Although the Duke University Medical Center is consistently ranked as one of the nation’s top 10 hospitals, administrators believe the rankings should be viewed with some reservations.
Despite their widespread use, the methodology of lists and rankings have long been a subject of debate. In July, the U.S. News and World Report ranked Duke as ninth in the country in the 2011-2012 “Best Hospitals Honor Roll” out of nearly 5,000 hospitals. The evaluations were based on a reputational survey and hard data, such as death rates and nurse staffing.
Because the rankings can be subjective due to their reliance on perceived excellence, Dr. Victor Dzau, chancellor for health affairs and president and CEO of the Duke University Health System, said they must be taken “with a grain of salt.”
“The [U.S. News] rankings are one of many ranking tools used in the U.S.,” Dzau said. “Therefore, while we are always proud to be included among the leading institutions in various rankings... none of them are an exact science that can effectively conduct apples-to-apples comparisons of institutions that are large and complex.”
The U.S. News rankings primarily consider a hospital’s structure, way of delivering care and tangible results. Although Dzau acknowledges that the rankings look at objective metrics, he believes they would be more comprehensive if they placed additional weight on cost and access—factors that are especially important to patients as well as medical professionals.
Dzau added that the lists do reflect reality—to an extent.
“While I don’t think this represents the deepest possible dive into objective measures, it is interesting that their rankings each year seem to line up with what most experts would consider to be the country’s leading academic medical centers,” Dzau said.
DUMC is not expected to make significant changes based on the rankings.
Dean of the School of Nursing Catherine Gilliss acknowledged that some people believe institutions may manipulate programs in order to gain a higher ranking, but said this fear is unfounded.
“Few academic leaders would be inclined to make major changes in the operation of their programs to tinker with the rankings,” she said. “Most schools that are doing well continue to maintain a stable ranking.”
Christopher O’Connor, director of the Duke Heart Center, wrote in an email Sunday that the center was able to clinch the seventh spot for “Cardiology and Heart Surgery” because of its high standards as opposed to direct attempts to raise their ranking.
“Duke cardiology distinguishes itself from other programs by its commitment to high-quality patient care, innovative clinical programs, patient satisfaction, clinical research and recruiting and retaining the best and brightest faculty and staff,” he said.
DUMC’s high ranking reflects well on the University as a whole, some administrators said.
Michael Schoenfeld, vice president of public affairs and government relations, said Duke’s excellence in medicine and health care is an important part of the school’s overall reputation. Even though prospective undergraduates are not likely to come to Duke solely because it has a top 10 hospital, “having one strongly reinforces the University’s reputation for excellence,” he said.
“Many people around the world are aware that Duke is a center for important research and excellent patient care because they have heard or seen something about it in the media or online, they know somebody who was treated at Duke or their physician either trained here or used some innovation developed [here],” Schoenfeld said.
Ultimately, Dzau said the DUMC is able to maintain its tradition of excellence not because of reputation, but because of the people who work there.
“The best correlation is related to the type of people that we have,” he said. “Every one of them has done very well. Whether our programs rank in the top 10 or not, they all have a lot to be proud of.”
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