usnews_americas_best_hospitals-2009Although the core business of the U.S News & World Report franchise is the delivery of mainstream news, it is best known for annual rankings of the best colleges, graduate schools, and hospitals. Like clockwork every July, the magazine just released today its rankings for the best hospitals in the United States.

The overall ranking is based on the sum of points assigned to a hospital’s top-tier specialty services. A hospital gets 2 points for each specialty ranked “at or close to the top” when compared to its peer hospitals. They receive 1 point for each specialty that is ranked lower.

Topping the list this year, and for the nineteenth consecutive time, is the Johns Hopkins Hospital in Baltimore, Maryland. The hospital has 3 specialties ranked as the top in the nation, including Urology, Rheumatology, and Otolaryngology (Ear, Nose, and Throat). It also has 10 other specialties within the top-three rank. Its closest rival, the Mayo Clinic in Rochester, Minnesota, also has 3 first-ranked specialties, including Endocrinology, Gastroenterology, and Neurology/Neurosurgery. The remaining few contenders on the list may have at most one or two top-ranked specialties. The Ronald Reagan UCLA Medical Center, which has now taken the third spot since 2007, and the title “Best in West [Coast]” for the 20th consecutive year, leads the nation in geriatric care. The top 7 institutions on the list has not changed since last year.

Drum roll for the top twenty-one (#10 and #11, #17 and #18 below are tied) …

  1. Johns Hopkins Hospital (Baltimore, Maryland)
  2. Mayo Clinic (Rochester, Minnesota)
  3. UCLA Medical Center (Los Angeles, California)
  4. Cleveland Clinic (Cleveland, Ohio)
  5. Massachusetts General Hospital (Boston, Massachusetts)
  6. New York-Presbyterian University Hospital of Columbia and Cornell (New York, New York)
  7. University of California, San Francisco Medical Center (San Francisco, California)
  8. Hospital of the University of Pennsylvania (Philadelphia, Pennsylvania)
  9. Barnes-Jewish Hospital / Washington University (St. Louis, Missouri)
  10. Brigham and Women’s Hospital (Boston, Massachusetts)
  11. Duke University Medical Center (Durham, North Carolina)
  12. University of Washington Medical Center (Seattle, Washington)
  13. University of Pittsburgh Medical Center (Pittsburgh, Pennsylvania)
  14. University of Michigan Hospitals and Health Centers (Ann Arbor, Michigan)
  15. Stanford Hospital and Clinics (Stanford, California)
  16. Vanderbilt University Medical Center (Nashville, Tennessee)
  17. NYU Medical Center (New York, New York)
  18. Yale-New Haven Hospital (New Haven, Connecticut)
  19. Mount Sinai Medical Center (New York, New York)
  20. Methodist Hospital (Houston, Texas)
  21. Ohio State University Hospital (Columbus, Ohio)

Although there are a few other competing rank lists of “best hospitals”, the U.S. News & World Report seems to be the industry standard. At the top hospitals, there are prominent displays of banners and posters proudly proclaiming their status as being among the best in the country. These announcements further permeate to the hospitals’ websites and literature.

I have no qualms with this open display of celebrated accomplishment. These hospitals deserve to rejoice in the rewards of their focus, excellence, diligence, dedication, and teamwork. I would nevertheless argue that we need to view these ranks with a grain of salt. There are so many variables involved in health care. It would be difficult to tease out whether specialty care in a third-ranked hospital is necessarily better or worse than one in the sixth rung. The degree of patient satisfaction, and quality of the physician and nursing staff are also difficult to quantify. Given the diversity of patient care needs and desires, a particular hospital may be best fit for one patient, but not necessarily for his neighbor.

And sometimes these rankings can get out of hand … U.S. News & World Report has branched out to include rankings for the best high schools, cars and trucks, health insurance plans, places to retire, nursing homes, and places to work in the Federal government. What’s next? Ranking the best places to elope? Oh wait, that already exists.

While I am pseudo-critical of the rankings, I can understand that we are by human nature programmed to rank, categorize, and stereotype. It is an instinctive mechanism to permit our puny brains to make sense and remember some of the infinite bodies of knowledge. I have no personal grievances about the rankings either: in fact, I train and work at one of the institutions listed above, and I am very pleased with the results. I heartily congratulate each and every one of them for making the list and for their endless team-focused dedication to excellence in patient care.

Additional Resource: addresses and social media directory of the top hospitals.