It is natural, I think, that we want to get the best service possible especially in medical care or education. So, we seek the best hospital or the best university.

I learned how wrong that is.

Years ago, when I consulted for the government of Ghana in Health Delivery Planning, I learned that there are three types of hospitals: research, teaching or service.

Usually hospitals are a combination of the three types. The difference is in the degree of emphasis given to each goal: research, teaching or service.

What makes the reputation of a hospital or a university is their research, hardly ever the level of their service.

So, if you go to “the best” hospital, you are going to a hospital that is known for its research, the service there takes a back seat. If you do not have some rare disease that they are doing research about, if you have a garden type of a disease, going to the “best hospital” might mean you will get second class service, i.e. treatment might not be possible. They just do not have time for you.

And that applies to education too. We all want to send our children to “the best” university. I did. I sent one of them to Berkeley. What a name!!! Reputation!!!
A friend of mine who had a PhD from Berkeley warned me “this is a great University to get a PhD from but not for undergraduates. “It is a research oriented University, that is what gave it its fame. Undergraduates do not interest them. They do not add to the fame of the University. And he was right. My son was taught mostly by teaching assistants in large crowded classes.

I sent the other two to a local community college. Very good teaching. Excellent attention to students.

The best solution was to send the undergraduate to a small school that cares about its teaching and then for the Masters and or PhD to a famous, “best “university”.

Same with medical care. If what you have is a run of the mill disease start with local community care. If it does not work, escalate to a teaching hospital who knows what is the latest in protocols and medicine. If that does not work, now you are ready for what is called the most reputable, the best name hospital.

If you have a problem with your car where should you go first to? To a university where they do research about mechanical engineering or should you go to a neighborhood car mechanic?

Obvious answer.

I wish I knew this years ago.

Just thinking,
Ichak Kalderon Adizes