I would like to be seen at an institution where they have the most modern equipment (means they can pay for it), they hire the best of the best (they can pay the best salaries), and where the are doing clinical trials (not everyone gets to play in this game, and if so not in most trials related to our area of interest), where they see the largest patient volumes, (they have the most experience, have seen the most complications and are better prepared for when something doesn't go as planned, as they have seen that something a hundred times before), and are rated well by an independent source like the US News and World Reports annual survey which looks at many more criteria than I have mentioned here. By and large a small community hospital on more than one of these points can't offer the same as a big teaching institution that is a NCI designated CCC. This isn't my opinion alone. The hospital ranking system uses these same criteria, including which I didn't add, survival rates, doctors education, number of doctors per patient, number of nurses per patient, and affiliated ancillary staff such as a dedicated dental oncology department with in the H&N department.