly Guides

3

4

ABOUT CASTLE CONNOLLY MEDICAL LTD.

The mission of Castle Connolly Medical Ltd. is to help consumers find the best healthcare. To this end, we publish a variety of books including the "Top Doctors" series, the most popular of which is America's Top Doctors®. The top doctors who are listed in our books and on this website's directory were nominated by their peers in an extensive survey process of thousands of American doctors each year. These Top Doctors' medical educations, training, hospital appointments, disciplinary histories - and much more - are screened by the Castle Connolly physician-led research team. Those doctors who are among the very best in their specialties and in their communities are selected for inclusion. Doctors do not and cannot pay to be included in any Castle Connolly Guide or online directory. www.castleconnolly.com.

Castle Connolly offers individual and corporate memberships to its website along with a number of corporate products and services such as a New Movers Program, a Doctor-Patient Advisor Service and Castle Connolly LifeStream MD service.

The company was founded by two respected leaders in healthcare, John K. Castle and John J. Connolly, Ed.D. Dr. Connolly was the President of New York Medical College for more than ten years. He has served on the boards of two hospitals, chairing one. Mr. Castle served for six years as a commissioner and executive officer of the Joint Commission (formerly JCAHO); he also served as Chairman of the Board of New York Medical College for eleven years and served on its Board for twenty-two years. He has served on the boards of five hospitals.

- Continued

ABOUT CASTLE CONNOLLY MEDICAL LTD.

Castle Connolly principals and its publications of America's Top Doctors® have been recognized by major American media including "Good Morning America" (ABC-TV), "20/20" (ABC-TV), "48 Hours" (CBS-TV), Fox Cable News (national), "Morning News" (CNN) and "Weekend Today in New York" (WNBC-TV), The New York Times, the Chicago Tribune, The Daily News (New York) the Boston Herald and other newspapers. Many national and regional magazines have featured Castle Connolly guides to America's Top Doctors® and/or Doctor Connolly in stories. Magazine coverage of "Top Doctors in America" has included Fortune, Town & Country, Good Housekeeping, Redbook, Money Magazine, New York Magazine, Philadelphia, Boston, Chicago Magazine, Atlanta Magazine and many others.

Castle Connolly Graduate Medical Publishing Ltd.

Castle Connolly LifeStream M.D.

5

CASTLE CONNOLLY MEDICAL LTD.CASTLE CONNOLLY MEDICAL LTD.

Founded in 1991 by John K. Castle and John J. Connolly, Ed.D. – former Chairman of the Founded in 1991 by John K. Castle and John J. Connolly, Ed.D. – former Chairman of the Board and President, respectively, of New York Medical College – the company identifies top Board and President, respectively, of New York Medical College – the company identifies top doctors on the regional and national levels through a proprietary research process based on doctors on the regional and national levels through a proprietary research process based on extensive surveys of physicians. Information is distributed in print, through publication of extensive surveys of physicians. Information is distributed in print, through publication of consumer guides, and online – at company website and in partnership with other online consumer guides, and online – at company website and in partnership with other online companies. The Castle Connolly management team has extensive experience in the health companies. The Castle Connolly management team has extensive experience in the health care and business sectors. care and business sectors.

John J. Connolly, Ed.D. – President & CEO Dr. John Connolly has extensive background in management and healthcare. He was one of the youngest college presidents in the United States before transitioning from academia to healthcare. For more than a decade, he was President of New York Medical College. He is extensively involved in healthcare activities including serving as a director of the Northeast Business Group on Health, as founder, a director and past chair of the American Lyme Disease Foundation, as a member of the Presidents Advisory Council of the United Hospital Fund of New York, and as a Fellow of the New York Academy of Medicine. Dr. Connolly is also the President of Castle Connolly Graduate Medical Publishing, Ltd., a company that produces review manuals to assist residents and fellows in the preparation for the board exams.

Continued -

6

CASTLE CONNOLLY MEDICAL LTD.CASTLE CONNOLLY MEDICAL LTD.

Jean Morgan, M.D. – V.P., Chief Medical & Research Officer Dr. Jean Morgan received her medical degree from Charing Cross Hospital Medical

School, London University. She was a Research Assistant Professor at New York Medical College and carried out clinical studies and presentations in the Department of Surgery and Intensive Care unit at the Westchester Medical Center and published numerous articles in professional journals. She heads Castle Connolly’s research department for the selection and credentialing of physicians.

William Liss-Levinson, Ph.D. – V.P., Chief Strategy and Operations Officer Over the past three decades Dr. Liss-Levinson has held executive positions in healthcare

in administration, operations and strategic planning. He has served in senior positions in hospice care, acute care, long-term care and behavioral health systems in the metropolitan New York area. He has written and lectured extensively, and testified before Congress on healthcare issues. He is responsible for all strategic partnerships, business development, sales and marketing, as well as oversees company operations.

7

THE NOMINATION SURVEY PROCESSTHE NOMINATION SURVEY PROCESS

Annually, Castle Connolly Medical Ltd., (Castle Connolly), identifies tens of thousands of board-certified physicians across Annually, Castle Connolly Medical Ltd., (Castle Connolly), identifies tens of thousands of board-certified physicians across the nation, who are invited to go online to a special website to enter nominations, on an anonymous and confidential basis, the nation, who are invited to go online to a special website to enter nominations, on an anonymous and confidential basis, of physicians whom they feel are clinically outstanding, both on the regional and national level.of physicians whom they feel are clinically outstanding, both on the regional and national level.

Physician nominators have opportunity to nominate outstanding physicians in various specialties and sub-specialties – key Physician nominators have opportunity to nominate outstanding physicians in various specialties and sub-specialties – key opinion leaders who excel in academic medicine and research but, most importantly, those who exhibit excellence in patient opinion leaders who excel in academic medicine and research but, most importantly, those who exhibit excellence in patient care, someone to whom nominating physicians would send members of their own family.care, someone to whom nominating physicians would send members of their own family.

In addition to professional qualifications, we suggest that nominating physicians consider interpersonal characteristics In addition to professional qualifications, we suggest that nominating physicians consider interpersonal characteristics when proposing a physician for inclusion as a Castle Connolly Top Doctor.when proposing a physician for inclusion as a Castle Connolly Top Doctor.

Castle Connolly also solicits nominations from hospital Presidents, Vice Presidents of Medical Affairs or the equivalent Castle Connolly also solicits nominations from hospital Presidents, Vice Presidents of Medical Affairs or the equivalent position; and Chiefs of Service in Neurology, Orthopaedic Surgery, Ob/Gyn, Medicine, Pediatrics, Otolaryngology, Radiology position; and Chiefs of Service in Neurology, Orthopaedic Surgery, Ob/Gyn, Medicine, Pediatrics, Otolaryngology, Radiology and Surgery at more than 1,500 hospitals across the United States.and Surgery at more than 1,500 hospitals across the United States.

Castle Connolly also has expanded its nomination process in critical markets through its work with various Castle Connolly also has expanded its nomination process in critical markets through its work with various regional magazine partners, creating special opportunities for ALL licensed physicians in those markets to regional magazine partners, creating special opportunities for ALL licensed physicians in those markets to participate in the nomination process. The enthusiastic response has led to expansion of the Castle Connolly Top participate in the nomination process. The enthusiastic response has led to expansion of the Castle Connolly Top Doctors database, particularly on the level of regional top doctors and in some of the primary care areas of Doctors database, particularly on the level of regional top doctors and in some of the primary care areas of medicine. Our new nominations model will be based on this process.medicine. Our new nominations model will be based on this process.

8

THE RESEARCH & SCREENING PROCESSTHE RESEARCH & SCREENING PROCESS

During this phase of the selection process, the Castle Connolly research staff also conducts extensive interviews by telephone with leading physicians, specialists, chiefs of service and healthcare executives to strengthen the information-gathering processes.

Castle Connolly considers the following among the varied criteria used to determine physician eligibility for inclusion in our guides; professional qualifications; education, residency, board certification, fellowships; professional reputation, hospital appointment, medical school faculty appointment, experience and disciplinary history.

The Castle Connolly physician-led research staff reviews and refines the pool of nominated physicians in a region, validates nominations, and verifies credentials. This results in the development of a preliminary list of physicians. Each provisionally selected physician is then asked to complete a comprehensive professional biography form. The information contained in the biographical forms becomes an integral park of a selected physician’s listing in the Guide.

9

SELECTION OFSELECTION OFCASTLE CONNOLLY TOP DOCTORSCASTLE CONNOLLY TOP DOCTORS

The last phase of the process refines the list of provisionally selected doctors by cross-The last phase of the process refines the list of provisionally selected doctors by cross-referencing their names against a variety of databases providing confirmation of: board referencing their names against a variety of databases providing confirmation of: board certification, licensing, disciplinary history.certification, licensing, disciplinary history.

Physicians ultimately selected for inclusion receive formal notification of their nomination Physicians ultimately selected for inclusion receive formal notification of their nomination for listing upon completion of the final confirmation of their professional credentials.for listing upon completion of the final confirmation of their professional credentials.

Physicians selected for inclusion as a Castle Connolly Top Doctor may appear in: one of Physicians selected for inclusion as a Castle Connolly Top Doctor may appear in: one of Castle Connolly’s national top doctors guides, such as Castle Connolly’s national top doctors guides, such as America’s Top Doctors®America’s Top Doctors® or or America’s Top Doctors® for Cancer;America’s Top Doctors® for Cancer; in a regional top doctors guide, such as Top Doctors: New York Metro Area; in a national or regional magazine that partners with Castle Connolly to create a “top doctors” feature article; and/or online at www.castleconnolly.com as a regional top doctor (online only, if in an area in which Castle Connolly is not doing any print publication).

10

SELECTION OFSELECTION OFCASTLE CONNOLLY TOP DOCTORSCASTLE CONNOLLY TOP DOCTORS

Online profiles of 26,000+ top doctors in 72 medical specialties and subspecialties, across all 50 states, representing 1,500 hospitals as their primary or secondary affiliation are available. Information includes: medical specialty; primary and secondary admitting hospital (if applicable); full office address information; medical school; residencies; fellowship; faculty appointment; and areas of special expertise.

Castle Connolly is involved in the expansion of its Top Doctors database in major markets across the country. We anticipate doubling our database by the end of 2011 – or earlier – and tripling it by late 2012.

11

OUTCOMESOUTCOMESThe 800 Pound GorillaThe 800 Pound Gorilla

Castle Connolly does not use outcomes data in our selection process.Castle Connolly does not use outcomes data in our selection process.

WHY?WHY?

There is not enough outcomes data available throughout the nation on There is not enough outcomes data available throughout the nation on individual physicians to make this factor usefulindividual physicians to make this factor useful

12

Numbers

Total number of nominations received last year was 74,924

Total number of doctors who nominated was 7,589

It’s not really possible to come up with a response percentage, as for the magazine nominations process we don’t send our specific invitations to doctors. Any doctor from the area can nominate.

We currently have 27,633 doctors in our database who are online.

1,865 hospitals have doctors online. (Note this is not the same as hospitals who have doctors in one of the three guides – that number is 1,015).

50,000-60,000 uniques a month 11 million page views

35 million doctor profiles

63 hospitals in Partnership for Excellence

13

POWERFUL MARKET DEMOGRAPHICSAND

ONLINE VIEWERSHIP

14

Castle Connolly Book BuyersCastle Connolly Book BuyersoMore than 50% female – the healthcare decision-makers for the family

oMore than 50% between the ages of 34-60; 27th are 65 years of age and older; 82% are in families of two or more

o96% have health insurance

o33% have had a family member hospitalized within the last two years

oA survey of our readers reveals:98% of respondents trust the guides as a source of healthcare information92% would recommend Castle Connolly Guides to family and friends75% use the guides to find a doctor

Castle Connolly WebsiteProjected for full year 2011

oMore than 10 Million page viewsoMore than 1.1 Million user sessionsoMore than 34 Million top doctors’ profile views – which means focused healthcare consumers will find information about top doctors and the hospitals they are affiliated with!

Castle Connolly Online Members

oIn every state in the U.S. – and in many foreign countries as well!o67% female – average age = 40 years old – the healthcare decision-makers for most familieso33% male – average age = 47 years old

Castle Connolly Book and Website Users

15

25% book users only

65% website only

More than 75% researched for two plus specialists

75% made appointments with one or more doctors

What characteristics were important to them?o Credentials – 72%o Medical School – 53%o Special Expertise – 73%o Residency – 57%o Hospital Affiliation – 74%o Speed of Appointment – high or medium over 75%o Identification as a Top Doctor – high 60%o 92-plus% were pleased with the quality of care

PARTNER WITH NATIONAL & REGIONAL MAGAZINESPARTNER WITH NATIONAL & REGIONAL MAGAZINES

16

Castle Connolly has partnered with National magazines to create feature articles on the very Best in American Medicine, such as:

Good Housekeeping – read by more than 15 Million people

Ladies Home Journal – read by more than 15 Million People

Men’s Health – read by nearly 11 Million people

Redbook – read by more than 10 Million people

Women’s Health – read by nearly 5 Million people

Town & Country – read by more than 3.5 Million people

Regional partner magazines include:

New York, Chicago, Philadelphia;Boston, Pittsburgh, Atlanta;Inside Jersey, Seattle, Indianapolis Monthly;Gulf Shore Life, Portland Monthly, Westchester;Memphis, Oklahoma, Buffalo Spree;Nashville Lifestyles, Greenwich, New Canaan/Darien;Palm Springs Life, Sarasota, Hudson Valley’;Ocala, Westport, Desert Companion;Golf Coast Magazine, Boca Life, The Palm Beacher

Magazine PartnershipsMagazine Partnerships

17

WHAT IS THE WHAT IS THE PARTNERSHIP FOR EXCELLENCE PARTNERSHIP FOR EXCELLENCE HOSPITAL INFORMATION PROGRAM?HOSPITAL INFORMATION PROGRAM?

Leading medical centers and specialty hospitals are invited to sponsor advertorial pages that describe their institution in general, as well as their special cancer centers for excellence in more than 20 specialty areas.

Advertorials will appear in both the print edition of America’s Top Doctors® for Cancer AND online 24/7/365 at the Castle Connolly website: www.CastleConnolly.com.

Promotion to local, national and international healthcare consumers seeking the very best medical care for cancer.

Online at www.CastleConnolly.com – a specially designed, advanced search engine for consumers to find America’s Top Doctors® for Cancer doctors and hospitals – your advertorial:

Appears every time a profile of one of your affiliated doctors is viewed, and Is accessible through a “Hospital Search”; Appears in rotation throughout the website in a special section as a “featured hospital.”

18

BENEFITS OF PARTICIPATION IN THE BENEFITS OF PARTICIPATION IN THE PARTNERSHIP FOR EXCELLENCE PARTNERSHIP FOR EXCELLENCE PROGRAMPROGRAM

We compared two nationally recognized, major academic medical centers- both We compared two nationally recognized, major academic medical centers- both located in large, urban settings. Both hospitals have consistently achieved significant located in large, urban settings. Both hospitals have consistently achieved significant top positions in the top positions in the U.S. News & World Report U.S. News & World Report annual “Best Hospitals” issue.annual “Best Hospitals” issue.

Each has the exact same number of Castle Connolly Top Doctors™ who were Each has the exact same number of Castle Connolly Top Doctors™ who were selected and appear in the current 10selected and appear in the current 10thth edition of edition of America’s Top Doctors® America’s Top Doctors® - more - more than 100.than 100.

The NON-PARTICIPATING hospital’s Castle Connolly Top Doctors™ profiles have The NON-PARTICIPATING hospital’s Castle Connolly Top Doctors™ profiles have been viewed been viewed 12,080 times 12,080 times in the four-month period January 14-April 14, 2011.in the four-month period January 14-April 14, 2011.

The PARTICIPATING hospital’s Castle Connolly Top Doctors™ profiles have been The PARTICIPATING hospital’s Castle Connolly Top Doctors™ profiles have been viewed viewed 396,069 times 396,069 times in the four-month period January 14-April 14, 2011 - AND – in the four-month period January 14-April 14, 2011 - AND – their associated advertorials describing the hospital and their centers of excellence their associated advertorials describing the hospital and their centers of excellence have been viewed have been viewed 235,889 times235,889 times

19

WHAT WE DO NOT DOWHAT WE DO NOT DO

1.1. We do not accept payments for including physiciansWe do not accept payments for including physicians

2.2. We do not include physicians who do not see patients – not a We do not include physicians who do not see patients – not a “Who’s Who”“Who’s Who”

3.3. We do not We do not rankrank physicians – numerical or otherwise

4. We do not claim to include every excellent physician

20

““Issues and Opportunities for Transparency of Oncology Reporting in California.” Issues and Opportunities for Transparency of Oncology Reporting in California.” HTMS – December 2010 HTMS – December 2010

“What You Don’t Know Might Kill You” – “What You Don’t Know Might Kill You” – Newsweek, Newsweek, October 17, 2009October 17, 2009

21

Why Top Doctors Matter: Why Top Doctors Matter: A Message for Families and EmployersA Message for Families and Employers

22

Most people would agree that gambling with their health is a dangerous idea.  When it comes to

medical care, excellence and expertise are crucially important.  Yet Americans receive top-quality care

from their doctors and hospitals only about half of the time.  From inadequate screening during routine

checkups to subpar treatment of critical illnesses, inferior care can have costly and tragic results.  Too

often, patients simply don’t know how to find the best doctor to deliver the best care.

Castle Connolly takes this challenge seriously.  Since the company’s founding in 1991, our “Top

Doctors” guides have been identifying the nation’s best doctors and hospitals in every part of the

country and in every medical specialty.  Our lists are based on peer nominations and professional

assessments by our physician-led research team – not on hype, advertising, or third parties that have

something to gain by recommending a particular provider.  Castle Connolly’s Top Doctors are rigorously

selected from among hundreds of thousands of physicians.  Our intensive research methodology is

designed to identify doctors that will speed patients’ healing, minimize pain and discomfort, shorten

recovery periods and enhance and lengthen lives – in other words, achieve the best possible health

outcomes.

23

Today such independent assessment of medical care is more important than ever.  Anyone can draw

up a “best of” list – and many organizations do.  Pharmaceutical companies favor those physicians

who are high prescribers of their drugs.  To many health insurers a physician’s fees are often a more

important factor than quality.  Many magazines and websites recommend health care providers who

pay to get their names mentioned. But Castle Connolly has no such conflicts of interest.  Our sole

purpose is to help patients, their families and their employers find health care providers who deliver

superior results.

 

After a physician’s name is submitted by colleagues as part of our nomination process for

consideration as a Top Doctor, our physician-led research team delves into the professional records of

top nominated physicians in order to ascertain those that have exceptional training, experience and

are highly regarded by their peers.  In addition, disciplinary histories and malpractice actions, when

available, are also carefully scrutinized.

24

Top Doctors can have an enormous impact.  For patients and their families, the value of receiving first-

class medical care is great but unquantifiable – it’s measured in quality and even length of life. 

Employers, however, can see the results in their bottom line.  Faulty diagnoses and improper treatment

take a toll in productivity and ripple out into higher workplace costs.  No company should have to make

do for weeks or months without a key employee or executive, when a Top Doctor may have solved the

patient’s problem efficiently and simply.

25

Some Examples:

Castle Connolly has dozens of examples, some dramatic and lifesaving, that demonstrate the point that

finding the best doctor or hospital can make a significant difference in patients’ lives.  The few that follow

clearly demonstrate this point.

 

Kay was examined by her local physician, who advised her that lumps in her breast were very likely

malignant and recommended an immediate mastectomy.  Closer investigation by a Castle Connolly

specialist showed that the lumps were in fact benign and Kay avoided the cost, trauma and pain of a

radical mastectomy.

After Bill was diagnosed with kidney stones, his family doctor recommended surgery.  Bill got a second

opinion from a Castle Connolly Top Doctor who treated the condition with medication instead – and five

years later, he is still doing fine without surgery. 

Jim was scheduled for surgery to amputate his foot. A relative contacted Castle Connolly to check out

his doctor. The research team quickly identified the surgeon as one who had lost his license in one

state and was disciplined in another. The surgery was rescheduled with a different surgeon.

26

Rose and Liz, both in their 60’s and carrying a few extra pounds, needed knee surgery.  Rose chose

a physician who practiced near her home, while Liz picked a Castle Connolly Top Doctor.  Two years

after her operation, Rose still uses a cane much of the time.  Six months following surgery, Liz was

back to her old self and feeling terrific.  No doubt, a Top Doctor had a major impact on Liz’s favorable

outcome.

Karl, the manager of a horse farm, suddenly had a problem with one of his eyes.  A local

ophthalmologist diagnosed glaucoma and told Karl he needed immediate surgery.  Castle Connolly

referred him to a Top Doctor, who has been successfully treating Karl with eye drops ever since.

 

Expertise and leading-edge technology are especially important in diagnosing and treating cancer, stroke

and cardiovascular patients.  Administered by a Top Doctor, sophisticated techniques may keep

pancreatic and brain cancer sufferers alive for years, compared with the few months that

conventional chemotherapy normally achieves.  Top Doctors often have higher cure rates for

prostate and breast cancer, thanks in part to early detection, but also due to more advanced

treatment options.

27

Patients with cardiac disease can frequently avoid open-heart or multiple-bypass surgery with stents and

other less-invasive technologies.  And although many physicians will counsel elderly patients to avoid

surgery under any circumstances, a Top Doctor may be able to operate on people 90 years of age or older

and still achieve excellent outcomes.  Stroke victims, in the hands of a Top Doctor, can recover to a

degree unheard of just a few years ago.  World-class neurosurgeons can deal with bleeding strokes that

were formerly inoperable.  Early detection through imaging and swift treatment with drugs can dissolve

clots blocking critical blood flow to the brain before permanent damage is done – and without invasive

procedures.  Men operated on at hospitals and by surgeons with high volumes of particular procedures,

specifically radical prostatectomy, had a 7.7 percent risk of recurrence of prostate cancer as compared to

10.9 percent for surgeries done by physicians with lower surgical volumes.

 

As further evidence of this principle, consider the following statistics, all reported in a recent Newsweek

article and based on professional journal reports. At leading cancer centers:

The five year survival rate for Stage IV prostate cancer is 71 percent vs. 38 percent nationally.

For Stage IV cervical cancer the survival rate is 33 percent vs. 16 percent nationally.

For breast cancer, after a mastectomy, 81 percent of women treated at top centers are still alive after five

years compared to 77 percent nationally.

In addition, a recent study in the Journal of the National Cancer Institute found that treatment variation

from surgeon to surgeon are significant and may account for up to 30% of recurrences of the cancer.

28

The Bottom Line:

Top Doctors can help patients in ways not generally available in the medical community.  But while

people intuitively know this to be true, most lack the resources to make the best choices when they fall

ill.  Many people rely on referrals from the family physician, yet even a trusted and competent physician

may not be the best source of information.  Doctors are busy with their practices, and their referral

contacts are usually limited to their plan network or hospital.  Few have time to research who, wherever

in the nation, is really the best for a particular procedure or problem.  That often leaves patients who

need a top specialist at the mercy of advertising and hearsay.  They may even pick a name at random

from their insurer’s directory or website, or even respond to advertising.

 

Knowledgeable employers realize that providing employees and their families with access to the best

medical care, as well as avoiding the worst, impacts a company’s bottom line in a positive way.  Money

saved on the wrong treatment, unnecessary surgery, days lost from work, or the focus on the illness of a

loved one or oneself instead of work, are worth the effort to identify the best doctors.

29

Castle Connolly is committed to helping such patients get the care they need and deserve.  Our

professional staff, with years of experience, has earned us the trust and respect of the medical and lay

communities alike.  We are in a unique position to assist individuals and companies in accessing the

best and most efficient healthcare available today.  Castle Connolly Guides and our website are

comprehensive, user-friendly resources that let consumers find a doctor by name, specialty, and

geographic location – or even by special expertise in a particular disease or procedure.  Hospital

affiliations and contact information are presented clearly and concisely.  The guides and website also

include helpful tools for choosing a Top Doctor, with tips on how to evaluate a physician’s education,

experience, and personal suitability.

 

When it comes to healthcare, cutting corners rarely pays off.  Unlike its imitators, Castle Connolly

provides thorough and unbiased research by trained professionals.  We believe that choosing a Top

Doctor is the most important decision a patient can make and we work tirelessly to facilitate that

decision.