You know, everyone criticizes college rankings and whines about how you should look for a school that is a "good fit" for you rather than a "top" school. Really, though, how are we supposed to know? For instance, with med schools I don't have the time or money to go cross country and tour a bunch of med schools to figure out what I like. I look in the MSAR and on the web page and guess what, I have no clue if they are a "good fit" for me, and I don't think I would really know until a few months into my first semester. Obviously rankings are far from perfect, but I say basing your decision on imperfect objective information is better than basing it on hearsay from friends, family, and publications put out by the school itself.
Does anyone else out there actually kind of like the rankings?
Also, note that if you get into several top-30 schools or something like that you obviously would not blindly choose the highest ranked one, you would choose the one you liked most on a visit (once it is narrowed down to a couple of schools, a visit for an interview or second look seems called for).