US News

[Chimed]

The most US News rankings of psychiatric hospitals came out today. Nothing much new here.

http://health.usnews.com/best-hospi...name=Hospital+name&service_offered=All&page=1

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[whopper]

I can tell you I have personal experience in some of these places and it makes me wonder how the eff these places got the ranking they did.

One place, that I will not name has great research, but the hospital psychiatry unit is decrepit, and the quality of the treatment is far worse than places I've seen not on the list.

Another place I know if, I'd rank that as the best place I've ever seen if I wanted someone to get psychiatric treatment, but that place isn't on the ranking, though they also don't want to be considered a hospital. They do, however, have inpatient units.

 

[dl2dp2]

What I think is kind of interesting is the consistent high ranking of JHU, which is generally not known to be a research powerhouse in this field, nor is it particularly well known for fancy clinical facilities like McLean's Pavillion or The Retreat @ NYP. I wonder what the logic is.

 

[whopper]

Hmm, well I am willing to mention the place where I'd most like a family member or friend to be...
http://lindnercenterofhope.org/

Hotel quality rooms, professional chef makes the food, and all the doctors I know working there actually do decent work, not some idiot throwing as much Xanax as the patient wants. The quality of the work there I've seen is much higher vs. several places on the US News list.

 

[notdeadyet]

The sooner folks forget about USN&WR and let it die a quiet and long overdue death, the better. Their news bureau is flatline, only the ratings machine keeps it pumping.

 

[billypilgrim37]

The sooner folks forget about USN&WR and let it die a quiet and long overdue death, the better. Their news bureau is flatline, only the ratings machine keeps it pumping.

The rankings serve so much more function in law and business. The gap between the #2 and #4 law schools in terms of your job prospects is probably the same as the gap between the #2 and #24 medical schools.

 

[nitemagi]

Psychiatry, unlike other specialties, is ranked by "reputation," AKA votes from individuals surveyed.

 

[Chimed]

The sooner folks forget about USN&WR and let it die a quiet and long overdue death, the better. Their news bureau is flatline, only the ratings machine keeps it pumping.

I have mixed feelings about the whole thing. I do think there is utility in having a list of hospitals that are known to have a good reputation so patients can get a sense of their quality and which hospitals are known to be good at a certain specialty. The problem that I see is that medical students view the US News ranking as being equivalent to the "top 20 psychiatry departments". The US News ranking is based on inpatient hospital reputation. It has nothing to do with the quality of resident education. That is the key difference and is often misunderstood.

 

[whopper]

Psychiatry, unlike other specialties, is ranked by "reputation," AKA votes from individuals surveyed.

Then hospitals that give all the Xanax, Ativan, and Percocet a patient wants, and allows malingerers to freely come in whenever they want will be the ones that get the votes.

I'm sure that's not the case with all of these hospitals, but I can tell you that is the case with some doctors I've seen who've won local awards as top doctors.

Some of the facilities I've seen on the list that I wouldn't want anyone I know treated didn't do these things, but they were facilities with poorly maintained units (e.g. cracks in the windows), and I didn't see any reason to believe the treatment there was in any form superior to other hospitals.

 

[nitemagi]

Then hospitals that give all the Xanax, Ativan, and Percocet a patient wants, and allows malingerers to freely come in whenever they want will be the ones that get the votes.

I'm sure that's not the case with all of these hospitals, but I can tell you that is the case with some doctors I've seen who've won local awards as top doctors.

Some of the facilities I've seen on the list that I wouldn't want anyone I know treated didn't do these things, but they were facilities with poorly maintained units (e.g. cracks in the windows), and I didn't see any reason to believe the treatment there was in any form superior to other hospitals.

I would presume this is reputation amongst professionals, not patients. But who knows.

 

[whopper]

Yeah, I read the website's criteria of how they picked the best hospitals but no exact details, only generalities were given, unless I missed it.

I really don't know how they picked the hospitals.

In all fairness, there really is no perfect way to rate a hospital, and no one can come up with a list that would not generate complaints. In a magazine written for lay-people, however, you figure they'd rate it in a manner where the focus was on clinical care, not research. (Yes I know, the two do usually go hand-in-hand to some degree).

I recall being a chief resident and the GME came up with a great new way to figure out how much our yearly bonuses should be--patient satisfaction. I raised my hand and said something to the effect of "you know, when I petition a guy for involuntary commitment because he wants to kill the President for being an alien, I'm doing my job right but this will kill my bonus. You realize that patient satisfaction doesn't work across all fields."

 

[sunlioness]

I would so not be getting a bonus either. Right now I'm that nasty doctor who won't give out the Ativan that people need. And I am so evil that I even told a diabetic guy today that I wasn't going to write him for the double portions he wanted, and was instead going to write for a low carb diet. I'm awful.

 

[NJWxMan]

Cleveland Clinic ranked so high? I don't ever remember it being ranked in too 20, let alone, ranked at all in the past.

 

[digitlnoize]

I really don't know how they picked the hospitals.

Well, if it's similar to how they pick their law schools, it would make more sense:

http://leiterlawschool.typepad.com/leiter/2011/03/us-news-rankings-fraud-watch.html

There are many reports of less than savory practices by US News in these "rankings." The undergrads have been trying to get them abolished for a couple of decades now.

It seems that most of the ranking is based on "reputation," which Hopkins and MGH certainly have tons of...I've also heard clandestine reports of money exchanging hands for spots on the list, but I have no proof.

 

[billypilgrim37]

I remember our dean had a talk with us after we dropped about 3 or 4 slots one year. He explained the whole thing, and while I'm paraphrasing, I don't think I'm changing the tone much:

"Basically, Stanford was mad because in the equation they use, the research dollars they use are just the raw number. Stanford wants them to use research dollars per investigator. Because the of the way they do their accounting, this makes them look a lot better. So you notice Stanford went up 3 or 4 slots, and we went down 3 or 4 slots. They whine about this every year. The magazine has to make changes to their formula every year so schools will go up and down so people will buy the magazine. In a few years, somebody will whine again, and they will change it back to the way it was, and US News will act like it's some big improvement, and we'll go right back up. And we'll be about as good a school then as we are now as we were last year. Don't worry, you're still going to match in ophthalmology probably. Residency directors still rate us higher."

It was candid, and I thought one of the best insights into the way those rankings for med school work. They're political, the deans are in active arguments with the magazine and each other, and people follow the incentives.

 

[BobA]

Quote:
Originally Posted by OldPsychDoc
Until the NCAA finally gets off its ***** and institutes a true national playoff system, we'll never know for sure.

 

[OldPsychDoc]

Quote:
Originally Posted by OldPsychDoc
Until the NCAA finally gets off its ***** and institutes a true national playoff system, we'll never know for sure.

Way to dredge the depths of the archive... How long ago was that?
Was that in response to last year's rankings?
And here I was, doing such a good job of staying out of this thread.

And so now I'm compelled to make a comment about MGH residents trading their white coats for tattoos...

 

[BobA]

Way to dredge the depths of the archive... How long ago was that?
Was that in response to last year's rankings?
And here I was, doing such a good job of staying out of this thread.

And so now I'm compelled to make a comment about MGH residents trading their white coats for tattoos...

It was a while back, but it stuck!

 

[Ibid]

Hmm, well I am willing to mention the place where I'd most like a family member or friend to be...
http://lindnercenterofhope.org/

Hotel quality rooms, professional chef makes the food, and all the doctors I know working there actually do decent work, not some idiot throwing as much Xanax as the patient wants. The quality of the work there I've seen is much higher vs. several places on the US News list.

A few things that bother me about the linder centre:

Why is it out in the middle of nowhere?
Why are "hot pants" on the restricted items list?

Can't see Punk Rockers fitting in well here. Maybe the place is full of them and they just haven't found themselves in the publicity shots.

God I hate private sector providers. It's the prissy victorian value system that you have to fit into in these sorts of places even if the care is otherwise excellent.

 

[billypilgrim37]

Why is it out in the middle of nowhere?

In the states, just there truly are a few people that live between Philadelphia and Las Vegas. I promise. It's not all "the middle of nowhere." We even have our own baseball divisions!

 

[Ibid]

In the states, just there truly are a few people that live between Philadelphia and Las Vegas. I promise. It's not all "the middle of nowhere." We even have our own baseball divisions!

lol. I get that. In fact if I were to ever live in the US I would probably choose the midwest. I mean if its good enough for loni its good enough for me!

[YOUTUBE]http://www.youtube.com/watch?v=aUkpEtzdyt0[/YOUTUBE]

And if I had to support a baseball team it would have to be a National League one. Designated Hitter??? What is that all about? I mean what is so special about the pitcher....I don't get it. Seems like two leagues and two different games. The world series could just as well include cricket, just rotate the rules! I'd watch.....

I guess what I really meant is why is the Linden Centre up a tree lined drive? Its just that in my perverted mind psychiatric hospitals should be in the community they serve. Having taken part in a campaign to make sure one such facility was located in a red light district and attendant drug using community rather than "out of town".

I'm not a fan of the private sector. As whopper said about the linden centre its the sort of place we all might want our families treated but while some of us, me included can opt out of the state system for any sort medical care, then no one with any real influence is going to care about the state system because they know they don't have to rely on it. Of course you can't ban private hospitals but at the same time they have a pernicious effect that can't be denied. None of this is new to you I'm sure.

Oh well. There are worse things than nice hospitals for nice middle class people.

http://news.bbc.co.uk/1/hi/uk/8433285.stm

The back ground to the story above is that he was clearly in the midst of a manic episode at the time.