For the 10th straight year, Johns Hopkins Hospital topped the list of "America's best hospitals" as rated annually by U.S. News and World Report magazine.
As in the past, when the rankings were released, Dr. Edward D. Miller, the chief executive of Johns Hopkins Medicine, modestly noted that the rating is not as important as some people say.
Avery Comarow, editor of the magazine's report, again decried the way the rankings have become a marketing tool for hospital administrators.
And a lead researcher with another national hospital survey pointed out that the magazine depends heavily on one subjective factor - reputation - that could make each year's result much the same as the last. Still, Hopkins administrators acknowledged that the recognition yields practical benefits beyond the inevitable relief from worry about when their remarkable winning streak will end.
"It's always nice to be ranked No. 1," Miller said. "It gets our name out in front of people and lets them know the kind of expertise we have. But it also helps us recruit faculty and staff. A good example is with the nurses. In the midst of a nationwide nursing shortage, to be a nurse in a No. 1-rated hospital is a good recruitment tool. A lot of people would like to work at one of the best places."
To make the assessment, the magazine's researchers considered three factors: reputation based on a survey of physicians nationwide, mortality (the number of actual deaths compared with the number of expected deaths) and aspects of treatment such as technology and nursing care.
Among 17 medical specialties evaluated, Hopkins ranked in the top 10 in 16 of them, including No. 1 rankings in ear, nose and throat; gynecology; urology; and eye care. It ranked second in geriatrics and rheumatology, third in cancer, digestive disorders, hormonal disorders, neurology and neurosurgery, respiratory disorders and pediatrics. It ranked fourth in cardiac care and orthopedics, fifth in psychiatry and tenth in kidney disease. Its rehabilitation program ranked 15th.
Other Maryland hospitals included in the "best hospitals" report were Anne Arundel Medical Center for gynecology and respiratory disorders, University of Maryland Medical System for hormonal disorders, Maryland General Hospital for neurology and neurosurgery, Doctors Community Hospital in Lanham for rheumatology and Sheppard Pratt Hospital for psychiatry.
The Mayo Clinic in Rochester, Minn., and Massachusetts General Hospital in Boston, ranked two and three respectively, are also among the centers that appear regularly on the magazine's list. Because the ratings do not recognize medical centers with one or only a few specialty services and excludes hospitals not associated with a medical school, a number of excellent institutions did not make the cut to be rated, Comarow said. Of more than 6,000 medical centers in the United States that could be ranked, the magazine winnowed the field to about 1,700.
"The reason we do 'best hospitals' is not to tell people where to go for every kind of treatment," Comarow said. "You don't need to go to these ranked hospitals for everyday ailments. There's an astounding range of procedures that are handled very well by your local hometown hospital that doesn't have a national or regional reputation. This is for people whose problems have become uncontrollable, if they haven't otherwise found a satisfactory resolution."
In another nationally recognized survey, "100 Top Hospitals," produced for the past seven years by the HCIA-Sachs company in Baltimore, Hopkins has appeared twice. Relying on objective data, such as length of hospital stay, percent of occupancy, profitability and mortality, HCIA has found that hospitals may appear more than once on its list, but do not return year after year, as they do in the magazine's survey.
"Attitudes don't change radically over time," said Jean Chenoweth, HCIA's senior vice president, noting that physicians' opinions have a strong impact on the results of the magazine's report.
"Surveying opinions is a ver legitimate way to do research, but it's also why they will consistently come out with big-name institutions" every year.
Top 15 U.S. hospitals
1. Johns Hopkins Hospital
2. Mayo Clinic
3. Massachusetts General Hospital
5. UCLA Medical Center
6. Duke University Medical Center
7. Stanford University Hospital
8. Barnes-Jewish Hospital
9. Brigham and Women's Hospital
10. Hospital of the University of Pennsylvania
11. University of California, San Francisco Medical Center
12. University of Michigan Medical Center
13. University of Chicago Hospitals
14. University of Washington Medical Center
15. University of Pittsburgh Medical Center
Source: U.S. News and World Report