This week, Thomson Reuters came out with their list of the top 100 hospitals in the country.  I love the way they take a very analytical approach that is not based on reputation but rather on the results of the procedures at the institutions.  Take a look at the list and see what you think.  I love it that the hospital down the road from my house, one of the top teaching institutions, and the hospital in Ann Arbor where my kids were born both made the list.  Anything you see of interest?

There are a ton of very good hospitals on the list and some that are noteworthy in their absence.  It is important to recognize why some of the biggest names don’t make the list.  A while back I was talking with an elected official from Minnesota and a leading researcher from Duke.  The woman from Minnesota was bragging, rightfully so, about how good healthcare is in her state and the numbers prove she is right.  The physician from Duke just asked one question, “And how often do patients come to your hospitals not wearing shoes?”  Whether people go to North Carolina hospitals without shoes is really not the point, but rather the individual patients treated really make a difference on the outcomes and the resulting comparative ratings.

I guess I love to look at hospital lists for another reason.  As a pharmaceutical executive, hospitals have always been the museums or galleries where our “art” is on display.  Hospitals are where the sickest people go and it is where our drugs have the greatest impact.  To me, hospitals are where science meets reality.  The best work that comes from our research labs is used by the most skilled physicians to treat the sickest patients.

One of the ways I measure the depth of those in our industry is to ask them how many of the biggest teaching hospitals they have been to in order to personally meet with thought leaders.  To me, it is an indication of how much they really love the business and science of our industry.  My son loves baseball, and he has travelled the country seeing as many ballparks as possible.  I know a lot of bird lovers who do different things to grow their “life list” of birds they have seen.  I even have a relative who is a funeral director who visits the graves of presidents during his vacations.  Seeing and understanding the places most of the thought leader physicians live and work gives you a much greater understanding of their context and the patients we are collectively trying to help.

Our healthcare system is not a homogeneous entity.  It is made up of a wide variety of different approaches to patient care and the rating article might suggest a variety of different outcomes.  To truly understand why physicians think and prescribe differently, it really helps to look back at where they were trained and who ran the department when they were residents.  Just like for everyone else, physicians’ habits are formed at a very young age.  Doing decile analysis only tells you what a physician does while looking at the places they were trained.

If you ever need a boost to your level of confidence about our health system take a road trip and visit a number of the great medical facilities in our country.  Talk to the thought leaders who work there.  Ask them to show you their labs, if they do that type work, or ask them to just talk about what they and their institutions are doing about healthcare reform.  Go to various different parts of the country and notice the similarities and differences.  Go to a few VA hospitals, county hospitals that serve the poor and hospitals from different categories on the ratings list.  The one thing I will guarantee that you will notice is that there is not just one way that medicine is practiced in our country.

For me, whenever I really need a lift I make the trip up to Rochester, Minnesota and spend some time with friends at the Mayo Clinic.  I love their approach to medicine.  The patients, rich and poor, are treated with immense dignity by the absolute best physicians in our country.  To an outsider it seems the entire system is set up to make the patient’s experience as pleasant as possible, recognizing they treat some of the toughest medical cases in the world.  Everything seems totally integrated with the physician only being one part of the equation.  I am not an expert on rating hospitals, but I just know when I am at Mayo I am very proud of the healthcare profession.

How does your personal list of hospitals compare to the ratings that came out this week?  When you see the list is it like watching the Oscars?  Do you think about seeing the winners you haven’t seen and vow to see more before next year’s awards come out?