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Best Hospitals 2006

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FERTILITY
New YorkPresbyterian Hospital, Weill Cornell

In a city known for its trailblazing fertility programs, New YorkPresbyterian’s Weill Cornell Center for Reproductive Medicine and Infertility leads the way. Under Dr. Zev Rosenwaks, known to his peers as the guru of the science, the facility has pioneered many of the proceduresincluding egg donation, embryo freezing, and in-vitro fertilizationthat are now standard practices in fertility centers nationwide. The busiest facility of its kind in the city, Weill Cornell administers some 2,200 IVF and related cycles a year and has achieved a 50 percent live-birth rate with non-frozen embryos, according to the latest Centers for Disease Control statistics (and the world’s highest success rate, 30 percent, of conception with frozen embryos, according to Rosenwaks). While its overall live-birth rate is not the highest in the city, experts say it’s arguably the most impressive because Weill Cornell treats a disproportionately high percentage of difficult cases; nearly every woman who conceives there has failed an IVF cycle somewhere else. The center’s Male Reproductive Medicine and Microsurgery division is also at the forefront of fertility treatments; doctors there were the first to report successful births fathered by men rendered sterile by chemotherapy or radiation. People are treated very thoughtfully at Cornell, and they’re serious about the science of their work, says Joe Isaacs, the president of the infertility-advocacy group Resolve: The National Infertility Association. They’re one of the premier centers in the country.

RUNNER-UP: The NYU Program for In Vitro Fertilization, Reproductive Surgery & Infertility performs fewer IVF cycles than Weill Cornell, but boasts a 52 percent success rate for live births using non-frozen embryos. The staff of 60 is overseen by Rosenwaks’s protégé James Grifo, a nationally recognized leader in egg freezing and preimplantation genetic diagnosis, which allows for screening of embryos for inherited genetic defects. NYU also has a reputation for being gay-and-lesbian-friendly.

STROKE
New YorkPresbyterian Hospital, Columbia

The stroke center at New YorkPresbyterian’s Columbia facility was created more than two decades ago by Dr. J.P. Mohr, a founding father of research in the field whose 1986 textbook, Stroke: Pathophysiology, Diagnosis, and Management, remains one of the most influential volumes on the subject. Mohr was behind the groundbreaking study concluding that aspirin was as effective in staving off strokes as the commonly prescribed blood thinner Coumadin, a drug with risky side effects. Today, the facility is headed by Dr. Ralph Sacco, a renowned epidemiologist in his own right and head of the Northern Manhattan Stroke Study, a first-of-its-kind look at race and ethnicity that has established risk factors specific to Hispanics, who have the highest stroke incidence in the country. Columbia is also one of seven hospitals nationwideand the only one in the cityto be awarded the $10 million Specialized Program of Translational Research in Acute Stroke, a National Institutes of Healthfunded grant aimed at finding new treatments. Columbia is the place other top doctors come to polish their skills; the facility has trained the directors of several of the stroke centers in the tri-state area, including NYU Medical Center and Long Island Jewish Medical Center. And Columbia is known not only for its research: The facility saw 669 stroke patients last year, the most of all the city’s designated stroke centers, and still managed to come out with a low-risk-adjusted mortality rate of 9.3 percent, according to the Alliance for Quality Healthcare. It’s not just the best in New York City, says Dr. William Powers, a professor of neurology, neurological surgery, and radiology at Washington University. It’s one of the best in the country. Though it lags behind its sister hospital in research, New YorkPresbyterian Hospital, Weill Cornell’s stroke center excels in patient care, with a risk-adjusted patient-mortality rate of 7.4 percent. As part of an effort to raise its profile, Weill Cornell recently lured the renowned Dr. Pierre Gobin, who invented the merci Retriever, a mechanical device that can remove clots in arteries up to eight hours after a stroke.

RUNNER-UP: Last year, NYU was named the first state-designated primary stroke center in Manhattan. And NYU’s Rusk Institute of Rehabilitation Medicine, with a section devoted to stroke, was rated the No. 1 facility of its kind in New York State and No. 8 in the nation by U.S. News & World Report.

ALZHEIMER’S DISEASE
New YorkPresbyterian Hospital

There’s no cure for Alzheimer’s, so a patient’s best hope is to be seen at a hospital known for cutting-edge research and access to the latest clinical trials. An Alzheimer’s Disease Research Center and one of three Alzheimer’s Disease Centers in New York (the designations are federal and state marks of excellence), New YorkPresbyterian’s Taub Center (at Columbia University Medical Center) has one of the largest DNA Alzheimer’s databases in the world. Containing the genetic fingerprints of 1,000 families affected by late-onset Alzheimer’s, the database is considered a uniquely promising tool for unlocking the secrets of the disease and perhaps finding a cure. Led by Dr. Richard Mayeux and Dr. Michel Shelanski, Taub Center doctors are involved in studies that promise immediate benefits as well. In one recent clinical trial, Mayeux demonstrated that maintaining a Mediterranean diet can slow the progression of Alzheimer’s and in some cases prevent it. From a research point of view, Taub stands out, says Dr. David Knopman, a professor of neurology at the Mayo Clinic and an investigator at the Mayo Alzheimer’s Disease Research Center. New YorkPresbyterian’s Memory Disorders Program (at Weill Cornell) is another leading research facility. Program director Dr. Norman Relkin is currently heading a study involving human antibodies called intravenous immunoglobulin. The antibodies (FDA-approved, though not for Alzheimer’s) have been shown to latch onto and draw out certain proteins that cause the loss of memory and cognitive ability that characterize Alzheimer’s. The experimental therapy, which it’s hoped could someday lead to an Alzheimer’s vaccine, recently received significant National Institutes of Health funding. New YorkPresbyterian has the latest diagnostic tools, including advanced brain imaging and molecular diagnostic testing, which are essential for detecting the disease early (early detection can slow Alzheimer’s progression and improve a patient’s quality of life). And the hospital’s world-class team of neurologists, neuropsychologists, and social workers has a reputation for providing thorough and sensitive care to help patients cope with Alzheimer’s debilitating effects.

RUNNER-UP: New York’s other Alzheimer’s Disease Centers are Mount Sinai Medical Center and NYU. Mount Sinai is also an Alzheimer’s Disease Research Center.

PARKINSON’S DISEASE
New YorkPresbyterian Hospital

As Rush Limbaugh recently found out a few days too late, each case of Parkinson’s is highly idiosyncratic. There’s no cure, a still-limited body of knowledge about how the disease progresses, and an equally limited understanding of how to deal with the often-unpredictable effectslike the controversial movements in Michael J. Fox’s stem-cell adof the known therapies. The best approach, therefore, is to have access to the largest possible body of treatment options and, just as important, doctors familiar with the multitude of turns the disease can take. New YorkPresbyterian’s Dr. Stanley Fahn, chairman of last year’s first-ever World Parkinson Congress oversees more Parkinson’s-specializing doctors (seven) and more patients (five to six new cases each day) than any other physician in the city. Robin Elliott, executive director of the Parkinson’s Disease Foundation, describes Dr. Fahn as the leading Parkinson’s specialist in the country; his program, based at New YorkPresbyterian’s Columbia University Medical Center facility, also encompasses heavily funded research labsamong other projects, they link highly precise scanning equipment to motion-capturing devices to try and find patterns behind seemingly random tremorsand Fahn’s colleague, Dr. Blair Ford, is an authority on leading-edge non-pharmaceutical treatment, deep brain stimulation. The DBS surgeons at Columbia have performed hundreds of the proceduresa battery and two electrodes are implanted within the brain’s motor-control systemin the decade since the FDA approved its use. On average, patients see a 90 percent reduction in tremors, a 90 percent reduction in dyskinesias (the shaking movements triggered by Parkinson’s medication), and a 40 to 70 percent reduction in the time spent in motionless spells, which means several more hours a day of functional mobility, says Ford. New YorkPresbyterian’s Weill Cornell facility conducts its own next-generation research. In one experimental trial program currently being coordinated by Dr. Michael Kaplitt, gene compounds are being injected into the same region as the DBS electrodes in the first-ever attempts to achieve brain-rejuvenating effects through genetic therapy.

RUNNER-UP: Beth Israel’s program, run by Dr. Susan Bressman (who was at Columbia for some twenty years), has been instrumental in researching family histories to establish the disease’s genetic origins.

MIGRAINES
Montefiore Medical Center

The 29 million Americans who suffer from migrainesthe head-splitting pain, the debilitating nausea, the hypersensitivity to light and smellswant one thing, and fast: They want all of those things to stop. The doctors at Montefiore’s Headache Center, one of just two comprehensive headache facilities in the city, are among the world’s leading authorities on how to quiet the pounding. Montefiore’s program, which sees almost 4,300 patients per year, among the highest number in the city, is run by Dr. Richard Lipton, the president of the American Headache Society and professor of Neurology, Epidemiology and Population Health at Albert Einstein College of Medicine (the university with which Montefiore is associated) and an internationally recognized headache authority. Lipton and his team are currently conducting research on experimental pain-treatment devices like neurostimulators (which use electrodes to deliver stimulation to the spinal cord or nearby nerves), and PFO closure (the PFO is an abnormal opening between the heart’s upper chambers, and sealing it often reduces the incidence of headaches). Lipton has the best worldwide reputation, says Dr. Jerome Goldstein, director of the highly regarded San Francisco Headache Clinic. He’s written a tremendous amount, he’s doing the most advanced research, and he’s a very good clinician. Lipton and his team also have a well-deserved reputation as outstanding diagnosticians, which is critical, considering that migraines are notoriously difficult to diagnose (there are multiple types of headaches and the differences can be subtle, which may explain why more than half of headache sufferers are misdiagnosed), and each kind of headache can require different treatment. Migraine treatment is also about pain relief, of course, and Montefiore excels there too. The program’s staff psychologist has specialized training in pain-control techniques, and patients have access to nontraditional migraine therapies like vitamins, herbs, and Botox.

RUNNER-UP: St. Luke’sRoosevelt Hospital’s Headache Institute is the city’s other comprehensive headache center, and its program director, Dr. Larry Newman, was trained by Lipton.


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