'Mayo magic': How Mayo Clinic built its reputation as a leading hospital

During a recent appearance at the 22nd annual Wharton Leadership Conference in Philadelphia in June, Jeffrey Bolton, vice president of administration and chief administrative officer at the Rochester, Minn.-based Mayo Clinic, discussed the "Mayo magic" that has helped raised the institution's profile as one of the nation's top hospitals, Knowledge@Wharton reports.

Mr. Bolton sat down with J. Larry Jameson, MD, PhD, executive vice president of the University of Pennsylvania Health System and dean of UPenn's Perelman School of Medicine, to discuss how "in the middle of a relatively small town of about 125,000 people in Minnesota, you've got the No. 1-rated healthcare system probably in the world."

Mr. Bolton pointed to several of the health system's founding tenets as part of the "Mayo magic" that has made the system one of the most well-known healthcare institutions in the world and ranked as the No. 1 best hospital in the nation by U.S. News & World Report for its 2018-19 Best Hospitals Honor Roll.

Here are three characteristics Mr. Bolton cited as contributors to the system's "Mayo magic":

1. Patients come first. While many organizations cite patients as the most integral component of their institutions, Mayo Clinic is structured to support patients and foster teamwork among providers and staff, not as a hierarchy. Mr. Bolton recited an oft-repeated anecdote from the system's founding days nearly a century ago during which one of its co-founders, William Mayo, MD, was asked by a patient who the head physician of the operation was. Dr. Mayo reportedly told the patient, "No, my brother's the head doctor. I'm the belly doctor."

According to Mr. Bolton, the system's philosophy has always been that "the wisdom of peers is greater than any individual." He said if a physician is ever unsure about a patient's treatment, they "pick up the phone and call a colleague — either within [their] specialty or another specialty — and seek out insight," the report states.

2. Mayo Clinic is a physician-led organization. Mr. Bolton said the system uses a "leadership dyad" model in which a physician leader is paired with an administrative partner. In his case, Mr. Bolton is paired with Mayo Clinic President and CEO John Noseworthy, MD. He also stressed that physicians' salaries are consistent across departments and that all specialists, sub-specialists and physician-scientists receive a salary after five years on staff.

"There's no real incentive for driving volume within your practice," when department physicians are all paid equally, Mr. Bolton said. "You're really, again, focused on what the needs of the patient are," rather than volume-based incentives.

3. "No mission, no need for money." Healthcare, like various other industries, is people-centric, Mr. Bolton said, and that implies an inherent push-pull dynamic between maintaining financial stability and the quality of care provided. While Mayo provides a significant amount of charity care and subsidizes a large proportion of Medicaid and Medicare business, the system must also maintain a certain amount of commercial business to generate funds despite its nonprofit status.

"Every hospital system that has some Catholic roots has heard the phrase, 'no money, no mission,'" said Mr. Bolton, referring to the system's founding Catholic influence. "A lot of people forget, though, the other side of that: 'No mission, no need for money.'"

To access the full report, click here.

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