No one wants to make an unexpected trip to the ER. No one wants to hear a diagnosis that includes the word “cancer.” No one wants an early delivery to hamper a newborn’s journey through childhood. We recently sat down with five doctors who work in complex medical fields treating patients who are experiencing unexpected medical emergencies and challenging diagnoses.
Learn how these professionals shepherd their patients through difficult times. See how they’re pushing the potential of science, technology, and collaborative medicine. Tapping new treatments, medications, and approaches to care, these doctors are helping patients realize better outcomes.
Read on to discover more than 800 top doctors, from 45 fields, who have been selected, through a process involving extensive research and peer review. If—or maybe when—you find yourself in one of those medical moments, here’s a good place to start.
See the complete list of doctors selected to this year's Top Doctors.
Battling Prostate Cancer on All Fronts
Photography by Jake Armour
Christopher Warlick
Christopher Warlick, MD, PhD, Urologist, University of Minnesota
Christopher Warlick, MD, PhD
- Urologist
- University of Minnesota
No one likes to hear the C-word in a diagnosis. When University of Minnesota urologist Dr. Christopher Warlick delivers a diagnosis of prostate cancer, which carries with it the prospect of erectile dysfunction and urine leakage, some men seem like they would rather die than battle the disease.
“Just watching their faces change as you describe those things—it’s tough,” says Warlick, associate professor and interim chair of the department of urology at the U of M. Prostate cancer is one of the deadliest cancers among American men (it’s the second leading cause of cancer death, just behind lung cancer). “But with further education and discussion, hopefully we can give patients a realistic sense of the risk.
“Not all prostate cancers are treated equal. . . . Some of them don’t require immediate treatment.”
Dr. Christopher Warlick
“Not all prostate cancers are treated equal,” Warlick says. “Some don’t require immediate treatment. In the past, we had been reluctant to observe anybody, because it was cancer.” However, Warlick believes in “active surveillance” of prostate cancer for appropriately selected patients. Caution is key.
This shift in thinking arose from data that demonstrate there can be overdiagnosis and subsequent overtreatment for men with low-risk prostate cancer. Now those men are candidates for active surveillance. “The idea is you monitor these patients, periodically reassess them, and if they show evidence of disease progression, then we go ahead and treat them,” he says. “For other men, where their disease is more aggressive, or too aggressive at the time of diagnosis to sit on it, we offer definitive management, including, among other things, surgery and radiation therapy with localized prostate cancer,” he says.
“Most men who have the surgery do very well,” Warlick adds, “meaning 90 percent of men end up being dry and don’t have to wear a pad every day. ED is much more variable, even though the vast majority of them are going to do OK. They learn to compensate for those things, too.”
There have been advances in radiation therapy as well as in surgical approaches, including robotic surgery, for men who do require treatment. And there are new drugs for men with advanced prostate cancer. “The drugs provide a survival advantage—they are lengthening life,” Warlick says. “We don’t have anything that is curative yet, but we have been able to significantly prolong life for men with advanced disease. Some of these drugs are pretty remarkable in that they have relatively few side effects.”
Warlick hopes some of the next breakthroughs will help African-American men, who have a 76 percent higher incidence of prostate cancer than white men—and twice the death rate from it. Warlick is a co-leader of the Research Core of the Center for Healthy African American Men through Partnerships, a federally funded collaborative research project between the University of Minnesota and the University of Alabamaat Birmingham.
Although Warlick’s focus is on prostate cancer, the center takes a broad view of black men’s health across the life course. “More needs to be done to understand these effects and create interventions,” Warlick says. “It’s a combination of socioeconomic factors, for sure.”
Searching for a Cure
Hyun Joo Kim
Hyun Joo Kim, MD, Critical Care Physician, Pulmonologist, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Minnesota
Hyun Joo Kim, MD
- Critical Care Physician, Pulmonologist, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine
- University of Minnesota
Even though pulmonologist Dr. Hyun Joo Kim works in a specialty without a lot of happy endings, she is beginning to see cause for optimism. Kim is a University of Minnesota specialist in interstitial lung disease. The broad category includes more than 200 rare lung diseases, making it a challenge to find the right diagnosis and appropriate treatment.
Some forms of the lung disease happen spontaneously. Farmer’s lung, for instance, which is caused by exposure to moldy hay, is one form of interstitial lung disease in Minnesota, according to Kim. Other forms are caused by autoimmune diseases such as lupus, rheumatoid arthritis, and scleroderma.
“We see a lot of idiopathic pulmonary fibrosis, which we call IPF. That’s one of the spontaneous interstitial lung diseases,” she says. “This is one of those diseases that just happens in Minnesota and around the world.” Affecting about 200,000 people in the United States, IPF is rare, but it can be deadly. Kim says more people die from IPF in this country every year than die from breast cancer.
Most people with IPF die within three to five years. But in the past three years, researchers have developed two new medications that are making a difference. “They are not a cure,” Kim says, “but they are a first step in treatment. We are hopeful that with these two medications people will be able to live a little bit longer. This is the first time ever that there has been any kind of treatment for IPF.”
The only other current option for IPF is a lung transplant. “The university has a large lung transplant center, so we get a lot of referrals,” Kim says. “Sometimes there is no effective treatment, or people don’t respond to treatment, and then we are able to offer them a lung transplant as an option, if it’s available.”
One of her patients, a woman just in her early 20s, looked to be a candidate for a lung transplant, but she has responded well to the new medications for her lung disease. Even though she still has shortness of breath, she has been able to be more active and travel with her family.
Kim is optimistic that in the next 10 years, she and other IPF researchers will be able to develop more medications with fewer side effects, along with stem cell options for growing renewed lung tissue. “That’s the holy grail,” she says, “a cure.”
For now, a cure for IPF is almost as futuristic as science fiction, the genre Kim reads to take her mind off disheartening days. “When one of our patients dies, it’s really difficult, because we get to know them so well,” she says. “So, what I do to relax is I read sci-fi books. I don’t want to read anything deep. I want pure escapism.”
But then she gets back to work—on her research, her teaching, and, most important, her care for IPF patients. Recently, her clinic helped create a support group for pulmonary fibrosis patients. “I think what they get from us is a sense of hope,” Kim says. She also helped organize a pulmonary fibrosis patient and family education day. “It’s a way for patients to meet others and caregivers,” she says. “They bond and learn from each other.” Along with receiving hope and support, patients and families also learned about the latest research advances in pulmonary fibrosis and treatment options—work that might seem like science fiction today but could one day save lives.
Preparing for the Unknown
Kurt Isenberger
Kurt Isenberger, MD, Emergency Medicine Physician,Regions Hospital
Kurt Isenberger, MD
- Emergency Medicine Physician
- Regions Hospital
“Those who know me well know that I can’t sit still,” says Dr. Kurt Isenberger, medical director of emergency medicine and an ER physician at Regions Hospital in St. Paul. “I always like to be moving and on the go. In medical school, I realized that emergency medicine was the right fit for me.”
Now he practices in a 365/24/7 department and says, “I am in the right place. We are seeing patients at one of the worst times in their lives. It’s very unpredictable and unscheduled.” It’s a pace and patient base he enjoys because “we get to see everybody.” By federal law (the Emergency Medical Treatment and Labor Act), emergency rooms are required to stabilize and treat patients regardless of their insurance status or ability to pay.
“With our proximity to the Capitol, we can have a congressperson or a ranking official in the state next to somebody who has no insurance or no home,” Isenberger says. “The benefit is that everybody gets treated the same.”
In the fast-paced ER environment, innovative technology has improved care in many ways. But when seconds count, Isenberger says, the electronic medical record is one of the greatest advances of the past 15 years. “This is especially helpful when patients are unconscious,” he says. “We can quickly examine the patient’s medical history, what pharmaceuticals they use or other medical issues they have.” Electronic records put that critical information at his fingertips in an emergency.
Another critical tool: the bedside ultrasound. “We are now doing bedside ultrasounds for a variety of conditions extending from Level 1 trauma to cardiac care,” he says. “The use of ultrasound at the bedside has given us better diagnostics to treat our patients more safely and with higher quality of care.”
Other important advances that excite Isenberger happen beyond the ER. For instance, Regions’ ER has a Community Paramedic program for patients who could heal just as well at home with close follow-up care. Isenberger’s team is now referring one or two patients a day into the program. “We will send paramedics to the patient’s home in order to institute treatment guidelines for them,” he says. “Paramedics might weigh you, talk about diet, check vital signs or medications. We want to know what the fall risks are. The paramedics check for that.” The goal is to decrease the need for hospitalization but still provide high-quality care.
The stakes are high when you have a career in emergency medicine. On any given day, some of society’s most difficult problems can spill into the ER, such as the escalating number of patients struggling with mental illness and substance abuse. “We are now seeing some of the long-term effects of methamphetamine abuse with mental illness,” Isenberger says. “We need to fight for therapies that will make that population healthier.
“We are also at the intersection between things happening out on the streets with violence and drugs,” he says. The intensity he alludes to that invariably finds its way into the ER mirrors experiences captured in a recent poll by the American College of Emergency Physicians. It found nearly half (47 percent) of emergency physicians reported being physically assaulted. “We have to focus on the safety of the workplace,”Isenberger says. Protecting patients and staff from violence is part of quality patient care. He points to increased use of metal detectors, law-enforcement support, and other deterrents to keep the ER as safe as possible.
Even with the noise, constant action, and overnight shifts, there is something special about the ER, Isenberger says. “Every day and every hour is different. We are caring for the community’s sickest patients—and everybody is important. We are always here for you.”
Preventing a Broken Heart
Retu Saxena
Retu Saxena, MD, Cardiologist and Researcher, Minneapolis Heart Institute, Abbott Northwestern
Retu Saxena, MD
- Cardiologist and Researcher
- Minneapolis Heart Institute, Abbott Northwestern
A woman, 36 weeks pregnant, checked into a Twin Cities emergency room because she wasn’t feeling well and was having chest discomfort. After an exam, she was on the verge of discharge to home follow-up when her partner mentioned that the patient’s father had died from a heart attack at a relatively young age. The ER doctor immediately admitted her for observation and called cardiologist Dr. Retu Saxena to discuss what had seemed to be an abnormal test result. It indicated the patient, who was young and otherwise healthy, was having a heart attack.
According to Saxena, a test result like this is far from uncommon. “Women may be at risk for having symptoms as well as cardiac events during and after pregnancy,” Saxena says. A subsequent angiogram revealed “a very tight blockage in the patient’s artery.” Doctors rushed to open the blockage, inserted a stent, and then were able to send the patient home to recover. A few weeks later, she delivered a beautiful, healthy girl.
The ending could have been far different, Saxena says. “The number-one maternal cause of death is heart disease. There are a lot of women who die each year while pregnant.”
This young ER patient was diagnosed with a rare condition that leads to early coronary artery disease. Now, with Saxena’s help, she’s managing her risk and disease. “I like to tell her story, because it illustrates what women go through and how they have to advocate for themselves,” Saxena says.
Simply put, women’s hearts are different from men’s, and Saxena is working to build greater knowledge about the kinds of heart issues women experience. While heart disease has long been the number-one killer of men and women in the United States, Saxena says there is a lack of research on the sex-specific differences in how heart disease manifests. For instance, she says, “We are still not quite certain why women get broken-heart syndrome (stress-induced cardiomyopathy) more than men. That’s where your heart is acting like it’s having a heart attack, but you actually don’t have any blockages.”
Saxena and her colleagues at the Minneapolis Heart Institute Foundation are working to fill the knowledge gap and increase awareness of heart disease through the development of a Women’s Heart Science Center. They also are working with OB-GYN and family practice doctors to share insights about and strategies for addressing cardiovascular risks that are specific to pregnant women. “Women often present with different symptoms from men—shortness of breath, nausea and vomiting, overwhelming fatigue—but they can still have typical chest discomfort,” she says.
“In cardiology, we are getting better at advancing our understanding of heart disease by our ability to image and evaluate the heart in every way,” she says. A heart scan that takes only three to five minutes and has minimal radiation can expose potential cardiac issues. “With our ability to look at the heart in probably every possible aspect—three-dimensionally as well as understanding what’s happening to the heart tissue—we are able to make a diagnosis,” she says. “As we get better at seeing the heart, we hopefully will be able to intervene prior to the late stages in disease. It has really transformed both prevention and management of heart disease.”
Changing Outcomes for the Smallest Patients
Andrea Lynn Lampland
Andrea Lynn Lampland, MD, Neonatologist, Children’s Minnesota
Andrea Lynn Lampland MD
- Neonatologist
- Children’s Minnesota
Nearly every week is a 70- to 80-hour workweek for Dr. Andrea Lynn Lampland. Board-certified in neonatal-perinatal medicine, Lampland has a dizzying array of medical, leadership, teaching, and research roles.
“I have the best job. I go to work every day and love what I do,” she says. “I love treating little tiny babies, and I love talking to their parents and helping them through this crazy, tumultuous time.”
At Children’s Minnesota, she is the medical director of Level 2 nurseries, associate medical director of neonatal transport operations, lead neonatologist with the Midwest Fetal Care Center clinical team, and site liaison for the Neonatal-Perinatal Medicine Fellowship at Children’s Minnesota–St. Paul. She is also the director of Children’s translational research lab and neonatal research department.
“I clearly have trouble saying no,” she says with a laugh. “That’s a chronic problem, if there is a need. It’s the same in my personal life: I am the manager of all my kids’ baseball teams and the tourney director of their hockey association. I just feel like if I am able to give back, I should give back. It can be a plus and a minus.”
The core of her work is treating premature babies, babies born with problems involving any of their organs, and babies who suffer an injury during the birth process. According to the National Institutes of Health, infants born before 37 weeks of pregnancy are considered premature. But Lampland says the gestational age at which babies can actually survive and thrive has dropped dramatically in the past 20 years.
“Now, babies, who are born barely halfway through a regular pregnancy have more than a50 percent chance of living without severe handicaps.”
Dr. Andrea Lynn Lampland
While serious efforts are made to keep babies in utero as long as possible, “Now, babies, who are born barely halfway through a regular pregnancy, such as 24 weeks, have more than a 50 percent chance of living—and not only living but thriving without severe handicaps,” she says. This is due to the improvements in obstetric care for mothers and improvements in medications, breathing support technology, and neuro-protective agents for babies.
Another area where she is seeing change is in the development of effective treatments for full-term babies deprived of oxygen or blood flow in the birth process. “For those babies, the pivotal, life-changing advance in the last 10 years is total body cooling/therapeutic hypothermia,” she says. “We purposely cool their bodies to hypothermic temperatures for 72 hours, and it has shown significant impact in improving their long-term brain development and minimizing brain damage, and their rates of cerebral palsy and delayed development.
“It’s truly been a game-changer in my short 15-year career,” she says. “Back in the day, more than half of those babies would have died or lived a life with a permanent handicap.” Now, after being treated with hypothermia, a significant number of those kids don’t have any long-term challenges, she adds.
It has since become a standard procedure in the U.S. and around the world. “We use it frequently—in our system at least a handful of babies a month,” she says. “It has been a true ‘aha’ moment in my career. To have participated in the original trials and seen it come to fruition, it’s really fulfilling. We were not only part of the groundwork for it, but now we can incorporate it into our day-to-day care of these babies.”
Meet the 2019 Top Doctors
See the complete list of doctors selected to this year's Top Doctors.
The 23rd edition of our Top Doctors list includes 819 doctors in 45 specialties. Here’s how we put it together. When compiling a list that’s as relied upon as our annual Top Doctors list, research is essential. We asked physicians to nominate one or more doctors (excluding themselves) to whom they would go if they or a loved one were seeking medical care. From there, candidates were grouped into 45 specialties and evaluated on myriad factors, including (but not limited to) peer recognition, professional achievement, extensive research, and disciplinary history. Doctors who had the highest scores from each grouping were invited to serve on a blue-ribbon panel that evaluated the other candidates. Only doctors who acquired the highest total points from the surveys, the research, and the expert physician review panel were selected to this list. Of course, no list is perfect. Many qualified doctors who are providing excellent care to their patients are not included on this year’s list. However, if you’re looking for exceptional physicians who have earned the confidence and high regard of their peers, you can start your search here. In addition, this year’s crop of Top Doctors will join a prestigious group of doctors from more than 20 cities around the country who have been selected to Super Doctors, the full list of which you can find at superdoctors.com.
Editor’s Note: Many of our Top Doctors have specialty certification recognized by the American Board of Medical Specialties. This board certification requires substantial additional training in a doctor’s area of practice. We encourage you to discuss this board certification with your doctor to determine its relevance to your medical needs. More information about board certification is available at abms.org.
© 2019 MSP Communications. All rights reserved. Super Doctors® is a registered trademark of MSP Communications. Disclaimer: The information presented is not medical advice, nor is Super Doctors a physician referral service. We strive to maintain a high degree of accuracy in the information provided. We make no claim, promise, or guarantee about the accuracy, completeness, or adequacy of the information contained in the directory. Selecting a physician is an important decision that should not be based solely on advertising. Super Doctors is the name of a publication, not a title or moniker conferred upon individual physicians. No representation is made that the quality of services provided by the physicians listed will be greater than that of other licensed physicians, and past results do not guarantee future success. Super Doctors is an independent publisher that has developed its own selection methodology; it is not affiliated with any federal, state, or regulatory body. Self-designated practice specialties listed in Super Doctors do not imply “recognition” or “endorsement” of any field of medical practice, nor do they imply certification by a Member Medical Specialty Board of the American Board of Medical Specialties (ABMS) or that the physician has competence to practice the specialty. List research concluded May 1, 2019.
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