When Everyone Is the Best
- Wickersham Team
- 14 hours ago
- 4 min read
Why superlatives stopped working in healthcare, and what patients trust instead.
Open almost any hospital website, and you'll find the same three claims in some order: the best doctors, the most advanced technology, the most compassionate care. Every competitor down the street is saying the same thing. A quick look at why that happens, why it stopped working, and what genuinely differentiates a provider when the word "best" no longer means anything.
Why 'Best' Stopped Meaning Anything
A claim only carries information if it's possible for it to be false. When every hospital in a market calls itself the best, the word stops functioning as a claim at all. It becomes background noise, the verbal equivalent of a building having a front door, technically true, uninformative, and identical to what every competitor is also saying.
This isn't unique to healthcare. Hotels inflate star ratings, software companies all claim to be best-in-class, and online marketplaces are so full of near-perfect review scores that a 4.6 and a 4.9 barely register as different anymore. But it shows up more often, and more consequentially, in healthcare than almost anywhere else, and the reason has less to do with marketing habits than with the nature of what's being sold.
Why This Happens So Much in Healthcare
Economists have a term for products where quality is genuinely hard to judge, even after you've used them: credence goods. You can inspect a pair of shoes before buying and judge a restaurant meal the moment you taste it. You generally can't judge whether a surgeon made the right call, or whether a diagnostic scan was read correctly, even after the procedure is over. Most patients simply don't have the expertise to verify the claim, which means the claim can be made freely, with very little risk of being contradicted by the patient's own experience.
Add to that the fact that the stakes are unusually high and the outcome unusually uncertain, and reassurance language becomes almost irresistible. "Best" and "most advanced" aren't really claims about comparative quality at that point. They're attempts to calm someone down at a moment when they're scared and need to make a decision quickly.
There's also a real structural reason genuine differences are often smaller than marketing suggests: hospitals are heavily regulated, accredited against similar standards, and frequently buy equipment from the same handful of vendors. When the actual gap between providers is narrow, the marketing gap tends to widen to compensate, which is exactly backward from what would help a patient make a real decision.
What Actually Differentiates
There's a useful distinction from economics between cheap talk and costly signals. Cheap talk is a claim that costs nothing to make and nothing to be wrong about, which is why "we're the best" persuades almost no one anymore. A costly signal is a claim that would be expensive or embarrassing if it turned out to be false, which is exactly what makes it credible.
Cleveland Clinic has published detailed outcomes data every year since the mid-2000s, including mortality and complication rates for major procedures, measured against national benchmarks, publicly, for anyone to check. That's a costly signal. If the numbers were bad, everyone would know. Geisinger built an entire program, ProvenCare, around treating certain surgical complications at no additional cost to the patient if something preventable went wrong, and has since extended lifetime guarantees to some joint replacement procedures. That's not a claim about quality. That's money attached to a promise, which is a fundamentally different kind of statement than an adjective.
Patient experience factors work the same way, when they're specific rather than generic. "We care about you" is cheap talk. A published average wait time, a described process for how a diagnosis actually gets communicated, a specific and checkable detail about how a visit unfolds, functions as a small costly signal precisely because it could be checked and found wanting.
The Community Health Cost
When every provider's marketing sounds identical, patients don't stop choosing. They just stop choosing based on anything resembling quality. Proximity, insurance network, a family referral, or simply which system has the biggest local ad budget quietly become the deciding factors, because the marketing itself has given people nothing else to go on.
That has a real cost at the community level, and it isn't distributed evenly. Patients with more time, more health literacy, and more access to specialists who can give an informed second opinion are better equipped to look past the marketing and find the provider with genuinely stronger outcomes. Patients without those advantages are the ones most likely to be steered by whichever system markets loudest rather than whichever one performs best, which means claim inflation doesn't just waste marketing budget. It can quietly widen the exact health disparities a community's providers should be working to close.
A claim that costs nothing to make convinces no one. The providers patients actually trust are the ones willing to put something on the line besides an adjective.
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