I don't really have anything bad to say about either Altru or Sanford, and I or my family have been referred to both about equally over the years. I live 100 miles away from both and whenever one of us gets "sent on", our primary doctor basically asks what city we prefer, Grand Forks or Fargo.
I have been very pleased with the care that Altru provided to my children over the years.
tnt had a good analogy with the restaurant comparison.