New Rankings of the Best US Hospitals

“Medscape Today”
from WebMD — a health information Web site for patients
Bill Hendrick

July 20, 2009 — U.S. News & World Report has released its annual “honor roll” of America’s best medical centers, and Johns Hopkins Hospital in Baltimore is at the top of the list for the 19th straight year.

The top 21 hospitals all earned high scores in at least six of 16 specialties, ranging from cancer and geriatric care to orthopaedics and urology.

Scores were based on both objective measures — such as mortality rates, patient safety, and other care-related factors — and subjective measures, such as reputation.

“I think these rankings are extremely meaningful to an extremely small number of patients, relatively speaking, who represent a very small piece of the patient population but whose need for a very high quality of care is extreme,” Avery Comarow, the U.S. News & World Report statistician who compiled and analyzed the data, tells WebMD. “These rankings are not at all intended for those who need relatively routine procedures.”

The ‘Best Hospitals’ for 2009

Hospitals are listed below by total points. Here are the 21 hospitals that made the magazine’s honor roll (two are tied for 10th place):

1. Johns Hopkins Hospital, Baltimore
2. Mayo Clinic, Rochester, Minn.
3. Ronald Reagan UCLA Medical Center, Los Angeles
4. Cleveland Clinic
5. Massachusetts General, Boston
6. New York-Presbyterian University Hospital of Columbia and Cornell
7. University of California-San Francisco Medical Center
8. Hospital of the University of Pennsylvania, Philadelphia
9. Barnes-Jewish Hospital/Washington University, St. Louis
10. Brigham and Women’s Hospital, Boston
11. Duke University Medical Center, Durham, N.C.
12. University of Washington Medical Center, Seattle
13. UPMC-University of Pittsburgh Medical Center
14. University of Michigan Hospitals and Health Centers, Ann Arbor
15. Stanford Hospital and Clinics, Stanford, Calif.
16. Vanderbilt University Medical Center, Nashville, Tenn.
17. New York University Medical Center
18. Yale-New Haven Hospital, New Haven, Conn.
19. Mount Sinai Medical Center, New York
20. Methodist Hospital, Houston
21. Ohio State University Hospital, Columbus

Top Hospitals by Specialty

Here are the No. 1 hospitals in each specialty, according to U.S. News and World Report:

* Cancer: M.D. Anderson Center, University of Texas, Houston
* Diabetes and endocrine disorders: Mayo Clinic, Rochester, Minn.
* Digestive disorders: Mayo Clinic
* Ear, nose, throat: Johns Hopkins Hospital, Baltimore
* Geriatric care: Ronald Reagan UCLA Medical Center, Los Angeles
* Gynecology: Brigham and Women’s Hospital, Boston
* Heart and heart surgery: Cleveland Clinic
* Kidney disorders: Brigham and Women’s Hospital
* Neurology and neurosurgery: Mayo Clinic
* Ophthalmology: Bascon Palmer Eye Institute, University of Miami
* Orthopaedics: Mayo Clinic
* Psychiatry: Massachusetts General, Boston
* Rehabilitation: Rehabilitation Institute of Chicago
* Respiratory disorders: National Jewish Hospital, Denver
* Rheumatology: Johns Hopkins Hospital
* Urology: Johns Hopkins Hospital

Best Hospital Lists: How Useful Are They?

American Hospital Association Senior Vice President Rick Wade tells WebMD that hospitals that made the honor roll and those that were ranked in the 16 specialty groups were generally teaching hospitals “with the most cutting-edge research and technology.”

Wade says that hospitals that didn’t score enough points to make a list should be avoided.

“You can investigate on your own,” he says. “For people who don’t live near a Hopkins, there are many community hospitals that have very good records.”

Arthur Caplan, PhD, director of the Center for Bioethics at the University of Pennsylvania, tells WebMD that lists for most people “are almost useless. The only data of value is on specific doctors, treating cases analogous to your own.”

Rankings “are a quality perspective from 75,000 feet when what the prospective patient needs is precision at ground level about particular doctors doing particular things in situations close to the one the patient has,” Caplan says.

SOURCES:

News release, U.S. News & World Report.

U.S. News & World Report: “America’s Best Hospitals.”

Avery Comarow, health rankings editor, U.S. News & World Report.

Arthur Caplan, PhD, director, Center for Bioethics, University of Pennsylvania.

Rick Wade, senior vice president, American Hospital Association.

Building bridges

Metabolism related disorders can really sneak up on you with no warning. Actually almost any disease can, the question is what you can do to prevent it or to manage it. There are many articles around how to prevent various disorders but, really, there are so many of them you don’t even want to know. Plus, it can create an anxiety to think about that. Before attending Chinese medicine school I had no idea about the variety of diseases, and at some point in the western medicine section of my education, particularly pathology, I even freaked out looking at all these scary photos. The bottom line is you never know what your genetic blueprint is exactly going to produce, what new flu is about to emerge, and which next food choice would be proved dangerous. I’m not even mentioning numerous prescription and over-the-counter drugs with various issues. However the reality, there is not so much you can do to control external environment, even by washing your hands and buying organic. Don’t take me wrong, please by all means take precautions – watch your diet, visit your doctor for regular checkups, follow the news on health and nutrition. And whatever happens – stay calm. It is your internal environment you can control to make decisions from the balanced and educated mood.

Many of us experienced scary moments when dreadful news are delivered to us and loved ones about the disease that has no cure and at the best can be managed with medications or nothing at all – just wait and see. Probably the scariest of all is placing your fate to the hands of your doctor while “googling” for hours, asking friends, pacing back and forth, screaming at heavens, feeling powerless. Then you have to make a decision – either disease has you – or – you have been diagnosed with the disease. I would strongly advocate for the second choice simply because it leaves you with the power to choose what to do from the place of your own unique constitution – on all levels. The disease never manifests exactly the same for everyone, and never can be treated exactly the same. The limitation here is what you already know vs what you don’t know yet.

The rule of thumb: never give up. The miraculous cures are recorded over and over again – while you have a hope you have a chance. Don’t believe a doctor who takes hope away from you, it is your health and your body – you have the right to press for answers, demand explanations, copies of your medical records, and consultations about other choices. Turn your attention to alternative medicine. A good medical doctor never blindly dismisses an alternative option – he will study it and give you his/her opinion. Some doctors don’t have time to educate themselves about other kinds of medicine and you can encourage them to do so. More and more medical doctors embrace acupuncture, nutrition, homeopathy, and other modalities in their practice or in collaboration with other practitioners. It all comes down to what patient will benefit from the most, and the safety of therapies integration. It is equally important to provide your alternative medicine doctor with copies of your lab results, especially if you are looking to benefit from herbal medicine or nutrition care.

We are lucky to live now – the age of technology. Modern and ancient medicines are dancing together building bridges between top-notch machines and dried herb decoctions, brain surgeries and homeopathy. Using it all you can expand your choices and the most important – build a well-defined plan to heal yourself using the expertise of doctors and specialists you trust.

So I quit smoking. Now what?

Quitting smoking is one of the best decisions people can make in their life. In my practice I use hypnosis to help people quitting and it is always effective when there is a commitment not only to quit but to achieve goals in various areas of your life that are incompatible with smoking. It is helpful to write your goals on a piece of paper and post it on your bathroom wall, or in your office where you will always see it. After you quit it is important to track
your progress so you can feel getting closer to some of these goals. This way you are encouraged to keep on track and find even more resources to help you achieving your goals.

As any recreational drugs or alcohol, smoking cigarettes harms the liver, digestive system, cardiovascular system and many other body functions. From the Chinese medical point of view nicotine is a very hot substance which enters smoker’s blood through the lungs and dries up capillaries, veins, and arteries.

After you quit smoking it is preferable to maintain the positive attitude towards new healthier life ahead of you. Time after time I see people who quit and have absolutely no withdrawal symptoms and no body weight changes. It proves the point that mind and body successfully work together when you make a strong decision to improve your health. However, because smoking affects body functions, gaining extra weight afterwards can happen for some people – and the good news that there is something you can do about it besides maintaining your exercise routine and counting calories.

There are a few tips of how to deal with the quitting smoking aftermath:

1. Every morning immediately after waking up drink a glass of water (room temperature) with squeezed 1/2 lemon. It will help to detoxify the liver. It will make your liver happy, as according to Chinese medicine “liver likes sour taste”, and it will gladly perform its daily functions.

2. Consider gentle intestinal and/or liver cleanse. It might help you with potential food cravings and shedding these seven pounds of waste stored in intestines. Consult with your doctor or alternative medicine practitioner first.

3. Check out in your area for the ear acupuncture detoxification treatments (NADA). It involves relaxing in the chair with hair-thin acupuncture needles inserted in specific points on your ears. It is one of the best and proven techniques to detoxify and rebuild your body after years of smoking or any drug / alcohol addiction. It is helping your liver, lungs, kidneys, heart, and nervous system to recover. And yes, it is painless – needles are tiny.

4. Hang out with non-smoking friends more often.

5. Start juicing! Have a fresh squeezed juice instead of a snack.

6. Talk to your nutritionist or alternative medicine practitioner about amino acids. It might be beneficial for you to take some specific amino acid supplements for a period of time.

There are so much more in life you can do as a non-smoker with your lungs full of fresh clean air, with your hair and clothes smelling fresh, and free to control your own health. And the best news is that in only a few years your body will complete restoring all the systems affected by that old habit.

So… please sit down, take a deep breath and make a decision to live.

Are you training for a Sumo Wrestling Competition?

As strange as it sounds some athletes keep a special diet to have their metabolism low – and to get fat! I’m talking about Rikishis – the official term for sumo wrestlers. The Sumo wrestling is a traditional Japanese contact sport when two almost naked and incredibly fat guys trying to overthrow each other or to push each other off the court. Of course the competitors should be very strong and stable, so they exercise daily; however one of the most important components is keeping the weight extra heavy. The average rikishi weight starts from 400 lbs –and it is considered to be lightweight…

Let’s look at your typical diet/lifestyle plan just in case you decide to become a rikishi:

1. Skip breakfast. You need to keep your metabolism low to avoid losing weight.
2. Definitely overeat at night to store the extra energy as fat.
3. Eat only twice a day and eat a LOT! Get extra big servings of high fat content food.
4. Sleep at least four hours immediately after each meal.
5. Make sure you eat close to 20K calories a day.
6. Exercise on an empty stomach to keep your metabolism even lower.
7. Drink lots and lots of beer. Alcohol increases cortisol levels which creates a layer of fat around the belly. This way your abdominal area will become the “beer belly”!
8. Eat socially as much as you can. Research shows that people who eat socially consume at least thirty percent more calories and eat almost twice more.

Sadly enough this plan closely resembles the lifestyle of an average American. Except that the exercise is often out of question in our overloaded daily routine.

So, next time you decide to skip breakfast or overeat at night- think: do you really want to pursue a rikishi career? As for the most people the named above plan is the sure way to accumulate extra fat extra fast. So watch what and how you are eating; you might just turn into a (really weak) sumo wrestler!

To Be Present

What does it mean to be present? Many self-development books, TV shows, and people are talking about it, however how is it applicable to the healthy metabolism conversation? As we are constantly making choices about how to live our lives, our body is making choices how to sustain this life by providing constant chemical reactions in order to create biologically essential components and to break down organic matter. So it is all about choices we make, because our mind and body are inseparable and always in synch. If they get out of synch we might develop physical or emotional illness.
Therefore our choices about everyday life directly affect how our body functions process everything we feed it with – whether it is a physical substance or the mental thought. Staying consciously present means paying attention to every choice we are facing and deciding on the action to take about this choice. Often in life we are acting out of habit choosing the path of less resistance – eating this doughnut, drinking this extra cup of coffee, gossiping about the neighbor, obsessing about that conversation… It is important to realize that all of it is a material for our body to process and make a decision what to do with it. Our body is smart, it will do the best it can with what it got, however way too often we supply it with the material difficult to digest. And we do it because way too often we run on the autopilot not paying attention on the signals our body is constantly sending us.
Sometimes right before doing something I ask myself “Is it going to give me pleasure or happiness?” And if the answer is “pleasure” I think twice about doing it. Staying present, listening to my body, evaluating my surrounding and my situation. How this choice will benefit me as a person, how it will affect my life? I might choose” pleasure” after all, but it will be my conscious choice at that specific time and space.

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