I think the teaching hospitals tend to follow the research more actively. Private doctors only listen to drug salespeople, and attend the basic continuing ed, which may not be good, and is usually paid for by drug companies to just reinforce the drugs advertised (their product).
Also teaching hospitals see the hardest cases, usually referred to them by private physicians. So they have broader experience.

Some hospitals today are even limiting drug salespeople access.
The trend is to give Pharma less power over treatment.