Best Doctors of the Capital District
Finding a doctor you trust and feel comfortable with is important. The list of doctors on the following pages will be a valuable source when making informed decisions about your healthcare.
We worked with Best Doctors, Inc. to bring you our debut Best Doctors issue. According to their statistics, New York ranks second in the United States for Best Doctors per state. The number of Best Doctors selected for New York for 2007-2008 is 3,314 representing 43 specialties and over 400 subspecialties. But, we whittled the list down to cover the Capital Region area, listing 150 doctors in varying specialties.
Best Doctors, Inc. was founded in 1989 by two renowned physicians affiliated with Harvard Medical School. Their goal was to provide greater access to dependable, high quality medical information and care for individuals with serious illnesses and injuries. That concept continues to propel Best Doctors and has led to their pioneering work being featured on 60 Minutes, The Wall Street Journal, USA Today, Reader’s Digest and CNN. Today, Best Doctors is the world’s leading resource for patients, families and physicians seeking expert medical resources and guidance to treat illnesses and injuries of all kinds.
Best Doctors® believes that physicians are the most qualified to evaluate the experience and skill sets of other physicians. The Best Doctors survey asks physicians: “If you or a loved one needed a doctor in your specialty, to whom would you refer them?” The responses form the basis of the Best Doctors’ global database, which has been consistently recognized by doctors, patients and the public for its quality and integrity.
Dr. Barry Kogan
“I’m a urologist that takes care of children, not a true pediatric physician,” said Pediatric Urologist Dr. Barry Kogan, who treats children up to age 14 or 15, but mostly focuses on infants and young children.
Kogan, who has 25 years in the field, is in private practice at Community Care Physicians, P.C. in Latham and is also a professor of surgery and pediatrics at Albany Medical Center.
His practice is about 50/50 surgery and office based. They treat three major areas including congenital anomalies of the genitalia, where penises aren’t completely formed or testicles aren’t descended. With infants and older children, they focus on urinary infections including anomalies of the kidneys and bladder that cause urinary infections. The final category involves daytime incontinence and bedwetting.
Bedwetting can originate from many causes including genetic issues, inappropriate fluid intake and child abuse.
“You could spend years treating someone inappropriately if you didn’t know that they were abused,” said Kogan. “Very few parents will openly talk about that stuff. They say their child is lazy or stupid, which makes self-esteem even more of a problem.”
Patients from low socio-economic groups are at higher risk for incontinence problems and bedwetting. They typically have less prenatal care, take fewer vitamins, have more prevalence for genetic issues and have poorer outcomes.
He likes the surgical aspects of his job because so much of what he does is really fixable. “Kids and parents are very anxious about genitals, so if we can fix them, it’s very rewarding. And helping out children with incontinence and bedwetting is rewarding because these diseases impact their lives and self–esteem.”
A critical component of treating children born with ambiguous genitalia, or disorders of sexual differentiation, involves counseling the parents to choose to raise the child with the sex that is most appropriate.
“We try to explain the pros and cons to the family of each alternative and what the likely results would be, and where necessary, perform reconstructive surgery, Kogan said.”
The Capital Region lacks enough psychologists who specialize in the issues surrounding incontinence, bedwetting and ambiguous genitalia.
“The psychological aspects are important across the board,” Kogan stated. “You can’t fix one thing without dealing with the other. I think the health care system doesn’t have the best resources for this group.”
As Chair of the Division of Urology at Albany Med, Kogan is responsible for the educational programs for the medical students in the field of urology, as well as all of the residents. The residency is one of the best in the country from an educational standpoint and Kogan describes the combination of teaching and private practice as a model for the country in terms of future medical care.
“We’re all full-time faculty at Albany Med and are very dedicated to teaching, research and the academic functions of our field,” said Kogan. “But our business at Community Care Physicians is more private practice. We try to be a model center for providing patient care and at the same time advancing the field to be role models for a system that can achieve both.”
Kogan attended medical school at Northwestern University in Chicago and completed his residency in surgery and urology at the University of Michigan. He completed his fellowship in pediatric urology at the world famous Alder Hey Children’s Hospital in Liverpool, England.
“I love taking care of children because they’re so honest and straight forward. When they’re sick, they’re really sick,” he said.
—Amy E. Tucker
Dr. Kevin Costello
Dr. Kevin Costello is a very busy man. Not only is he a Lieutenant Colonel in the Army Reserves and a father of six children, he is also a geriatrician who practices internal medicine at Albany Medical Center.
His two main charges involve a post-hospital care program called the Early Facilitated Discharge Program (EFDP) and his primary care practice for home-bound patients. EFDP is part of the Hospitalists program at Albany Med and is a collaborative program with the Visiting Nurses Association of Albany, the Case Management Department and the Department of Medicine.
“We enroll primarily elderly patients and help facilitate and coordinate post-discharge care for patients leaving the hospital until they get re-established with their primary care providers.”
Costello, born and raised in Cohoes, was an orderly with the old Cohoes Hospital before it closed and was always interested in geriatrics.
His mother was a caretaker for older relatives and his great aunt lived with them. While in college, he lived for awhile with his grandfather who had Parkinson’s.
He attended Columbia University Medical School and spent five years in Montreal where he completed both his residency and fellowship at McGill University.
With five boys under age 18 and a five-year-old daughter, Costello, who also comes from a large family, said his home-care practice allows him the flexibility in his schedule to juggle work and family life.
“It’s a challenge,” said Costello, whose wife is a stay-at-home mom. “When emergencies come up I have to miss events that are important. But, most times I’m able to be there for my family.”
He describes home-care medicine as a growing field, in great demand with few providers in the area.
“The elderly population is growing, causing an influx in need of home-based care. Most of the patients are home-bound or end up in my care because they’re referred by the Visiting Nurses Association.”
Costello finds it helpful to be in the home from a diagnostic point-of-view. He can accomplish things in a house call that he can’t do in an office visit, such as inspecting the home environment for safety and seeing how a patient’s prescriptions are kept.
Though he tries to work efficiently and schedule appointments geographically, emergencies sometimes make traveling distances unavoidable.
Also, because many of his patients are frail and sick, he typically sees only five to six patients a day, much less than a doctor would see in an office setting.
“This type of practice used to be common before WWII,” said Costello. “Before the War, 40 percent of all physician encounters were in homes. After WWII, because of increasing specialization and reliance on equipment, it became less and less common.”
Costello understands war and medicine, having returned from his second tour of Iraq in May 2006. Doctors in the Army Reserves do short, 90-day rotations, but Costello did eight months the second time because he voluntarily extended his tour. He provided internal medicine and critical care to a mix of American soldiers and Iraqis.
“Ironically, the same technology that made doctors want to stay in the office has now been miniaturized to the point that, with laptops and portable EKG machines, we can bring that technology out on the road with us. Technology has enabled us to go back out to the patients’ homes again.”
Costello’s military salary supplements his salary from Albany Med, but he maintains that even with reimbursement changes made a decade ago, performing house calls still isn’t economically feasible.
“It’s still not a money-making proposition by any means”.
—Amy E. Tucker
Dr. Edward Lee
Colorectal cancer is the second leading cause of cancer-related deaths in the United States and is expected to cause about 52,180 this year, according to the American Cancer Society.
But, there is hope. Getting a colonoscopy at age 50 is still the best preventive for colon cancer. However, according to Dr. Edward Lee, one of three colon and rectal surgeons in the Gastrointestinal and Surgical Oncology Department at Albany Medical Center, there is still have a long way to go in educating both the public and their primary care providers.
“Teaching the general public to be screened for colon cancer is only half the battle. More than 50-60 percent of our patients with colon cancer weren’t screened because their primary care physician didn’t talk about it,” said Lee, who has had 15 years in the field.
Cancers such as breast and prostate are discussed more often because, said Lee, they’re a more ‘sexy’ cancer to talk about. “Colon cancer, because it’s a dirty organ, isn’t talked about as much.”
He sees colon cancer patients in their 70s who have never had a colonoscopy and feel cheated that their primary care physicians never suggested screenings.
Lee came to Albany in 1995 and pursued the field of colon and rectal surgery because of the variety it provided. He attended medical school at the University of California in San Diego and completed his residency at the New England Deaconess Hospital in Boston.
“This field provides me with a variety of patients and opportunities from private practice to performing surgeries. I can do small surgeries or big operations for patients with colon and rectal cancer or inflammatory bowel disease.”
He also enjoys the combination of surgery with medicine, including diagnostic treatments.
“Many surgeries are strictly that—you meet the person, operate and never see them again,” said Lee. “With my patients, I follow them for a long period of time and get to know them.”
Patients with chronic diseases like Crohn’s Disease have multiple surgeries in their lifetime requiring continuity of care.
Lee performs nearly 300 laparoscopic surgeries for colon and rectal cancer annually.
“It’s not a rare procedure, it’s just not the current standard of care at this time because few people are facile at the [laparoscopic] surgery.”
The procedure involves a smaller incision, producing less pain and recovery time. Because laparoscopic tools are more expensive, however, the cost currently remains about the same, even with the shortened hospital stay.
“It’s still in-patient surgery because we’re removing a few feet of the colon,” said Lee. “It shortens the hospital stay from five to seven days to only three to four. Patients pass gas and have bowel movements much quicker with laparoscopy, usually after the second day versus the third or fourth day.”
Surgeons started doing colon surgeries in the early 1990s, but the learning curve was very steep and involved doing many surgeries. Unlike gall bladder surgeries, which have been done laparoscopically for some time, colon and rectal surgeons had to take the cancer into effect.
“There was a moratorium on doing cancer surgeries via laparoscopy for five years until we had some good data” Lee explained. “Three years ago, a randomized trial showed that laparoscopic surgery was safe for cancer surgery, but the average general surgeon only performs about 15-20 colon surgeries a year.”
Residents in the program at Albany Medical Center are now taught how to do it. And, some patients come in specifically asking for laparoscopic surgery because they heard it from the Internet or word-of-mouth, said Lee.
Lee stresses that both men and women should have a colonoscopy at age 50, or sooner if you’re showing symptoms of colon cancer or have a genetic history of the disease.
“We, as a collective group of physicians, should be better at preventive medicine,” said Lee. “Women are much better at it. They’re used to seeing gynecologists and doctors early on. Men avoid doctors.”
—Amy E. Tucker
Dr. Daniel Kredentser
September is Ovarian Cancer Awareness Month. Despite the ongoing crusade to encourage women to be proactive about their health—such as performing monthly breast exams—many don’t and choose to ignore the risks.
“It’s hard to blame the patients for their diseases,” said Dr. Daniel Kredentser, surgeon and gynecological oncologist with 24 years of experience in the field. “I think there’s a segment of the population that is proactive and there’s a large segment of the population that will avoid doctors at all costs.”
Kredentser, who has been in this area since 1991, has a private practice at Women’s Cancer Care Associates and chose this field because he found it “interesting, challenging, difficult, and rewarding.”
He attended medical school at the University of Alberta, Canada and completed his three–year residency in California at Stanford. His fellowship work in gynecologic oncology was at Mt. Sinai Hospital in New York City.
Kredentser’s practice has a large hereditary genetics program providing genetic counseling for patients with breast and ovarian cancer.
Because few Capital Region surgeons practice gynecological oncology, Women’s Cancer Care Associates services a geographic area from Poughkeepsie to Plattsburgh and from Southern Vermont to Oneonta.
“You don’t have to go to New York City or Boston or Philadelphia for treatment,” explained Kredentser. “Whether you come here or see one of my colleagues in San Diego, you’ll get the same type of treatment here as you would anywhere else.”
The practice belongs to the GYN-Oncology Group, a National Cancer Institute-sponsored group for women with cancer which sponsors all of their research. Kredentser explained how treatment has changed over the years.
“Our surgical techniques are better, our radiation techniques are better and every year we have new chemotherapy drugs. So, our ability to treat the diseases is infinitely better than it was a decade ago and certainly much better than when I started.”
Kredentser’s group of four gynecologic oncologists is pioneering the use of laparoscopic surgery in the field. Using a robot at St. Peter’s Hospital, dubbed “DaVinci” after a naming contest, they’re able to perform procedures that were previously only possible with large incisions and have dramatically cut down on hospital and recovery time.
Whereas patients used to be in the hospital for a week, and were out of commission for six weeks following surgery, with laparoscopic surgery, they’re in the hospital for 24 hours and only out of commission for three weeks.
Approximately half of Kredentser’s surgeries are done laparoscopically now, compared to five percent when he started. He described the transition as a “gradual process” where the surgeons progressed from open laparoscopy to standard laparoscopy, where your hands hold the equipment, and finally, to using the robot.
“It was just a better way of doing things,” said Kredentser. “When there’s a new generation of computer, it’s not hard to learn, it’s just different. It’s very different for a surgeon not to be standing beside the patient, but to be standing in the corner playing with what is probably the most expensive video game in the Capital District.”
Standard laparoscopy uses a flat, two-dimensional screen. The robot enables surgeons to work on very large patients and, because it has binocular, three-dimensional vision, allows for more precise and delicate surgeries.
The equipment maneuvers the same way your wrist would. “It’s like a better mouse trap. I would imagine in the future there will be a robot in every other operating room.”
—Amy E. Tucker
Dr. Alan M. Sanders
Dr. Alan M. Sanders is an Infectious Disease internist in private practice with six others at Upstate Infectious Disease Associates (UIDA) and is the Chief of Infectious Disease at St. Peter’s Hospital.
The last decade has seen major changes in his field. From 1988-95, when he was in training and beginning private practice, there was much more in-patient care of AIDS patients with fewer positive outcomes. Since the introduction of more potent anti-viral medications in 1996, the care of HIV patients has changed dramatically.
“It’s rare when we take care of patients in the hospital anymore,” said Sanders. “My outpatient HIV practice has grown exponentially because more people are staying around longer.”
In fact, he has patients from the mid-90s who are still alive. “I follow AIDS patients for 10-12 years now. Before, it was rare to follow a patient more than five years. It’s been a major plus.”
Sanders, an Albany High School graduate, stayed close to home for medical school. He entered Albany Medical Center and did his first year of residency at New England Deaconess Hospital in Boston. He returned to Albany Med for his last two years of residency and did his fellowship in infectious diseases at Charity Hospital in New Orleans from 1992-94, before returning to Albany.
The internists at his practice treat a broad base of hospital-acquired infections and severe community-acquired infections. Their major focus areas include AIDS/HIV treatment, Lyme disease (which is showing increasing prevalence in this area), severe community-acquired diseases and skin infections, hospital-acquired infections and performing extensive research to find novel antibiotics and new ways to treat antibiotic-resistant infections.
“It’s never boring in my field,” laughed Sanders. “Every two years there’s a new disease to fight—be it avian flu, SARS, anthrax, E-coli or bioterrorism. The anthrax scare evoked fear in people, but there were few actual numbers impacted. What affects my everyday life is the emergence of antibiotic resistance.”
What Sanders is referring to is the over-prescribing of antibiotics for benign diseases to the point where bacteria are mutating and becoming resistant to treatment.
“There aren’t a whole lot of new antibiotics on the horizon,” he conceded. “The bugs and bacteria are winning the war and remain a step ahead of production. It’s a challenge every day to make sure physicians prescribe antibiotics appropriately and responsibly.”
Sanders described his practice as 90 percent in-hospital and 10 percent outpatient, and said that longer life spans and dramatic therapies are compromising immune systems, making it harder to fight off even simple infections.
“You’re dealing with a different patient population than you were 20 years ago. More folks are living longer and more medical procedures are being done to keep people alive. When you start doing bypass surgeries on eighty-five-year-old patients, they can’t bounce back as quickly.”
He and his colleagues are seeing a wider array of hospital-based infections from post-operative wounds and severe pneumonias to severe gastrointestinal infections. “We’re not going to turn back the clocks, so doctors have got to start prescribing judiciously.”
If you’re still wondering why someone would pursue a career diagnosing flesh-eating bacteria, let Sanders put your mind at ease.
“It’s fun and you make a difference,” he said. “It’s amazing and gratifying when you walk into a room, recognize a really bad infection that someone could die from, and say, ‘I know what this is!”
I’m not a macabre sicko like Dr. House on TV, and a good flesh-eating bacterium is not what I live for. I’m not taking out brain tumors or fixing hearts. But diagnostically, if we can make a rapid and precise diagnosis and save someone’s limb or their life, you can really change someone’s outcome. That’s rewarding.”
—Amy E. Tucker
Dr. Sharon Ann Alger-Mayer
Dr. Sharon Ann Alger-Mayer is a Clinical Nutritionist at Albany Medical Center studying childhood obesity and eating disorders among teens and adults. She attended medical school at the University of Buffalo and completed her fellowship in Clinical Nutrition at Albany Med. Following her fellowship, she conducted a year of research in metabolism and appetite regulation through the NIH in Phoenix, AZ, and joined the faculty at Albany Med in 1990.
The Plattsburgh native was always interested in nutrition and prevention, but it was her year of research in Arizona that became a catalyst for her career pursuits.
“I learned about appetite regulation from Rockefeller University in New York City and found it fascinating that the same chemicals that impact our moods also regulate appetite,” said Alger-Mayer. “I studied how serotonin and dopamine affect mood and appetite and the links between depression and anxiety with anorexia/bulimia and morbid obesity.”
The nutrition program at Albany Med focuses on anorexia/bulimia and morbid obesity including patients being considered for gastric bypass.
Even though they’re on opposite ends of the eating disorder spectrum many of the environmental and emotional triggers are the same, explained Alger-Mayer. “My practice began as a combination of in-patient nutrition and out-patient support and has become almost exclusively outpatient because of the growing number of patients with eating disorder and obesity needs.”
Traditionally, more women seek assistance with obesity. Nationally, the incidence of males with anorexia/bulimia is increasing from roughly 10 percent to nearly one in six.
Another high risk population for eating disorders has always been teenagers and young adults making the transition from high school to college. But, in the last decade, Alger-Mayer cites an increase in older women in their 40s and 50s who seek help for eating disorders triggered by divorce, their children leaving home or other life-changing situations.
“Albany Med is a center of excellence for obesity with a comprehensive educational program including exercise, dieting, nutrition and lifestyle changes for obesity and eating disorder patients,” said Alger-Mayer. “Our vision moving forward is to continue to bring in the lifestyle changes population and have experts available to create exercise and relaxation programs, to help people deal with emotional eating and to achieve and maintain healthy lifestyles.”
Two years ago Albany Medical Center received a Department of Health grant in conjunction with Four Winds Hospital in Saratoga and Bellevue Hospital in Schenectady to develop a comprehensive, team, outpatient approach and services to help people with eating disorders stay out of the hospital and transition back into their families and jobs. This as yet unnamed “Comprehensive Wellness Center” for outpatient services will be on Washington Avenue Ext. in Albany.
“The vision is an integrated medicine program featuring a variety of services from onsite psychologists, nutritionists, massage therapists, exercise physiologists and more,” Alger-Mayer explained.
Respecting that genetic differences among patients can prove challenging for treatment considerations, she also understands the importance of an individual’s environment in achieving success.
“Genetics loads the gun and the environment pulls the trigger,” she said, quoting renowned physician George Bray, M.D.
“It’s not a level playing field. “People who have a genetic predisposition to obesity will have to work harder and be smarter about their food than someone without that genetic predisposition.”
Alger-Mayer also spearheads a program for the Northeast Comprehensive Care Center for Eating Disorders (NECCCED) and encourages anyone in need of assistance for treatment with anorexia/bulimia or morbid obesity to contact Christine Campagna at 262.5391.
—Amy E. Tucker
Dr. Robert Giombetti
If you want to be a pediatrician, you have to love children. That’s one of the reasons why Dr. Robert Giombetti decided to enter pediatrics.
After completing his residency at New York Hospital in 1966, Giombetti entered the Army and spent two years stationed in Fort Rucker, Alabama. The NYC native moved to Delmar in 1968 and took over an already-established medical practice behind Saratoga Shoe Depot, off of Delaware Avenue.
When asked what drew him to the medical field, Giombetti laughs. “What doesn’t?” It was his own family physician he had while growing up who served as a role model to a young Giombetti, who always had an interest in medicine. “We were fortunate to have him as our physician,” he said. “He was a great example and gave me great pointers on what to look for [in the field].”
Of course, the children are important too. “I love kids,” said Giombetti, who has five of his own.
Having been in the industry almost 40 years, the doctor has seen the positive effects of technological advances.
“The more dramatic things have been in the therapies with children with leukemia,” he said.
That wasn’t the case 30 or 40 years ago. A child diagnosed with this dreaded blood cancer had little hope. “It was difficult to do anything for them.”
But today, with advances in bone marrow transplants, patients are diagnosed, treated and able to live longer, fuller lives.
When he first went into practice, Giombetti said caring for infectious diseases such as meningitis and pneumonia, was more prevalent. Fortunately, doctors today don’t see as many bad diseases as they once did, thanks to better immunizations and control of infectious disease.
Instead, what Giombetti sees among children today are psycho-emotional problems, such as depression.
He identifies technology as a cause for the increase in these problems. “Maybe society has developed at a faster pace. With technology, kids are learning about life a whole lot quicker.” He also feels that reality television, unstable families and academic pressures in schools can contribute to emotional problems.
About five years ago, Giombetti relocated to a bigger office down the street from his previous one, after his son Todd and daughter-in-law Kathleen joined him in practice. His other son, Greg, serves as office manager.
It’s not just working with his family that makes each day gratifying. It’s also getting the chance to meet several generations of families.
“That’s the great thing about pediatrics. Patients grow up, come back and bring their own children.”
He admits that working with children takes a little bit of creativity, especially talking to them while trying to relate to their parents. “It’s a balancing act when trying to deal with two individuals.”
What advice does Giombetti have for those contemplating a career in pediatrics? “Maintain a sense of humor and you’ll really enjoy pediatrics and medicine as a whole.”