Agreed, restaurant burgers are hit and miss, and sometimes regional. St. Louis has some good burger places. Thin, crispy edge diner style in STL my favorite is Carl's on Route 66, thicker burgers, although it's a pretty fancy place, the burgers at "The Block" in Webster Groves are hard to beat. Honorable mention goes to O'Connell's for some dang fine half-pounders. It seems like every restaurant I've been to in Minneapolis has killer burgers. The Map room in Cedar Rapids is also very good.
When I make em' at home, I usually stick to 3rd pound patties. My favorite topping is hot pepper cheese and guacamole, or a roasted and peeled pablano pepper. I don't usually go for "gourmet" buns, or toasting them although my son really likes it when I toast them. I wasn't planning on making burgers tonight, but now I might have to!