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The reason for that is Cleveland Clinic is more specialized in J Pouches than Mayo Clinic is. My Doctor who had a Fellowship there told me that Cleveland Clinic has something like 5,000 J Pouch patients, or some ridiculous number. Many of the major studies being done on J Pouches such as the rectal cuff cancer studies in J Pouchers are coming out of Cleveland. They have more meaningful studies because they have more J Pouch patients to draw from. Mayo is ranked number 1 based on the entire spectrum of IBD treatment, which is far broader than J Pouches. If it was just a ranking based on treatment and care of J Pouches, I have no doubt Cleveland would be number 1 and Mayo would not be the top dog.
From my experience, Mayo has excellent care for those of us with J Pouches and also with K/BCIR's.........no doubt CC has a fantastic group as well.........so I don't agree with what your saying, but, will say this.....no doubt in my mind that CC/Mayo are #1 and #2 regardless of "who" is at the top. They are the best of the best, period.