Originally Posted by Midnight Cowboy
I thought that CU-Med already had elite status. I always found it astonishing, when I lived in NYC, hearing about NY sports stars traveling to Colorado for treatment. I mean, shit, they passed on John Hopkins, Mayo Clinic, and University of Minnesota to get treatment in the Rocky Mountain West. I know you know more about hospitals than I, so I am not arguing with you, but I always had the perception that CU and the School of Mines were on par with the top ten schools in the nation with respect to their disciplines.
Most of the sports stars who travel to Colorado, from my experience, are going to Vail to either the Steadman clinic or a handful of other very well respected surgeons who specialize in professional and elite amature athletes. VERY serious spinal type injuries often are handled at the Craig hospital in Denver too but that's not part of the CU campus (which is too bad).
And I think I gave a wrong impression that there are huge differences in institutions once you're at a university or large tertiary center, or even a large level 1 trauma center like Denver Health. There are places you go, (Pueblo, COS, Grand Junction) when you have a medical emergency because you have no other choice. They are good at stabilizing you at these places and at performing routine procedures in all specialties. There is a gap from those kinds of places and every tertiary center in cases which are complicated (weird autoimmune diseases, anything at all in healthy older old populations 75-80 y/o and above, sarcomas, a legion of others). These gaps are small and amount to one or two things the clinician doesn't know how to integrate into a weird case. Not because they aren't smart enough, but because in any one community certain cases only appear very rarely and there isn't enough repetition to learn and retain what you need.
Once you get to the regional centers there is very little seperation. And that seperation is based on innovation and research, not on the quality of medical care you will get. We're talking about the same level of separation that would be between someone who gets a 1550 on the SAT compared to 1600. To carry that a little further, the three big ones in the US would be 1600, that 2nd teir would be 1575 and all other regional places like CU would be 1500-1550. Community medical centers would be around 1300 - 1400 depending on a number of factors; still great, still absolutely essential to American medicine, just not good at non routine (nor should they be).
Also, the experts in large referral centers share the same quality as the community physicians, only in reverse. In my case, I will become one of 4 or 5 physicians in the US with pediatric, neuro, anatomic and clinical pathology boards. This means I will be uniquely qualified to read EXTREMELY rare cases which are only seen 10-15 times a year in the entire country. It also means I'll be so focused on a group of diseases that almost never happen, that I'll be uniquely UNqualified to do things like manage someone's high blood pressure medications.
These things make me excited and rambly.. sorry about that!