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School of Medicine: Message From the Dean

February 2014 Archives

February 7, 2014

U.S. News & World Report Ranking of Best Hospitals: A Flawed Process

For years, the U.S. News & World Report (USNWR) magazine has used a complicated formula for ranking hospitals and health systems. Some of their measures are valid comparisons and include mortality rates, quality metrics and structural factors. One of the variables USNWR has used is a ‘reputational score’ that has been traditionally based on a random survey of U.S. physicians.

However, as you may know, this year USNWR has changed its approach for deriving the reputational score. In addition to surveying 200 board-certified specialists for their opinion on hospital quality, they will also survey 50,000 board-certified specialists who are registered with Doximity, an online professional network for physicians. Only physicians registered with Doximity will have access to the new survey.

This non-random approach by U.S. News & World Report has triggered a response from some to encourage loyal physician supporters, such as medical school alumni, to sign up for Doximity. I do not condone trying to influence alumni to register for Doximity. This is merely a subtle effort to persuade physicians to vote favorably for their alma mater, and it has the potential to corrupt the survey results.

The Best Hospitals ranking has long been criticized for relying on the reputational score, rather than on important quality measures. The USNWR has tried to address that this year by increasing the weight of the patient safety score. Even so, reputation factors heavily into the final formula – more than double the weight of patient safety.

Even flawed rankings have influence, but I will not participate in further degrading what should be an objective evaluation of a hospital’s quality. I advise our alumni who wish to participate in the survey to follow their conscience in communicating their opinions.

The above Feb. 7 blog post was edited to clarify that USNWR will use a pair of surveys to derive the reputational score component of its annual Best Hospitals rankings.

Jerome F. Strauss, III, M.D., Ph.D.
Dean, VCU School of Medicine
Executive Vice President for Medical Affairs, VCU Health System

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