The Best Hospitals
An exclusive survey of more than 1,000 leading doctors yields 43 sources of top medical care
RESOURCES
Federation for Children with Special Needs, (617) 482-2915. What to ask before surgery, and answers to other parental concerns. Parent Network, (301) 654-6549. Provides referrals to advocacy groups and other parents of sick children. Self-help. Most children's hospitals have information centers that are open to the public.
PSYCHIATRY McLEAN HOSPITAL BELMONT, MASS. / 22 pct.
MENNINGER CLINIC TOPEKA, KAN. / 18 pct.
UCLA MEDICAL CENTER LOS ANGELES / 15 pct.
MASSACHUSETTS GENERAL HOSPITAL BOSTON / 14 pct.
SHEPPARD AND ENOCH PRATT HOSPITAL BALTIMORE / 13 pct.
INSTITUTE OF LIVING HARTFORD, CONN. / 12 pct.
MAYO CLINIC ROCHESTER, MINN. / 11 pct.
COLUMBIA-PRESBYTERIAN MEDICAL CENTER NEW YORK / 10 pct.
NEW YORK HOSPITAL-CORNELL MEDICAL CENTER NEW YORK / 10 pct.
YALE-NEW HAVEN HOSPITAL / 9 pct.
The current fashion is to think of mental illness as a biological disorder, and therefore one that responds to drugs. Medication has its place, but mending the mind is not like mending the body. It takes a vastly more human touch, and good hospitals increasingly emphasize a proper balance between drugs and psychotherapy.
EXPERT'S VIEW
STEVEN MIRIN, psychiatrist-in-chief, McLean Hospital: The most important thing to look for is a continuum of care that extends beyond the patient's hospital stay. Are there day and evening programs for ex-patients? Or outpatient psychotherapy from the same people who treated you in the hospital? Is partial hospitalization available--nights only, for example, if that makes sense? When patients are discharged, they should get more than a phone number. They should feel that the hospital will be there for them when and if they need it. I also put a lot of stock on a team approach that brings doctors, psychologists, nurses and social workers together to both work with patients and assess their progress.
RESOURCES
National Alliance for the Mentally Ill, (800) 950-6264. Over 1,000 chapters nationwide. Information on local facilities, insurance coverage, legal help and support groups. National Association of Private Psychiatric Hospitals, (202) 393-6700. List of facilities in your area and special programs offered, such as alcohol treatment centers.
REHABILITATION
REHABILITATION INSTITUTE OF CHICAGO / 51 pct.
UNIVERSITY OF WASHINGTON MEDICAL CENTER SEATTLE / 46 pct.
MAYO CLINIC ROCHESTER, MINN. / 31 pct.
CRAIG HOSPITAL ENGLEWOOD, COLO. / 31 pct.
THE INSTITUTE FOR REHABILITATION AND RESEARCH (TIRR) HOUSTON / 26 pct.
RUSK INSTITUTE FOR REHABILITATION MEDICINE (NEW YORK UNIVERSITY MEDICAL CENTER) / 26 pct.
RANCHO LOS AMIGOS MEDICAL CENTER DOWNEY, CALIF. / 18 pct.
Rehabilitation units treat people who are disabled because of head and spinal injuries, strokes, amputations and arthritis, as well as people who have been injured in falls or sports. Patients are encouraged to leave the hospital as soon as possible and to strive for independence while undergoing outpatient rehabilitation.
EXPERT'S VIEW
HENRY BETTS, chief executive officer and medical director, Rehabilitation Institute of Chicago: Rehabilitation patients go through a lot of psychological stress. They often have had dire things happen to them, and they may have to learn to adapt to some remaining disability even after rehabilitation. Choosing a hospital with an environment that will motivate them to get through the process is particularly important. They should tour a hospital first to get a sense of whether it seems positive and dynamic, whether the staff is energetic and upbeat. The facility itself is far less important than the individuals who run it. Patients should also check that full-time attending physicians are in charge of the patients and the teams, not doctors who come in in the morning and aren't around the rest of the day.
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