Virginia Hospitals Rank High Nationally (They Are Not the Ones You Would Assume!)

Sentara Halifax Regional Hospital, South Boston

By Dick Hall-Sizemore

In a new national ranking of hospitals, two Virginia hospitals are included in the Top 20 Hospitals in the country. Furthermore, the Commonwealth’s two major teaching hospitals are in the list of the 50 best teaching hospitals. Finally, one Virginia hospital was one of the 100 best safety net hospitals.

The two Virginia hospitals in the top 20 (which included teaching hospitals) probably would come as a surprise to most readers. They are Norton Community Hospital in Wise County (ranked 11) and Sentara Halifax Regional Hospital in South Boston (ranked 14). In the teaching hospital category, UVa Medical Center was ranked 18 and Medical College of Virginia Hospitals was ranked 39. The Virginia hospital recognized as being among the top safety net hospitals in the country was the Lonesome Pine Hospital in Big Stone Gap (ranked 29).

The ranking has been produced by the Washington Monthly.  This more-than-50-year-old journal specializes in government and public affairs and is published bi-monthly (despite its name) in Washington, D.C.

The Washington Monthly chose to rank hospitals in a decidedly different manner than the more well-known ranking by U.S. News. The Monthly’s editor explains the different approaches this way:

“[The U.S. News] elevate[s] … prestigious institutions that primarily cater to the elite at the expense of those that serve the rest of us. Their hospital rankings focus almost exclusively on expensive specialized treatments and surgeries, like organ transplants. Meanwhile, they ignore the bulk of what most hospitals do, which is treating patients for more routine ailments, like broken bones and pneumonia. And they rely heavily on a survey of medical specialists, effectively boosting the ratings of hospitals with high national brand-name recognition, while downgrading or ignoring others that score better on measures of cost and value.”

In contrast to this approach to rankings, the Monthly compiled a large database to use in establishing its rankings. Working with a nonprofit healthcare think tank, the Lown Institute, they evaluated 3,362 hospitals in the country in an effort that took two years to complete. They used data in the following major categories and subcategories to compile their rankings:

I. Quality of Care (50 percent)

  1. Clinical outcomes
  2. Patient safety
  3. Patient satisfaction

II. Civic leadership (30 percent)

  1. Community benefit—includes charity care, subsidized health services (free clinics, etc.), contributions to community organizations
  2. Inclusivity—degree to which a hospital’s patient population reflects the demographics of its catchment area
  3. Pay equity—how much it pays its senior executives compared to its frontline workers.

III.    Value of care (Avoidance of overuse of medical procedures (20 percent)

More details, along with a lengthy explanation of the study’s methodology, can be found here and here.

The resulting rankings produced by this approach differ markedly from those in U.S. News rankings. For example, one will not find the Mayo Clinic or Massachusetts General in the Monthly’s lists. It is not that the Monthly editors feel those hospitals do not provide excellent medical care. In fact, they note, “The Mayo Clinic is world-renowned, and for good reason.” However, the Mayo Clinic may score very high in “quality of care”, but it “does abysmally on civic leadership and value of care … The Mayo Clinic is a great place to get a major surgery—as long as you aren’t poor, have excellent insurance, and actually need the surgery.”

The Monthly editors summarize its rankings this way: “Our top institutions are not at the cutting edge of advanced medical research, and they may not be at the forefront of experimental surgical techniques. … They are doing a great job, simultaneously, of treating a diverse patient population representative of their communities, healing those patients, and not overtreating them.”

The top-ranked hospital in the Monthly’s listing was the JPS Health Network.  (No, I had never heard of it, either.) It is a large, public, safety net hospital with more than 500 beds and 40 outpatient clinics in Ft. Worth, Texas. It was ranked best overall, as well as the best major teaching hospital and best safety net hospital. In fact, the three top-ranked teaching hospitals were all in Texas, as were five of the 20 overall best.

I should provide some background on the Washington Monthly for those unfamiliar with it, so as to establish its credibility. The publication was founded by Charles Peters in 1969. Peters is a West Virginia lawyer and former state lawmaker who got involved in John F. Kennedy’s 1960 presidential campaign. He then joined Kennedy’s administration as a top assistant to Sargent Shriver in setting up the Peace Corps.

The animating spirit of the Monthly is sort of a practical progressivism. One label that it had was neoliberalism. That term has come to mean different things to different people  Here is how Peters described his approach in 1982:

“We are liberals who took [a look at liberalism] and decided to retain our goals but to abandon some of our prejudices. We still believe in liberty and justice and a fair chance for all, in mercy for the afflicted and help for the down and out. But we no longer automatically favor unions and big government or oppose the military and big business. Indeed, in our search for solutions that work, we have come to distrust all automatic responses, liberal or conservative.”

The magazine has consistently upheld and encouraged the principles of entrepreneurship and community service. It has said that there is an important role for government—to protect society from the excesses and occasional rapacious behavior of private business and to help the weak and vulnerable. Its emphasis is on programs and approaches that work, rather than on those that primarily suit a specific agenda. In fact, there are no sacred cows for the Monthly. The writers are not content to just criticize, however; they offer solutions, as well.

The Monthly has been a training ground for many nationally known journalists and authors, such as James Fallows, David Ignatius, Jon Meacham, and Gregg Easterbrook.

Although now retired from the Monthly, Peters is still active. In his latest book, published in 2017, he took the Democratic Party to task for having lost its way. As one reviewer explained, “Democrats, Washington and too much of the country, he argues, have drifted from the sense of shared purpose that lifted America out of the Depression, created the will to win World War II and fostered the rise of a more egalitarian, if still inequitable, society.” Peters argues that the party’s traditional voters “can be won back if Democrats are again seen as the party of the common man rather than the liberal professional class.”

In each issue of the Monthly, there is likely to be something to appeal to a variety of political outlooks. For example, Jim Sherlock would probably feel a kinship with the article in the current issue that takes aim at large hospitals that use their nonprofit status to amass monopolistic power.

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16 responses to “Virginia Hospitals Rank High Nationally (They Are Not the Ones You Would Assume!)

  1. Fascinating. We’re used to CMS and US News & WR but here’s a group that has come up with their own criteria .

    Very Cool! And very reminiscent of BR a while back before the culture wars….

    thank you!

  2. I hate to be the bearer of negativity, but if Norton Community is in the top 20, God have mercy on our country. I live here, and one of my very close family members has suffered catastrophically bad health for several years now. During that time, we have experienced a litany medical mistakes, misdiagnoses, and so many non-essential tests that I’m sure we’re adding more than our fair share to the significant rise in the cost of health care in this country. To be fair, not all of this was directly related to Norton Community, but some of it was. Also, to be fair, it seems that doctors in our area are so overwhelmed by “pillbillies” (folks who frequent doctor’s offices for prescriptions to feed their drug habits) that so of these doctors approach most patients as if they fit this description. This is especially so in instances when the doctors can’t immediately diagnose the problem. In our family we have adopted a mantra- better to die on route to a more competent health care facility than to allow the locals to kill you.

    • Ah … an injection of reality born of first hand observation into a progressive hallucination.

      The pillbilly point is well taken and under reported. Here’s an article from last December …

      https://www.nbcwashington.com/news/local/feds-doctor-illegally-prescribed-more-than-50000-pills/2190152/

      From Wikipedia … “From 2006–2012, Norton had the highest rate of prescriptions for opioid pills in the United States. On average, 306 opioid pills per person (every adult and child), per year, were prescribed in Norton.”

      You don’t hear a lot about this from our governor or his minions in Richmond. I guess an opioid epidemic among poor white Virginians doesn’t fit Northam’s virtue signaling agenda.

  3. James Wyatt Whitehead V

    I hope the soon new Warren Memorial Hospital in Front Royal can join this list. The old hospital was a place to check in but not check out.

  4. It’s always interesting when someone uses criteria other than the obvious when they evaluate, and especially when they provide their reasons and justifications for results that are counterintuitive.

    Since the last two categories involve the community, it may bias the results if these are the only hospitals in a 2-hour drive.

  5. been reading this:

    ” Coronavirus death rates at some public hospitals in NYC are nearly FOUR TIMES higher than at the best private facilities in the city, report reveals

    The death rate for coronavirus patients at NYU Langone’s flagship hospital in Manhattan is about 11%, according to a New York Times investigation

    At Bellevue Hospital Center, at the same intersection, 22% of patients have died

    Some outer-boroough hospitals have COVID-19 death rates over 40% “

  6. It’s fine to track the prestige of hospitals, as US News does, and there’s something to be said for it. But, like Washington Monthly, I’m more interested in the institutions that excel at doing the yeoman’s work of serving the general population. Dick, I’m glad you brought attention to the unheralded hospitals that do such a good job.

    I’m also struck by a phrase used by Charles Peters — the “search for solutions that work.” I have been turning over a very similar phrase in my head the past few months: “What works?” I hope that can become an animating theme of Bacon’s Rebellion — finding out what works. I hope you will pursue it.

  7. “[The U.S. News] elevate[s] … prestigious institutions that primarily cater to the elite at the expense of those that serve the rest of us.”

    Claptrap. Pure garbage. Walk into the ER at Fairfax Inova on any night and tell me that only the elite that are being treated there. Visit somebody who has been admitted to Johns Hopkins and tell me that all the patients on the ward are members of the elite. Go to Sloane Kettering in New York and visit somebody who has just undergone cancer surgery and tell me that the majority of the patients you meet there are members of the elite.

    I’ve done all three. If the patients and the patients’ families I’ve met in those institutions are all millionaires they are doing a hell of an acting job.

    “Inclusivity—degree to which a hospital’s patient population reflects the demographics of its catchment area”

    Well, given that Norton County is 92% white I guess that’s a pretty easy mark to make.

    “Pay equity—how much it pays its senior executives compared to its frontline workers.”

    Yes, if you get into an accident or find yourself seriously ill make sure to use this critical metric in choosing a hospital. Just be sure to pick out your casket first.

    Here’s what every doctor I know in Northern Virginia has told me (off the record) … if you find yourself seriously ill or hurt in NoVa and you wake up in a hospital not named Fairfax Inova then Uber, drive, run, walk or crawl to Fairfax Inova.

  8. “Claptrap. Pure garbage. Walk into the ER at Fairfax Inova on any night and tell me that only the elite that are being treated there.”

    Bingo. Plus add Georgetown University hospital, a fine hospital serving all peoples where I underwent a procedure last week.

    Should you want to check our the origins of the claptrap, pure garbage, check out the political ideological orientation of Washington Monthly easily found on their website.

  9. “Claptrap. Pure garbage. Walk into the ER at Fairfax Inova on any night and tell me that only the elite that are being treated there.”

    Bingo. Plus add Georgetown University hospital where I underwent a procedure last week, in addition to the Washington Hospital Center across town where I was pre-checked for that procedure the week before.

    Should you want to find the origins of the claptrap, pure garbage, check out the political ideological orientation of Washington Monthly easily found on their website.

    • I think I was pretty clear as to the Washington Monthly’s ideological orientation. So, you would reject something as “claptrap” and “pure garbage” solely on the basis of the ideological orientation of the source? That is akin to Larry rejecting anything outright that is linked to the Koch brothers. I think Charles Peters’ approach of distrusting any automatic response, liberal or conservative, was a wise one.

      No one said that Georgetown or Washington Hospital Center or INOVA were not good hospitals; they just don’t rank among the best based on the methodology use in this study.

      Any ranking is based on specific criteria and the assumptions behind the data. Instead of dismissing something as garbage just because you do not like the results, you should critique the assumptions. Then your response would be more credible.

  10. Well I do pay attention to source but I usually take a heavy/skeptic trust but verify approach…. and I compare to other sources and information.

    This particular one – is kind of at odds not only with USN&WR but Medicare ratings also… so I’m not really giving a a lot of credence but it still has some validity – it’s not crap/garbage.

    In some respects, most folks are going to go to their local community hospital unless it has a really bad reputation… and that’s especially true if you’re flat on your back in an ambulance dying.. “take me to the nearest”.

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