"Once you choose hope, anything is possible." -- Christopher Reeve
2009-2010 U.S. News & World Report Best U.S. Hospital Rankings
Posted by Paul Cacciatore on July 16, 2009
Today, U.S. News & World Report issued its 2009-2010 rankings of the best U.S. hospitals for adults. The University of Texas, M.D. Anderson Cancer Center is rated #1 in cancer treatment; Brigham and Women’s Hospital is rated #1 in gynecology; and Johns Hopkins is rated #1 overall based upon all medical specialties.
If you would like more information regarding the 2009-2010 U.S. News & World Report best U.S. hospital rankings, click here. To better understand how U.S. News & World Report ranked the hospitals in each specialty, read America’s Best Hospitals: Here’s How We Selected Them – Deaths, reputation, and patient safety were among the factors the rankings took into account, written by U.S. News & World Report’s Avery Comarow. If you would like to review the current U.S. News & World Report America’s Best Children’s Hospitals list, click here.
MLO said
I have found that as long as your physician is willing to consult with the top hospitals, you will be in good hands in even smaller settings. Those settings tend to know what they cannot handle. (Those that won’t look at research or talk to other doctors, I would run from.)
Paul Cacciatore said
MLO,
Thank you for taking the time to stop by. Your weblog, http://www.mloknitting.com, is great because your writing covers a variety of topics and is truly honest.
I understand your comment in the context that such an approach worked for you. I am not sure that such an approach will work for all women. I am aware of remarkable success stories and disasters in large and small settings. I do not think there is a hard & fast rule. I agree that it is critical for each woman to be proactive and continually ask her doctor “why?” I agree that a doctor that won’t look at patient research (assuming it is current, relevant, and well-organized) should create a moment of pause. Unfortunately, there are many patients who do not have the skills, time and/or intestinal fortitude to research their disease and challenge a doctor while in the midst of fighting cancer. In addition, many of those patients also do not have a family member or friend to act as an advocate on their behalf.
There are a many critical issues that a woman facing an ovarian cancer diagnosis may have to address in the course of her treatment. First, I believe that treatment by a board-certified gynecologic oncologist is best. Second, we know that expert cytoreduction (debulking) surgery increases survival (see Bristow et. al., Johns Hopkins) and represents one of the best weapons against ovarian cancer. Third, we know that ovarian cancer generally responds well to chemo initially (with the exception of a few subtypes such as clear cell) but may become resistant to such treatment later. Fourth, if the first few mainstream lines of treatment are not successful, you require a doctor with knowledge of therapies that are in the clinical development pipeline (i.e., clinical trial drug and treatment knowledge), including the priority and sequence that should be assigned to multiple trials (e.g., possibly based on the tumor’s unique genetic characteristics, or entry/exclusion criteria). Needless to say, this is a lot of territory for a small group to cover, assuming the woman progresses ultimately through multiple levels of treatment. I am a fan of making sure that a treatment facility can address all of these issues prior to the start of treatment, even if the woman does not ultimately require all of these services. The facilities that tend to have all of these resources in one place are the NCI-designated cancer centers and the NCCN member institutions, many of which are highly ranked in the complete 2009-2010 U.S. News & World Best Hospitals Listing. These same centers usually have a team of doctors review difficult patient cases even though the patient may only have face-to-face contact with one doctor — a Socratic Method approach of sorts. Also, many of these centers have excellent translational research programs where clinical trials are conducted based upon research, but real patient experiences are taken into account and reviewed by those conducting the research. This structure creates an efficient flow of research information from lab to bedside and back again.
MLO, thanks again for the comment, and we wish you continued success with your weblog and in your battle against ovarian cancer. I encourage all of our readers to stop by and check out MLO’s blog.
Best, Paul