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Best Hospitals 2006

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HIV/AIDS
New York–Presbyterian Hospital, Weill Cornell

Even in the age of life-extending drug cocktails, the holy grail in HIV/AIDS remains a vaccine or cure. New York–Presbyterian’s Center for Special Studies (an affiliate of Weill Cornell) has the only NIH–funded HIV vaccine trial unit in New York City. The hospital is also leading the way in research into the metabolic complications of HIV, in areas such as specific bone loss and osteoporosis in postmenopausal Hispanic women. One of just a handful of New York State Designated AIDS Centers (defined by the state Health Department as “state-certified, hospital-based programs that serve as the hubs for a continuum of hospital and community-based care for persons with HIV infection and AIDS”), the Center for Special Studies employs eleven full-time doctors, five psychiatrists, and a team of nurses, nutritionists, and social workers who specialize in HIV/AIDS-related illnesses, including nationally recognized physicians like Dr. Jonathan Jacobs, the center’s director. “New York–Presbyterian has an absolutely outstanding program,” says Dr. Diane Havlir, chief of the internationally renowned HIV/AIDS program at the University of California, San Francisco School of Medicine. “It excels in leadership, research, patient care, and prevention.” New York–Presbyterian also has a “one-class care” policy, so patients with Medicaid/Medicare get the same treatments, doctors, and drug access as patients with private insurance. And the hospital also works closely with Gay Men’s Health Crisis, the premier community-based HIV-program in the country. GMHC provides legal services, insurance services, counseling, and free meals for patients who need them.

RUNNER-UP: Mount Sinai’s Jack Martin Fund Clinic is the other New York State Designated AIDS Center. Among its notable research programs is one for HIV-positive African-Americans suffering from HIV-related kidney problems.

HEART SURGERY
New York–Presbyterian Hospital

When Bill Clinton, after five decades of extreme living and who-knows-how-many Big Macs, needed emergency triple-bypass heart surgery, he went to Columbia-Presbyterian Medical Center. When Charlie Rose, David Letterman, Walter Cronkite, and Larry King all needed open-heart surgery, they went to Weill Cornell Medical Center. There’s a good reason the well connected find themselves there. Doctors at these once separate, competing institutions, now both part of New York–Presbyterian Hospital, have some of the lowest mortality rates anywhere for heart procedures, even though they take on some of the riskiest patients. The pioneering hospitals (the first successful pediatric heart transplant and the first robotically assisted open-heart procedure were performed here) are home to a dream team of internationally recognized cardiac superstars, including Cornell’s Wayne Isom and Karl Kreiger and Columbia’s Mehmet Oz, Craig Smith, Eric Rose and Jeffrey Moses. In 2004, New York–Presbyterian hired away almost the entire interventional-cardiology department from Lenox Hill Hospital. Led by Moses, the former Lenox Hill team had mastered the one thing that New York–Presbyterian’s doctors once lagged in: the less-invasive angioplasties and stent insertions that are rapidly becoming the state-of-the-art treatment for many heart patients (where the department Moses now heads once performed 700 procedures a year, it now does about 4,000). This year, New York–Presbyterian broke ground on the Milstein Family Heart Center, a $250 million, 142,000-square-foot freestanding building in Washington Heights that, when it opens in 2008, will be one of the most comprehensive heart facilities in the world. And if you ever need the big kahuna of heart surgeries, New York–Presbyterian is the place to do it. Says Jeffrey Gold, a heart surgeon who once topped New York’s low-mortality list and is currently dean of the Medical University of Ohio, “If I lived in New York and needed a heart transplant, I’d go to Columbia.”

RUNNER-UP: Mount Sinai Medical Center is headed by one of the grand old men in cardiology, Valentin Fuster, and New York newcomer David Adams, considered a major catch when he was lured from Harvard five years ago. New York University, St. Vincent’s, Lenox Hill, and Montefiore are often cited as top programs as well.

KNEE SURGERY
Hospital for Special Surgery

The Hospital for Special Surgery’s aptitude for treating the types of high-impact joint injuries sustained by Olympians took up nearly an entire page of the NYC 2012 bid team’s proposal for the International Olympic Committee. That’s the same amount of ink spilled touting Ray Kelly’s contributions to public safety, and it’s not just Doctoroff-ian hyperbole. HSS’s capabilities are held in higher esteem by the nation’s top doctors than any other orthopedic department in the country—which, in part, is because a good portion of the nation’s top knee specialists who don’t work at HSS trained there (9 out of the 22 past presidents of the American Knee Society, for example, have passed through at some point). Doctors like Brian Cole (a former HSS resident who’s now a Chicago White Sox team doctor) say the hospital’s most significant attribute is the experience and knowledge of Renaissance surgeons who specialize in both orthopedic research and the practical applications thereof. Says Cole: “It’s called translational research—the ability to investigate a problem in the lab, from test tube to animal models, and turn it into something that can be done clinically.” If you’re getting a knee replacement, for example, you’ll likely be receiving an artificial knee designed by HSS researchers (who patented the first such device in 1974) and getting it installed by doctors who pioneered the practice of using pre-op MRI scans to make operations as quick and uninvasive as possible. HSS’s surgeons and rehab therapists in “sports medicine”—the catchall term for ligament reconstruction and other non-replacement operations—are the team doctors for such healthy-knee-reliant organizations as the Knicks, Nets, Liberty, Giants, and Mets. And patients—at least Turkish basketball-team forward Ersan Ilyasova, a source located by the NYC 2012 committee—seem to think the staff is really, really nice. “It’s the best treatment,” Ilyasova said in the 2012 brochure. “Not just the medical part, but also people-wise.”

RUNNER-UP: Lenox Hill Hospital. Doctors like Chitranjan Ranawat, who helped pioneer the artificial knee at HSS, is among the surgeons here. Ranawat has been flown to Mumbai twice (once for each knee) to operate on Indian prime minister Atal Behari Vajpayee.

BACK SURGERY
Hospital for Special Surgery

Having a surgeon take a scalpel to your spine is every bit as scary as it sounds. One slip of the knife and a patient can be paralyzed or die. Back surgery can also be extremely painful, and studies show it’s often ineffective. HSS is the city’s, and one of country’s, leading innovators in safe and effective new surgical techniques. The current trend in back surgery is the use of minimally invasive procedures, which can reduce pain and recovery times and improve outcomes, and HSS is at the forefront of those techniques. The recently FDA-approved ProDisc, developed at HSS, is the most thoroughly researched and best-received total-disk-replacement device to date, and the most likely to restore maximum mobility post-surgery. Other recent advances to come from HSS include Dr. Frank P. Cammisa’s pioneering use of artificial, bonelike plugs as scaffolding for new bone to grow on for vertebrae-fusion patients, and the groundbreaking Isola Spine Instrumentation system, developed by scoliosis chief Dr. Oheneba Boachie-Adjei and his team, which allows for correction of spine deformities from all angles and can result in more-precise fixes. HSS’s thirteen surgeons perform 6,700 spinal surgical procedures a year, and their mortality rates are among the lowest in the country. “In New York, Special Surgery is No. 1 without a doubt,” says Dr. John Olsewski, who sits on the board of councilors of the American Academy of Orthopaedic Surgeons. The facility is also well known for its expertise in pain management and physical therapy.

RUNNER-UP: The NYU Hospital for Joint Diseases Spine Center has twenty highly regarded spine surgeons on staff, treats 1,400 cases annually, and was among the first hospitals in the country to perform artificial-disk implantation.

HIP REPLACEMENT
Hospital for Special Surgery

Hip replacement is now the safest and one of the most common types of joint-replacement surgery—about 330,000 procedures are performed in the United States each year—thanks in good measure to advances in the procedure pioneered at the HSS. The 270 doctors at the hospital replaced 2,608 hips last year—more than any other facility in the country—while maintaining safety standards that have been singled out as industry-leading by everyone from the NIH to the Consumers’ Research Council of America to the AARP. The average length of stay for a single hip replacement at HSS is 4.48 days (that’s considered excellent), and its strict adherence to surgical-infection-prevention measures earned it the No. 1 ranking in the area from the New York State Department of Health. Dr. Thomas Sculco has pioneered a smaller-incision hip-surgery technique that can minimize pain, side effects, and recovery time, and Dr. Edwin Su is one of the first surgeons in the country to do hip resurfacing, a new procedure that preserves the joint by using an innovative metal implant.

RUNNER-UP: New York–Presbyterian’s Center for Hip and Knee Replacement did 1,040 hips of its own last year, which would make it the most-trafficked hospital in just about any other city. The highly regarded Dr. William Macaulay is the program’s leader.


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