“Top Hospital” Rankings Not All They’re Cracked Up to Be

When you walk into the lobby of Johns Hopkins Hospital in Baltimore, you can’t help but notice all the signs informing you that Hopkins is ranked No. 1 hospital in the United States by U.S. News & World Report. Hopkins is justifiably proud of reaching that top spot year after year, but does it mean anything for patient safety and quality of care?

A new study in Annals of Internal Medicine finds that for the 50 top-ranked hospitals, there is little correlation between their U.S. News rank and any objective measures of quality of care. But when the authors crunched the numbers, they found the hospital’s subjective reputation among doctors accounted for 90 to 100 percent of the hospital’s overall U.S. News ranking. In other words, the word of mouth reputation of the hospital among doctors — not among patients — counts for a huge amount of the news magazine’s popular ratings system.

In my book, The Life You Save: Nine Steps to Finding the Best Medical Care — and Avoiding the Worst, I discuss how to find the right hospital. The short answer is: It’s not easy. But there are some simple steps. I would focus on the brand-name hospitals like Hopkins only if I had an exotic condition that very few doctors had ever seen. Here’s a short excerpt of what I wrote about the U.S. News rankings, and what I think is a good alternative:

In its 20 years of rating hospitals, U.S. News has never asked a single patient what they think; its ratings of a hospital’s reputation in a particular specialty is based solely on what doctors in that specialty believe. But now Medicare has started requiring hospitals to have patients fill out a standardized survey when they leave the hospital, and the questions focus on a lot of issues that people care about and have a big impact on the quality and safety of their care, such as:

• Did the doctors and nurses always communicate well?
• Was the bathroom always clean?
• Was your pain always well-controlled?
• Was the area around your room always quiet at night?

Note that little word “always.” These are things patients have a right to expect – always.

You can find the results of the patient surveys on Medicare’s Hospital Compare website by clicking here. You will find that many community hospitals do a better job than the mega-hospitals of taking care of patients in the ways that patients notice.

One chain that is quite good that I urge people to check out is called Planetree, which takes its name from the tree under which Hippocrates sat teaching medical students in ancient Greece. Planetree is dedicated to humanizing health care by making it “patient-centered.” Planetree has affiliated hospitals in 31 states; you can see a list at planetree.org.

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