If you or a loved one has been diagnosed with a serious medical condition, finding the right care can be a matter of life and death.
To identify the leading medical institutions in the country for various conditions, ranging from cancer and heart disease to Parkinson’s disease and degenerative joint disease, Bottom Line/Health recently spoke with Carey Gold, a medical advocate who has provided expert guidance to individuals and families faced with serious medical diagnoses for the past 20 years.
Important: The “best institution for one patient may be different for someone else. In each category listed here, it’s crucial to consider the individual patient’s specific condition, medical history and personal needs.
Consider seeking care, or a second opinion, at one of these excellent institutions if your community lacks physicians who are specialized and experienced in your diagnosis, or if your diagnosis is in question.
Before traveling, obtain copies of all your pertinent medical records to take with you (or double-check to make sure that they have been forwarded). Also check with your insurance carrier about coverage and precertifications. If you are unable to travel, many of the institutions offer second opinions by mail and/or telephone.
Mr. Gold’s recommendations for four key medical specialties (institutions are listed alphabetically)…
Oncology*
Dana-Farber/Brigham and Women’s Cancer Center, Boston, 877-332-4294, www.dfbwcc.org. One of the outstanding teaching institutions of Harvard Medical School, Dana-Farber offers a roster of subspecialists covering common and rare types of cancer ranging from Hodgkin’s disease and lung cancer to skull-base tumors.
Johns Hopkins Medicine, The Sidney Kimmel Comprehensive Cancer Center, Baltimore, 410-955-5000, www.HopkinsMedicine.org/kimmel_cancer_center. While this is a large medical institution, the doctors work hard — though not always successfully — to humanize the patient experience. The pathology department is among the best in the US — some say the world — often being called on to offer highly valued second opinions on biopsies.
MD Anderson Cancer Center, The University of Texas, Houston, 877-632-6789, www.mdAnderson.org. As the largest US cancer center (based on number of patient beds), MD Anderson has many of the assets — and a few of the liabilities — that result from sheer size. Subspecialists in virtually all common and rare cancer types practice here.
Memorial Sloan-Kettering Cancer Center, New York City, 212-639-2000, www.mskcc.org. Memorial Sloan-Kettering has some of the country’s leading physicians in medical and surgical oncology, hematology and research. Most patients speak favorably of inpatient experiences at Memorial Sloan-Kettering, but outpatients may experience delays and long waiting times.
Other excellent options: Mayo Clinic Cancer Center, Rochester, Minnesota… Duke Cancer Institute, Durham, North Carolina… University of California, Los Angeles, Jonsson Comprehensive Cancer Center… University of Pittsburgh Cancer Institute.
Cardiology and Cardiothoracic Surgery
Cleveland Clinic, The Heart & Vascular Institute, Cleveland, 800-659-7822, www.MyClevelandClinic.org/heart. The Cleveland Clinic remains the top medical center in the US for diagnosing and treating both common cardiovascular conditions, as well as unusual or treatment-resistant disorders ranging from advanced heart failure to the rebuilding of heart valves.
Johns Hopkins Medicine, The Heart and Vascular Institute, Baltimore, 410-955-5000, www.HopkinsMedicine.org/heart_vascular_institute. Because of Johns Hopkins’ comprehensive medical capabilities, this institution can be an excellent choice for patients who have both cardiovascular conditions and other chronic diseases, such as diabetes and neurological disorders.
Mayo Clinic, Cardiovascular Diseases, Rochester, Minnesota, 507-284-2511, www.MayoClinic.org/cardiovascular-disease-rst. Because Mayo handles a wide range of cardiovascular conditions, patients here are likely to receive care that is superior to that offered at many regional and community medical centers.
St. Luke’s Episcopal Hospital, The Texas Heart Institute, Houston, 832-355-4011, www.TexasHeartInstitute.org. The Texas Heart Institute has been a pioneer in cardiothoracic surgery, with such accomplishments as performing one of the first heart transplants in the late 1960s. Interventional cardiology, which involves cardiac catheterization and cardiac ablation procedures, is also strong here.
Other excellent options: Massachusetts General Hospital Heart Center, Boston… New York–Presbyterian Hospital’s Vivian and Seymour Milstein Family Heart Center and Ronald O. Perelman Heart Institute, New York City… Stanford Heart Center, Palo Alto, California… Duke Heart Center, Durham, North Carolina.
Neurology and Neurosurgery
Johns Hopkins Medicine, Neurology and Neurosurgery, Baltimore, 410-955-5000, www.HopkinsMedicine.org/neurology_neurosurgery. Movement disorders, such as essential tremor and Parkinson’s disease, that may be termed treatment resistant at other institutions are regularly treated here with approaches that rely on current, emerging and experimental technologies — some unavailable elsewhere. Multiple sclerosis and treatment-resistant epilepsy are extensively studied at Johns Hopkins, advancing the level of care offered here.
Massachusetts General Hospital, Neurology and Neurosurgery, Boston, 617-726-5533, www.MassGeneral.org/neurology. Both the sheer number and quality of clinicians, along with their access to advanced technology, distinguish this exceptional hospital. Innovations in surgical treatment of difficult neurological cancers, such as tumors of the brain, as well as research into the basis of chronic progressive disease, including Alzheimer’s disease, are areas of expertise here.
New York–Presbyterian, The Neurological Institute and Neuroscience Center, New York City, 212-305-2500, www.nyp.org/services/neurology.html. New York–Presbyterian is surprisingly little-known outside Manhattan, but its staff includes some of the brightest and most influential minds in neurology and neurosurgery. New York–Presbyterian excels at basic brain research, as well as focused treatments for movement disorders, such as Parkinson’s disease, and symptom control for Alzheimer’s disease.
University of California, San Francisco, Neurological Disorders, San Francisco, 888-689-8273, www.ucsfHealth.org/conditions/neurological_disorders. Less than one-third the size (based on number of patient beds) of New York–Presbyterian Hospital, UCSF makes up in innovation for what it may lack in size. For example, its Spine Center offers 48-hour case reviews for spinal tumors, allowing for faster, time-sensitive treatments, as well as novel neurosurgical techniques to improve outcomes. Its Memory and Aging Center focuses on all neurological conditions, from Alzheimer’s disease to the far less well-known Pick’s disease, that lead to dementia.
Other excellent options: Ken & Ruth Davee Department of Neurology at Northwestern University’s Feinberg School of Medicine, Chicago… departments of neurology and neurosurgery at Duke University, Durham, North Carolina… Mayo Clinic, Rochester, Minnesota… University of Pittsburgh.
Orthopedic Surgery
Cleveland Clinic, The Orthopedic & Rheumatologic Institute, Cleveland, 800-223-2273, www.MyClevelandClinic.org/ortho. The Cleveland Clinic has merged its orthopedics and rheumatology departments with centers focusing on rehabilitation. The resulting single institute addresses the full spectrum of orthopedic and rheumatologic conditions ranging from degenerative joint disease to reconstructive limb surgery.
Hospital for Special Surgery, New York City, 212-606-1000, www.hss.edu. The Hospital for Special Surgery has earned a stellar reputation for consistent excellence in all aspects of orthopedics, including joint replacement, foot and ankle surgery and complex fractures, as well as rheumatology and related treatments for such conditions as rheumatoid arthritis. Its outstanding clinicians offer advanced procedures and technologies, some of which were invented here, such as the total knee replacement now used worldwide.
Johns Hopkins Medicine, Orthopedic Surgery, Baltimore, 410-955-3870, www.HopkinsOrtho.org. While Johns Hopkins’ orthopedic surgery department offers the full range of therapies and interventions for all orthopedic issues, its Center for Musculoskeletal Research has made important contributions in the areas of biomechanics (for prosthetics and joint replacements, for example)… musculoskeletal cancer (for such conditions as soft tissue and bone sarcomas)… and nerve regeneration to address the needs of acute spinal cord injury patients.
Mayo Clinic, Orthopedic Surgery, Rochester, Minnesota, 507-284-2511, www.MayoClinic.org/orthopedic-surgery. Mayo is well-known for its huge database that its doctors use to track treatment outcomes for joint replacements. This careful analysis benefits patients by helping them develop realistic expectations of recommended procedures.
Other excellent options: Washington University Orthopedics in the Center for Advanced Medicine at Barnes–Jewish Hospital, St. Louis… departments of orthopedic surgery at Duke University, Durham, North Carolina… The University of Iowa, Iowa City… University of Pittsburgh… Massachusetts General Hospital, Boston.
