Best Hospitals 2007
The Best Hospitals
An exclusive survey of more than 1,000 leading doctors yields 43 sources of top medical care
AIDS SAN FRANCISCO GENERAL HOSPITAL / 61 pct.
MASSACHUSETTS GENERAL HOSPITAL BOSTON / 27 pct.
JOHNS HOPKINS HOSPITAL BALTIMORE / 22 pct.
UCLA MEDICAL CENTER LOS ANGELES / 18 pct.
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO MEDICAL CENTER / 16 pct.
MEMORIAL SLOAN-KETTERING CANCER CENTER NEW YORK / 14 pct.
CLINICAL CENTER, NATIONAL INSTITUTES OF HEALTH BETHESDA, MD. / 12 pct.
HIV infection opens the door to dozens of "opportunistic" diseases; AIDS specialists have to be familiar with the many therapeutic drugs used to fight them. As more is learned about treating HIV-related diseases, hospitals are moving toward outpatient care. Most patients prefer staying at home, where they are also less exposed to hospital-based infections.
EXPERT'S VIEW
PAUL VOLBERDING, professor of medicine at the University of California, San Francisco and director of the AIDS program at San Francisco General Hospital: You need to be willing to take care of the patient, and you need to know a lot about the disease. HIV infection is complex, but there are clear patterns. That makes experience crucial--if I were a patient I'd want the hospital to have seen several hundred cases. Experience helps you decide whether to treat the patient as an inpatient or an outpatient. A drop over time in the incidence of pneumocystis pneumonia means the hospital is giving high-quality preventive care. In this disease it's especially important to be doing clinical trials. That way you know what's happening before it's published. When things change as rapidly as they have in HIV disease, it gives the doctor and the hospital an edge they might otherwise not have.
RESOURCES
Project Inform, (800) 822-7422 outside California, (800) 334-7422 in California. Drug and treatment information. National Institute of Allergy and Infectious Diseases, (800) 874-2572. Trials of new drugs. National Association of People with AIDS, (202) 898-0414, or on-line bulletin board, (703) 998-3144. Current news, support-group listings.
CANCER UNIVERSITY OF TEXAS (M.D. ANDERSON CANCER CENTER) HOUSTON / 62 pct.
MEMORIAL SLOAN-KETTERING CANCER CENTER NEW YORK / 57 pct.
DANA-FARBER CANCER INSTITUTE BOSTON / 36 pct.
MAYO CLINIC ROCHESTER, MINN. / 23 pct.
STANFORD UNIVERSITY HOSPITAL STANFORD, CALIF. / 22 pct.
Cancer care has become extremely complex, and tumors are being diagnosed earlier; but surgery, chemotherapy and radiation still define the treatment options. Most large hospitals employ all three. Because cancer is really many different diseases, even large hospitals often have true expertise in diagnosing and treating only a few types of cancer.
EXPERT'S VIEW
JAMES COX, physician-in-chief, University of Texas, M.D. Anderson Cancer Center: A good cancer hospital will have a solid multidisciplinary approach where a single method of treatment, like radiation, doesn't dominate. I would go to a different hospital if the surgeons, radiation and chemotherapy experts couldn't agree on the best approach to treating my cancer. Another hallmark of top-quality care is that the hospital routinely sends out its lab work, such as tissue biopsies, for outside review. Any lab can make a mistake. I'd also find out if there is an emphasis on treatments that spare organs. Increasingly, that is possible with cancers of the breast, prostate, bladder and larynx, for example. Finally, I would check to see if the hospital has a full complement of imaging equipment such as MRIs and CAT scanners. Those are becoming more and more critical to an accurate diagnosis.
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