Along with asking all the doctors in Northern Virginia who, in their expert opinion, should be dubbed a Top Doctor, we took the process a step further than peer nominations. We worked with nine local hospitals, including Children's National Medical Center, and Mid-Atlantic Permanente Medical Group, and asked them to put together a panel of head doctors to discriminatively look at doctors with privileges at their hospital. Each panel nominated doctors based on all the internal tools they are privy to: internal evaluations, patient reviews, as well as overall quality of care (patient access, training, unblemished records and how the doctor works with other staff).