BEST HOSPITALS: U.S. News Releases Rankings

This week's U.S. News & World Report looks at America's "best hospitals and includes two features on the impact of managed care economics. In "The Hospitalist," the magazine profiles new medical specialists known as "hospitalists": Doctors who "care for patients throughout the hospital, not just in the intensive care units, and ... have limited, or no, outpatient responsibilities." By authorizing late-night CT scans and other procedures, U.S. News reports, hospitalists can save managed care plans millions in unnecessary hospital stays, and free family physicians for treating outpatients. In a separate story, U.S. News examines the growing trend of nurse practitioner-based primary care, in which NPs "diagnose, treat, prescribe refer and bill very much as if they were M.D.'s," often providing a "slower-paced, more personal" level of care. Physicians and other critics assail the gap between doctors' "four years in medical school and three years in residency training" compared to "the 500 to 700 hours of training that most nurse-practitioner programs call for," according to AMA president Nancy Dickey.

The Honor Roll
U.S. News, in conjunction with the National Opinion Research Center, ranked America's best overall hospitals and the best hospitals within 16 specialties. The final rankings include 132 hospitals. An "honor roll" of the best 14 hospitals, considering reputation, mortality and other data, includes:

1) Johns Hopkins Hospital, Baltimore
2) Mayo Clinic, Rochester, MN
3) Massachusetts General Hospital, Boston
4) Duke University Medical Center, Durham, NC
5) UCLA Medical Center, Los Angeles
6) Cleveland Clinic
7) Stanford University Hospital, Stanford, CA
8) Brigham and Women's Hospital, Boston
9) Barnes-Jewish Hospital, St. Louis
10) University of California, San Francisco Medical Center
11) Hospital of the University of Pennsylvania, Philadelphia
12) (Tie) University of Chicago Hospitals
13) (Tie) University of Michigan Medical Center, Ann Arbor
14) University of Washington Medical Center, Seattle (Comarow, 7/27 issue).

Top Specialties
According to the New York Daily News, New York's Memorial Sloan-Kettering Cancer Center was named the top cancer hospital in the nation, although no New York-area hospital appeared on the overall honor roll (Ferraro, 7/20). The Boston Herald reports that the Boston Children's Hospital ranked first for pediatrics for the ninth straight year (Lasalandra, 7/18). The Rehabilitation Institute of Chicago was tops in its category for the eighth year in a row (Houlihan-Skilton, Chicago Sun-Times, 7/17). The Cleveland Clinic was named best hospital for cardiology for the fourth year in a row (U.S. News release, 7/16). Johns Hopkins Hospital was the top overall hospital in the nation "for the eight year running" (Bor/Salganik, Baltimore Sun, 7/17).

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