Top Docs 2008 Part I: Who to See

The case for community hospitals
Why the beyond-city-limits lifesavers may be right for you.


Living among some of the nation’s most high-powered teaching hospitals comes with an odd side effect: shortsightedness. While patients in other parts of the country choose an academic health center less than 20 percent of the time for short-term hospital admissions, in Massachusetts we go for the name brand 50 percent of the time—even when we don’t need it.

Research has shown that for routine procedures such as appendectomies and pneumonia treatment, the care is just as good at community hospitals. Take childbirth: A 2003 analysis by the state Division of Health Care Finance and Policy concluded that the outcomes of low-risk vaginal deliveries at community hospitals were equivalent to those at their academic counterparts. The kicker? They’re also half the price.

The community hospitals offer other, less tangible benefits. Whereas your gallbladder removal may be a mere blip on the radar of a bustling teaching hospital like Mass General, it’s likely to command more attention at a smaller, less crowded facility like Winchester Hospital or North Shore Medical Center. According to a recent Consumers’ Checkbook survey, the Hub’s community hospitals largely outperform the teaching hospitals in terms of staffers’ willingness to listen and overall friendliness.

Certainly you shouldn’t ignore academic health centers for the highly specialized treatments in which they excel—the Brigham for kidney disease, say, or Mass General for heart surgery. But think of it this way: In an accident, you go to the ER nearest to you. You could do worse than to follow the same approach for basic medical care. “For most general procedures, you should choose the place closest to your house,” says Beth Israel’s Paul Levy, who’s, ahem, head of one of the top teaching hospitals in the country.