Mayo Clinic

Mayo Clinic is a not-for-profit medical practice and medical research group based in Rochester, Minnesota. It is the first and largest integrated not-for-profit medical group practice in the world, employing more than 3,800 physicians and scientists and 50,900 allied health staff. The practice specializes in treating difficult cases through tertiary care. It spends over $500 million a year on research.

Mayo Clinic has been near the top of the U.S. News & World Report List of "Best Hospitals for more than 20 years". The practice is distinguished by integrated care. It has been on the list of America's "100 Best Companies to Work For" published by Fortune magazine for eight years in a row.

Early years
In 1863, William Worrall Mayo (1819–1911) came to Rochester, Minnesota as part of his appointment as an examining surgeon for the military draft board during the American Civil War. The city would be to his liking, and his wife and children would join him in early 1864. William Worrall Mayo opened his medical practice after the war, and would also serve in several leadership roles in the community. Both of W.W. Mayo's sons, William James Mayo (1861–1939) and Charles Horace Mayo (1865–1939) would grow up in Rochester, and when old enough both attended medical school. William (Will) graduated in 1883 and joined his father's practice, with Charles (Charlie) joining after he completed his training in 1888.

On August 21, 1883, a tornado struck Rochester, causing at least 37 deaths in the area and over 200 injuries. One-third of the town was destroyed, but the Mayo family escaped serious harm. The relief efforts began immediately with a temporary hospital being established at the city dance hall, and the doctors Mayo (W.W. and Will) were extensively involved in treating the injured who were brought there for help. Mother Alfred Moes and the Sisters of Saint Francis (a teaching order) were called in to act as nurses despite having been trained as teachers and with little if any medical experience.

After the crisis had subsided, Mother Alfred Moes approached W.W. Mayo about establishing a hospital in Rochester if he agreed to help staff the hospital. On September 30, 1889, Saint Marys Hospital was opened by the Sisters. Dr. W.W. Mayo (who by this time was 70 years of age) was one of the consulting physicians at the hospital. His two sons began seeing patients and performing surgeries at the hospital when they returned from medical school in the 1880's.

Group practice
In 1892, Dr. Augustus Stinchfield was asked to join the practice by W.W. Mayo, who considered him to be the best doctor in the area. After Dr. Stinchfield joined the practice, W.W. Mayo retired at the age of 73. The practice continued to grow. The founders of Mayo Clinic are the Mayo brothers Will and Charlie, Dr. Stinchfield, Dr. Graham, Dr. Henry Plummer, Dr. Millet, Dr. Judd, and Dr. Balfour. These early founders and partners shared in the profits of the private group practice, while other staff hired by the partners were salaried. W.W. Mayo died in 1911, but the group practice continued strong with an ever increasing presence nationally as a cutting edge center. In 1919, the founders, with the exception of Dr. Graham, created the Mayo Properties Association, and their private practice became a not-for-profit entity. The founders gave the Clinic properties and furnishings to this newly formed association. The integrated practice model developed primarily by Dr. Plummer, created a foundation for what would grow into the Mayo Clinic.

Growth and current practice
The Group Practice continued steady growth throughout the 20th century. The research budget exceeds $500 million a year, chiefly provided by federal grants but with 40% from the Mayo budget.

The campus continued to grow to keep up with patient numbers and an increasing research focus of the Clinic's operations. In 1928, the Plummer Building was completed with considerable input from Clinic staff, and under the guidance of Dr. Henry Plummer (designed by John William Dawson and Ray Corwin from the architectural firm of Ellerbe & Round). At the time of its completion, it was the tallest building in Minnesota and remained so until the Foshay Tower was finished in Minneapolis in 1929. It was added to the National Register of Historic Places in 1969, and has recently undergone a complete restoration of its bell tower. The Ellerbe firm is the architect of record for the 1914 Mayo "Red" building, the 1922 Mayo Institute of Experimental Medicine, the 1927 Plummer building (completed in 1928), the 1954 Mayo Clinic building, and the 2002 Gonda building. The historic 1914 "Red" Mayo Clinic building, a National Landmark listed on the National Register, was demolished by the Clinic in the 1980s to make way for the HGA designed Siebens building. Since 1986, the Mayo Clinic campus has formally included the Rochester Methodist Hospital and Saint Marys Hospital, as all operations were integrated under one governing board to more efficiently serve the needs of Mayo patients. In 2011, the foundation went before the Supreme Court to argue that medical residents should remain exempt from Social Security deductions. In Mayo Foundation v. United States the court sided with the Social Security Administration and required FICA to be deducted going forward.

The Mayo Clinic is a member of the Consortium of Academic Health Centers for Integrative Medicine (CAHCIM). The stated mission of the CAHCIM is "to advance the principles and practices of integrative healthcare within academic institutions. The Consortium provides its institutional membership with a community of support for its academic missions and a collective voice for influencing change."

Locations
Mayo Clinic has a large presence in three U.S. metropolitan areas: Rochester (Minnesota), Jacksonville (Florida), and Phoenix (Arizona). The Clinic employs more than 32,000 people at the main campus in Rochester, Minnesota and the Arizona and Florida sites employ approximately 5,000 persons at each site. In addition, the Mayo Clinic owns and operates the Mayo Clinic Health System, which consists of more than 70 hospitals and clinics across Minnesota, Iowa, and Wisconsin with an employment of 14,000 persons. Mayo Clinic also operates several colleges of medicine, including Mayo Medical School, the Mayo Graduate School, and the Mayo School of Graduate Medical Education, Mayo School of Health Sciences.

Core values
As is evidenced by the Mayo Clinic logo, the institution has a three part focus. First and primary to the organization is the patient care practice, represented by the central shield. This is in accordance with the primary statement of the organization that "the needs of the patient always come first." The other two shields represent the areas of education and research, two areas of Mayo Clinic which have become more prominent over time.

Patient care
Each year, more than one million patients from all 50 states and from more than 150 countries are seen at one of the Mayo Clinic facilities. Mayo Clinic offers highly specialized medical care, and a large portion of the patient population are referrals from smaller clinics and hospitals from across the upper Midwest and the United States as a whole. Mayo Clinic physicians are paid a fixed salary that is not linked to patient volume (relative value units) or income from fee-for-service payments. This practice is thought to decrease the monetary motivation to see patients in large numbers and increase the incentive to spend more time with individuals. Salaries are determined by the marketplace salaries for physicians in comparable large group practices.

Research
Mayo Clinic researchers contribute to the understanding of disease processes, best clinical practices, and translation of findings from the laboratory to the clinical practice. Nearly 400 doctoral level physicians and research scientists are employed, with an additional 2,800 allied health personnel and students with appointments in research. In 2010, more than 2,300 research protocols were reviewed by the Mayo Clinic Institutional review board and 8,000 ongoing human research studies. These research initiatives led to more than 5,000 research publications and review articles in peer-review journals.

Education
Drs. William and Charles Mayo were proponents of education since very early in the history of Mayo Clinic. In 1917, they helped found and develop the medical school at the University of Minnesota with a two million dollar donation. Until the early 1970s, consulting physicians at Mayo Clinic in Rochester, Minnesota held joint appointments as professors at the University of Minnesota medical school. The Mayo Clinic was a pioneer in helping to establish the current residency education system. In 1972, Mayo Clinic opened the doors of its own medical school (Mayo Medical School) in Rochester, which is known for its contributions in the medical field.

Innovation
Dr. Henry Stanley Plummer became a full partner in the Clinic practice in 1901. He is considered by many American physicians to be the "architect of the modern medical practice" and a primary reason for Mayo Clinic's early success. He designed many of the systems which are now universally used around the world today, such as a shared, individual dossier-style medical record and an interconnecting telephone system. While the Mayo brothers excelled as surgeons, Dr. Plummer is largely credited with establishing and developing the diagnostic and clinical aspects of the practice. Dr. Louis B. Wilson was hired by the Clinic in 1907—at Dr. Henry Plummer's urging—to establish research and diagnostic laboratories. He was also first director of the Mayo Foundation.

Since about the year 2000, Mayo Clinic has also become known for achieving high quality at low cost. One extensive study found that the cost paid by insurers to treat Medicare patients in their last three years of life (the most expensive years) was only 54% of comparable costs in nearby clinics and hospitals. Mayo Clinic has been researched and presented many times during the passing of the 2009 healthcare reform bills in US Congress as a model to reduce healthcare costs while increasing quality for the nation. However, Mayo Clinic issued an open letter stating the healthcare reform bills as written in July 2009 would not reduce costs or increase quality nationwide.

The Biomedical Imaging Resource (BIR) at Mayo Clinic is dedicated to the advancement of research in the biomedical imaging and visualization sciences. The BIR provides expertise and advanced technology related to these fields, including image acquisition, processing, display and analysis; volume visualization; computer graphics; virtual reality and virtual environments; image databases; computer workstations, networks and programming. The BIR group developed the biomedical imaging software Analyze.

Leadership
Mayo Clinic is led by President and CEO John Noseworthy, M.D. In May 2009, it was announced that when previous CEO Denis Cortese retires in November 2009, Dr. John Noseworthy would be named the new President and CEO.

After his retirement from Mayo in November 2009, Dr. Cortese became director of the Health Care Delivery and Policy Program at Arizona State University (ASU), Foundation Professor at ASU, and President of the Healthcare Transformation Institute. On July 29, 2010, EGHC, parent company of Essence Healthcare and other subsidiaries, announced that Dr. Cortese would join its Board of Directors.

Rankings
In 2013, Mayo Clinic, Rochester, was ranked as the #3 overall hospital in the United States by U.S. News & World Report. A total of 4,793 hospitals were considered and ranked in 16 specialties from cancer and heart disease to respiratory disorders and urology; 140, or less than 3 percent of the total, were ranked in even one of the 16 specialties. Of the 148 hospitals that are ranked in one or more specialties, 17 qualified for the Honor Roll by earning high scores in at least six specialties. Mayo Clinic, Rochester, was ranked in the top 10 in all but one of 16 specialties, in the top 5 in 11 specialties, and was the #1 ranked hospital in four specialties.

U.S. News & World Report – Mayo Clinic, Rochester, 2013 Rankings by Medical Specialty