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If someone asked you to name the best hospitals in the United States, admittedly a ridiculous request, many people would start with the famous research and teaching hospitals. Perhaps Massachusetts General and Brigham and Women’s in Boston; Stanford and UCLA in California; and the Mayo Clinic and Johns Hopkins. If you are a health professional, you get these names from seeing them repeatedly in medical journal articles and knowing that they have great prestige around the world. If you are a US patient, you might get them from the widely circulated ratings published by the magazine US News & World Report, which since 1990 has annually ranked the “best hospitals” in America.<br>The most recent of the magazine’s rankings,1 released in July, included all the above institutions on its national “honour roll” of the 17 best hospitals. They also cited such mainstays as the Cleveland Clinic, Mount Sinai, Duke, Vanderbilt, and the hospitals of the Universities of Pennsylvania, Michigan, and Washington. No big surprises there.<br>So it was quite a shock to pick up the paper … <br>