What is a "Best Hospital"?

U.S. News ranked the hospitals again, and my employer came in first, for the 20th year in a row. I can't be unhappy about that!

But how should you choose a hospital anyway? I wrote about that a little while ago - it's more complicated than U.S. News makes it out to be.

Unfortunately, as a recent research article points out, the U.S. News index is based nearly entirely on reputation. Which is not a terrible thing, as I pointed out, just incomplete.

Maybe we should rank hospitals (or, at any rate, medical schools) according to a different index, say social mission? Some folks tried that, and their results are presented in the Annals of Internal Medicine (subscription required).

In that list, Hopkins, as well as NYU - where I trained for residency - are ranked rock-bottom. But the criteria used to quantify social mission has some big problems, as an accompanying editorial points out (sub. req.).

Until we have comprehensive outcome measures, it looks like we're going to have to integrate all indices according to our own individual metrics. Isn't that called reputation?

Presenting the presenters!

I was at Hopkins last week giving a talk as a recipient of one of the GIM Housestaff Research Awards. The other awardees were impressive. I wish they were as blogorrheic as I am, so I could provide links to their life & work. In any case, among the presentations were

• a discussion by Matt DeCamp of intellectual property rights and distributive justice, and their interdependence
  
• Lee Jennings' study of osteoporosis treatment in the hospital (per guidelines: calcium, vitamin D, and anti-resorptive/bone-forming agents). Two percent of patients got recommended treatment in-house!
• a sobering fact about residents' physical examinations of women (Rosette Chakkalakal): they don't listen to the heart like they should (is it because they respect too much their patients' modesty? or they're uncomfortable with moving their breast out of the way?)
• a study by Nitin Kapur of interpartner violence and sexually transmitted infections among Indian women (with a 1-month prevalence of IPV of around 20%, if I remember correctly; related link)

• Last but not least, my study about factors associated with patients' failure to fill new asthma prescriptions [Google version above not yet re-edited to account for Power Point - Google incompatibility].

The Yiddish Leprechaun of Baltimore

Presenting the genial, silver-tongued, exaggeration-prone professor (and friend of mine), Marc Caplan. His life story is worth reading about.

(He was a guest on this very blog some time ago.)